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A walking program's attenuation of cardiovascular reactivity in older adults with silent myocardial ischemia
Neumann SA, Brown JRP, Waldstein SR, Katzel LI
Journal of Aging and Physical Activity 2006 Apr;14(2):119-132
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Silent myocardial ischemia (SI) has been linked to increased risk of future coronary events. Enhanced systolic and diastolic blood pressure (SBP and DBP, respectively) and heart-rate (HR) reactions to stress (cardiovascular reactivity (CVR)) have been associated with greater severity of SI and are related prospectively to coronary-artery-disease endpoints. The authors examined the potential attenuating effects of 6 months of walking (aerobic exercise) versus control on CVR to three laboratory stressors in 25 older adults with exercise-induced SI. Maximal aerobic capacity was significantly improved by 12% for the exercise group and decreased by 8% for controls (p < 0.001). Groups had similar biomedical profiles pre- and postintervention. Walkers had significantly reduced DBP reactivity (pre 12 +/- 2; post 4 +/- 2 mmHg) compared with controls (pre 10 +/- 2; post 11 +/- 2 mmHg; p = 0.05), but no differences between groups were found for SBP or HR reactivity. These findings are the first to suggest that increased physical activity (via walking) can attenuate BP reactivity to emotional stressors in apparently healthy older adults with SI.

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