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All-extremity exercise training improves arterial stiffness in older adults
Kim H-K, Hwang C-L, Yoo J-K, Hwang M-H, Handberg EM, Petersen JW, Nichols WW, Sofianos S, Christou DD
Medicine and Science in Sports and Exercise 2017 Jul;49(7):1404-1411
clinical trial
4/10 [Eligibility criteria: No; 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: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Large elastic arteries stiffen with age, which predisposes older adults to increased risk for cardiovascular disease. Aerobic exercise training is known to reduce the risk for cardiovascular disease, but the optimal exercise prescription for attenuating large elastic arterial stiffening in older adults is not known. PURPOSE: The purpose of this randomized controlled trial was to compare the effect of all-extremity high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on aortic pulse wave velocity (PWV) and carotid artery compliance in older adults. METHODS: Forty-nine sedentary older adults (age 64 +/- 1 yr), free of overt major clinical disease, were randomized to HIIT (n = 17), MICT (n = 18), or nonexercise controls (CONT; n = 14). HIIT (4x4 min at 90% HRpeak interspersed with 3x3 min active recovery at 70% HRpeak) and isocaloric MICT (70% HRpeak) were performed on an all-extremity non-weight-bearing ergometer, 4 d/wk for 8 wk under supervision. Aortic (carotid to femoral PWV (cfPWV)) and common carotid artery compliance were assessed at pre- and postintervention. RESULTS: cfPWV improved by 0.5 m/s in MICT (p = 0.04) but did not significantly change in HIIT and CONT (p > 0.05). Carotid artery compliance improved by 0.03 mm/mmHg in MICT (p = 0.001), but it remained unchanged in HIIT and CONT (p > 0.05). Improvements in arterial stiffness in response to MICT were not confounded by changes in aortic or brachial blood pressure, HR, body weight, total and abdominal adiposity, blood lipids, or aerobic fitness. CONCLUSION: All-extremity MICT, but not HIIT, improved central arterial stiffness in previously sedentary older adults free of major clinical disease. Our findings have important implications for aerobic exercise prescription in older adults.

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