Simple physical performance measures and vascular health in late midlife women: the Study of Women's Health across the nation

Abstract

Background Physical performance measures have been shown to predict mortality and incident cardiovascular disease (CVD) mainly in elderly populations. We evaluated whether physical performance measures are associated with vascular health indices (carotid intima-media thickness (cIMT), adventitial diameter (cAD) and carotid plaque) in a large sample of multi-ethnic, late midlife women. Methods Participants from the Study of Women’s Health Across the Nation free of CVD and who had carotid ultrasound assessed at the 12th annual visit were evaluated. Physical function (PF) measures at visit 12 included: average 40-foot walking speed and average time needed for sit-to-stand assessment. Results A total of 1103 women (53.7% White, 30.5% Black, 15.9% Chinese) aged 59.6±2.7 years at visit 12, were included. In models adjusted for study site, race, current age, menopausal status and systolic blood pressure, slower walking speed and longer time needed for sit-to-stand were significantly associated with wider cAD, thicker cIMT and a higher probability of a high level of carotid plaque burden (all P-values <0.05). Associations between walking speed and cAD, and between time needed for sit-to-stand and cAD, remained significant (P=0.04) or marginally significant (P=0.07), respectively, after additional adjustment for CVD risk factors, medications and physical activity. However, the associations between PF measures and cIMT and plaque burden were largely explained by traditional CVD risk factors. Conclusions The current study suggest that worse performance in simple objective PF tests may be an early indicator of vascular structural changes that precede vascular disease among women at late midlife.

Exploring the Association between Vascular Dysfunction and Skeletal Muscle Mass, Strength and Function in Healthy Adults: A Systematic Review

“…All 33 studies were either cross-sectional or randomized controlled trials published within the past 10 years (Table 1). Twenty-three studies [20,26,27,[33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52] included healthy mixed-age adults (age range 18-95) and two studies [53,54] included healthy community-dwelling older adults (age range [65][66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81]. Six studies sampled participants with hypertension [55][56][57][58][59][60], one study sampled individuals with diabetes as a comparator to healthy aged popula...…”

“…Study populations varied from a minimum of 6 [20] to a maximum of 3356 [42] participants. Eight studies included only men [25,27,37,42,49,50,56,61] and four studies included only women [38,52,53,60]. Most studies reported the age range of the participants, except for two studies with one claiming to study "middle-aged" adults [46] and one using adult participants [62].…”

“…Thirteen studies assessed muscle mass [20,25,27,34,39,[42][43][44]47,48,54,58,61] and six studies assessed muscle fiber cross-sectional area (CSA) [33,46,47,56,61,62]. Seven studies examined muscle function [35,38,40,[49][50][51][52], one study assessed muscular power [41] and one study assessed the muscle anabolic response [20]. Body composition was measured as whole body lean mass [27,34,35,[38][39][40][42][43][44][47][48][49]51,52,54,58] or as appendicular lean mass [20,25,26,33,36,…”

“…Seven studies examined muscle function [35,38,40,[49][50][51][52], one study assessed muscular power [41] and one study assessed the muscle anabolic response [20]. Body composition was measured as whole body lean mass [27,34,35,[38][39][40][42][43][44][47][48][49]51,52,54,58] or as appendicular lean mass [20,25,26,33,36,37,41,46,50,53,[55][56][57][59][60][61][62]. To assess skeletal muscle mass various modalities were utilized including BIA [42][43][44]54,58], DXA [25,27,…”

Physical Activity

“…6) Khoudary, et al also revealed that poor physical activity performance correlated with vascular structural change. 7) Compared with these similar results, the findings of the current study are most meaningful in the clinical setting because plaque volume reduction is considered to be most influential to clinical outcome.…”