Progressive exercise training improves cardiovascular psychophysiological outcomes in young adult women with a history of adverse childhood experiences

Abstract

Adverse childhood experiences (ACEs) are early life psychosocial stressors that are associated with poorer mental health and increased cardiovascular disease (CVD) risk in a dose-dependent manner. We examined the feasibility of an 8-week combined aerobic and resistance exercise training program to improve systolic (SBP) and diastolic blood pressure (DBP), serum endothelin-1 (ET-1), resilience, hope agency, and hope pathways in young women with ACEs. Forty-two healthy women (21±3 y) with ≥4 (ACE+; n=28) or 0 ACEs (ACE-; n=14) completed this study. Women with ACEs were randomly assigned to an exercise (ACE+EXT; n=14) or non-exercise control (ACE+CON; n=14) group, whereas all ACE- participants were assigned to a non-exercise control (n=14). Hope agency and DBP did not change in any group (p³0.43), but hope pathways improved only in ACE+EXT (mean±SE change; +1.6±0.74 au; p=0.032). ET-1 decreased in ACE+EXT only (-0.31±0.15 pg/ml, p=0.043). Although the interactions for resilience and SBP did not reach significance (p=0.05­­­-0.06), forced post-hoc analyses indicated that resilience improved (+4.9±1.9 au, p = 0.012) and SBP tended to improve (-4.0±2.0 mmHg; p=0.053) in ACE+EXT only. There were significant associations between changes in hope pathways and SBP (ρ=-0.43, p=0.023) and ET-1 (ρ=-0.53, p=0.005), and between changes in SBP and ET-1 (ρ=0.49; p=0.012) in the ACE+ group. In summary, structured exercise training reduces serum ET-1 levels, improves positive psychological coping, and may improve SBP in young women with ACEs. The relationships among the changes in hope pathways, SBP, and ET-1 suggest a cardiovascular psychophysiological relationship in young women with ACEs.

Exercise to Prevent Accelerated Vascular Aging in People Living With HIV

“…Important future directions include adequately powered randomized controlled trials on the effects of various exercise modalities, in isolation or in combination with other forms of exercise (eg, combined HIIT and resistance exercise) and pharmaceutical drugs that have shown promise for reducing CVD in PLWH (ie, exercise with lipid modulating drugs (eg, pitavastatin 264 ) and BP modulating drugs), on endothelial function, indices of arterial stiffness (eg, cfPWV), immune function and gut health, and supporting mechanistic biomarkers in PLWH (Figure 4). In addition, given that exercise training may in itself enhance mood and positive psychological coping among individuals with a history of trauma in association with beneficial effects on cardiovascular risk factors, 265,318 exercise may also dampen vascular aging by mitigating the psychobiological impacts of stress in PLWH. 403,404 Given the likely role of (micro)vascular dysfunction and the potential benefits of exercise in neurocognitive disorders, 405 future studies will also be necessary to understand whether exercise is beneficial for PLWH with HIV-associated neurocognitive decline.…”

“…314,315 The high-intensity bouts in HIIT create a rapid and profound demand for increased blood flow, interspersed by bouts of rest or active recovery. Multiple studies indicate HIIT interventions lower blood pressure [316][317][318] and improve blood vessel structure and function, including in clinical populations. 317,[319][320][321] Taken together, the preceding information, gathered from a large body of literature in people without HIV, indicates that either alone or in combination, steady-state cardiorespiratory training, resistance training, and HIIT can provide comprehensive benefits for cardiovascular and metabolic health, inclusive of vascular health.…”

Non-response to ACE items is associated with demographic variables and health indicators in the 2021 Behavioral Risk Factor Surveillance System

“…While we cannot make specific conclusions regarding ACE non-response and health promoting behaviors, we did note similarities to ACE exposed respondents. It is possible that trauma-exposed individuals have developed coping strategies or engaged in protective factors that contribute to healthier lifestyles ( Rogers et al, 2023 ). Public health interventions should consider these protective factors and explore how to promote healthy behaviors among individuals who have experienced ACE, but may be less likely to disclose them.…”

Association of early life adversity with cardiovascular disease and its potential mechanisms: a narrative review

“…Endothelin-1 is a peptide produced by the vascular endothelium in response to stress ( 76 , 77 ) and is implicated in the pathogenesis of cardiovascular diseases ( 78 ). Physical exercise decreases endothelin-1 levels among women exposed to ELA and improves cardiovascular psychophysiological outcomes; endothelin-1 may therefore be a potential therapeutic target for the treatment of cardiovascular diseases following ELA ( 79 ).…”