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Effect of early exercise engagement on arterial stiffness in patients diagnosed with a transient ischaemic attack

Abstract

This study investigated the effects of regular exercise participation on common carotid artery stiffness in patients recently diagnosed with transient ischaemic attack (TIA). A total of 21 male and 4 female participants (mean±s.d.; 66±12 years, 1.72±0.07 m, 85.5±12.4 kg), recruited within 2 weeks of TIA diagnosis, completed a risk stratification assessment (including fasting blood glucose, cholesterol), a health history questionnaire and underwent measures of arterial stiffness (compliance and distensibility). Participants were then randomized to either an exercise (EX; 8-week intervention) or a usual-care control (CON) condition. Identical measures were obtained post intervention. Within-subject, repeated measures analysis of variance, with Condition as the between-subject factor (EX and CON), was used to assess measures of arterial stiffness at the baseline and postintervention assessment. Results revealed a significant interaction whereby an increase in compliance (0.71±0.24 vs 0.83±0.28 mm2 kPa−1, P=0.048, partial η2=0.159) and distensibility (15.98±5.95 vs 19.49±6.60 10−3 kPa−1, P=0.023, partial η2=0.204) was observed for EX but not for CON. The present study has demonstrated that engagement in exercise soon after TIA diagnosis leads to improved large artery health. These improvements in vascular health may reduce the risk of an ensuing or recurring cardio- or cerebrovascular event.

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References

  1. Gommans J, Barber PA, Fink J . Preventing strokes: the assessment and management of people with transient aschaemic attack. N Z Med J 2009; 122: 1–11.

    Google Scholar 

  2. Prior PL, Hachinski V, Unsworth K, Chan R, Mytka S, O'Callaghan C et al. Comprehensive cardiac rehabilitation for secondary prevention after transient ischemic attack or mild stroke: I: feasibility and risk factors. Stroke 2011; 42: 3207–3213.

    Article  Google Scholar 

  3. MacKay-Lyons M, Gubitz G, Giacomantonio N, Wightman H, Marsters D, Thompson K et al. Program of rehabilitative exercise and education to avert vascular events after non-disabling stroke or transient ischemic attack (prevent trial): a multi-centred, randomised controlled trial. BMC Neurol 2010; 10: 122.

    Article  Google Scholar 

  4. Laurent S, Boutouyrie P . Arterial stiffness and stroke in hypertension: therapeutic implications for stroke prevention. CNS Drugs 2005; 19: 1–11.

    Article  Google Scholar 

  5. Blacher J, Asmar R, Djane S, London G, Safar M . Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients. J Hypertens 1998; 16: S259–S259.

    Article  Google Scholar 

  6. Weber T, Auer J, O'Rourke MF, Kvas E, Lassnig E, Berent R et al. Arterial stiffness, wave reflections, and the risk of coronary artery disease. Circulation 2004; 109: 184–189.

    Article  Google Scholar 

  7. Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 2001; 37: 1236–1241.

    Article  CAS  Google Scholar 

  8. Blacher J, Asmar R, Djane S, London GM, Safar ME . Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients. Hypertension 1999; 33: 1111–1117.

    Article  CAS  Google Scholar 

  9. Boutouyrie P, Tropeano AI, Asmar R, Gautier I, Benetos A, Lacolley P et al. Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients-a longitudinal study. Hypertension 2002; 39: 10–15.

    Article  CAS  Google Scholar 

  10. Zieman SJ, Melenovsky V, Kass DA . Mechanisms, pathophysiology, and therapy of arterial stiffness. Arterioscler Thromb Vasc Biol 2005; 25: 932–943.

    Article  CAS  Google Scholar 

  11. Lennon O, Galvin R, Smith K, Doody C, Blake C . Lifestyle interventions for secondary disease prevention in stroke and transient ischaemic attack: a systematic review. Eur J Prev Cardiol, (e-pub ahead of print 11 March 2013).

  12. Naci H, Ioannidis JP . Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study. BMJ 2013; 347: f5577.

    Article  Google Scholar 

  13. Lennon O, Carey A, Gaffney N, Stephenson J, Blake C . A pilot randomized controlled trial to evaluate the benefit of the cardiac rehabilitation paradigm for the non-acute ischaemic stroke population. Clin Rehabil 2008; 22: 125–133.

    Article  Google Scholar 

  14. Faulkner J, Lambrick D, Woolley B, Stoner L, Wong L, McGonigal G . Effects of early exercise engagement on vascular risk in patients with transient ischaemic attack and non-disabling stroke. J Stroke Cerebrovasc 2013; 22: 388–396.

    Article  Google Scholar 

  15. Faulkner J, McGonigal G, Woolley B, Stoner L, Wong L, Lambrick D . The effect of a short-term exercise programme on haemodynamic adaptability; a randomised controlled trial with newly diagnosed transient ischaemic attack patients. J Hum Hypertens 2013; 27: 736–743.

    Article  CAS  Google Scholar 

  16. New Zealand Guideline. New Zealand guidelines for the assessment and management of people with recent transient ischaemic attack (TIA). 2008:1–41.

  17. ACSM's Guidelines for Exercise Testing and Prescription. Lippincott, Williams and Wilkins: Philadelphia, 2013.

  18. Paini A, Boutouyrie P, Calvet D, Tropeano AI, Laloux B, Laurent S . Carotid and aortic stiffness: determinants of discrepancies. Hypertension 2006; 47: 371–376.

    Article  CAS  Google Scholar 

  19. Stoner L, West C, Cates DM, Young JM . Optimization of ultrasound assessments of arterial function. OJCD 2011; 1: 15–21.

    Article  Google Scholar 

  20. Borg G . Borg's Perceived Exertion and Pain Scales. Human Kinetics: Leeds, UK, 1998.

    Google Scholar 

  21. Stoner L, McCully KK . Velocity acceleration as a determinant of flow-mediated dilation. Ultrasound Med Biol 2012; 38: 580–592.

    Article  Google Scholar 

  22. Stoner L, McCully KK . Peak and time-integrated shear rates independently predict flow-mediated dilation. J Clin Ultrasound 2012; 40: 341–351.

    Article  Google Scholar 

  23. Van Bortel LM, Duprez D, Starmans-Kool MJ, Safar ME, Giannattasio C, Cockcroft J et al. Clinical applications of arterial stiffness, task force III: recommendations for user procedures. Am J Hypertens 2002; 15: 445–452.

    Article  Google Scholar 

  24. Richardson JTE . Eta squared and partial eta squared as measures of effect size in educational research. Educ Res Rev Neth 2011; 6: 135–147.

    Article  Google Scholar 

  25. Cohen J . Statistical Power Analysis for the Behavioural Sciences. Academic Press: New York, 1969.

    Google Scholar 

  26. Cameron JD, Dart AM . Exercise training increases total systemic arterial compliance in humans. Am J Physiol 1994; 266: H693–H701.

    CAS  PubMed  Google Scholar 

  27. Tanaka H, Dinenno FA, Monahan KD, Clevenger CM, DeSouza CA, Seals DR . Aging, habitual exercise, and dynamic arterial compliance. Circulation 2000; 102: 1270–1275.

    Article  CAS  Google Scholar 

  28. Monahan KD, Dinenno FA, Seals DR, Clevenger CM, Desouza CA, Tanaka H . Age-associated changes in cardiovagal baroreflex sensitivity are related to central arterial compliance. Am J Physiol Heart Circ Physiol 2001; 281: H284–H289.

    Article  CAS  Google Scholar 

  29. Mourot L, Boussuges A, Campo P, Maunier S, Debussche X, Blanc P . Cardiovascular rehabilitation increase arterial compliance in type 2 diabetic patients with coronary artery disease. Diabetes Res Clin Pr 2009; 84: 138–144.

    Article  CAS  Google Scholar 

  30. Schmidt-Trucksass A, Grathwohl D, Frey I, Schmid A, Boragk R, Upmeier C et al. Relation of leisure-time physical activity to structural and functional arterial properties of the common carotid artery in male subjects. Atherosclerosis 1999; 145: 107–114.

    Article  CAS  Google Scholar 

  31. Seals DR, DeSouza CA, Donato AJ, Tanaka H . Habitual exercise and arterial aging. J Appl Physiol 2008; 105: 1323–1332.

    Article  Google Scholar 

  32. Ainslie PN, Cotter JD, George KP, Lucas S, Murrell C, Shave R et al. Elevation in cerebral blood flow velocity with aerobic fitness throughout healthy human ageing. J Physiol 2008; 586: 4005–4010.

    Article  CAS  Google Scholar 

  33. Barenbrock M, Spieker C, Witta J, Evers S, Hoeks APG, Rahn KH et al. Reduced distensibility of the common carotid artery in patients treated with ergotamine. Hypertension 1996; 28: 115–119.

    Article  CAS  Google Scholar 

  34. Boutouyrie P, Lacolley P, Girerd X, Beck L, Safar M, Laurent S . Sympathetic activation decreases medium-sized arterial compliance in humans. Am J Physiol Heart C 1994; 267: H1368–H1376.

    Article  CAS  Google Scholar 

  35. Stoner L, Erickson ML, Young JM, Fryer S, Sabatier MJ, Faulkner J et al. There’s more to flow-mediated dilation than nitric oxide. J Atheroscler Thromb 2012; 19: 589–600.

    Article  CAS  Google Scholar 

  36. Heffernan KS, Jae SY, Echols GH, Lepine NR, Fernhall B . Arterial stiffness and wave reflection following exercise in resistance-trained men. Med Sci Sport Exer 2007; 39: 842–848.

    Article  Google Scholar 

  37. Rakobowchuk M, McGowan CL, de Groot PC, Bruinsma D, Hartman JW, Phillips SM et al. Effect of whole body resistance training on arterial compliance in young men. Exp Physiol 2005; 90: 645–651.

    Article  CAS  Google Scholar 

  38. Ferrier KE, Waddell TK, Gatzka CD, Cameron JD, Dart AM, Kingwell BA . Aerobic exercise training does not modify large-artery compliance in isolated systolic hypertension. Hypertension 2001; 38: 222–226.

    Article  CAS  Google Scholar 

  39. Beck DT, Martin JS, Casey DP, Braith RW . Exercise training reduces peripheral arterial stiffness and myocardial oxygen demand in young prehypertensive subjects. Am J Hypertens 2013; 26: 1093–1102.

    Article  Google Scholar 

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Acknowledgements

This study was funded by the School of Sport and Exercise, Massey University.

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Correspondence to J Faulkner.

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Woolley, B., Stoner, L., Lark, S. et al. Effect of early exercise engagement on arterial stiffness in patients diagnosed with a transient ischaemic attack. J Hum Hypertens 29, 87–91 (2015). https://doi.org/10.1038/jhh.2014.56

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