Exercise Pressor Reflex and Lifelong Training (LEaSTCaRe)

The Effects of Lifelong Endurance and Strength Training on the Central and Peripheral Cardiovascular Responses

Cardiovascular diseases represent the first mortality cause in the world. Ageing is considered as the most prominent risk factor for this kind of diseases. Also, hypertension represents one of the modifiable risk factors. Blood pressure response to exercise is governed by three systems: central command, baroreflex, and a feedback mechanism originating in the skeletal muscle. An abnormal cardiovascular response to exercise facilitates the occurrence of cardiovascular events. The goal of the study is to characterize the cardiovascular response in lifelong trained individuals and explore the potential benefits of endurance and strength training on cardiovascular regulation to exercise onset.

Study Overview

• Status: Unknown
• Conditions: Healthy Aging; Cardiovascular Risk Factor
• Intervention / Treatment: Behavioral: Exercise History

Detailed Description

Population ageing represents a problem both for health outcomes and for social dynamics in the social welfare states. Currently, the over 60 represents the fastest growing segment of the population. Despite a downward trend in the incidence of cardiovascular diseases, they remain the main culprits for what concern mortality rates in the world. Increasing age is considered the major risk factor for cardiovascular mortality.

One of the main components of the cardiovascular response to exercise is dictated by the exercise pressor reflex originating in the exercising muscle and responding to metabolic and mechanical stimuli. Research indicates that at least 20% of the regulation of blood pressure could be ascribed to these cardiovascular reflexes. A dysfunctional reflex-mediated response increases the chances of cardiovascular events that may end up in severe consequences.

Chronic exercise training is recognized to be an important tool to control blood pressure. The mechanisms through which exercise exerts its effect are multiple. Among these, an improvement of the neural control of the reflex originating in the muscle seems a likely contributor. However, at present, the effect of chronic exercise training on the EPR response in the elderly has not been elucidated. The aim of the study is to characterize the central and peripheral cardiovascular response in the lifelong endurance and strength trained elders population.

• Study Type: Observational
• Enrollment (Anticipated): 48

Contacts and Locations

Study Locations

• Italy
  • Verona, Italy, 37131
    • Recruiting
    • University of Verona
    • Contact: Massimo Venturelli, PhD; Email: massimo.venturelli@univr.it

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years to 71 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Male

• Sampling Method: Non-Probability Sample

Study Population

Healthy population from different age groups and different exercise training history

Description

Inclusion Criteria

General:

• Young: 18 - 30, males, non smokers
• Old Sedentary: 65 -75, males, non smokers
• Old Endurance Trained: 65 -75, males, non smokers
• Old Strength Trained: 65 - 75, males, non smokers

Exercise history (different for each group):

• Young: ≤ 5 h/week
• Old Sedentary: ≤ 2h/week
• Old Endurance Trained: ≥ 5 h/week, ≥ 30 years of practice, ≥ 4 sessions/week
• Old Strength Trained: ≥ 5 h/week, ≥ 30 years of practice, ≥ 4 sessions/week

Exclusion Criteria:

• History of cardiovascular events/diseases
• Respiratory, musculoskeletal, renal, and insulin-resistant diseases
• Hypercholesterolemia
• Use of beta-blockers
• BMI ≥ 30

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Cross-Sectional

Number of groups / cohorts

4

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Young; Healthy young subjects (age 18 - 30 )	Behavioral: Exercise History; The groups will be divided based on their exercise history
Old Sedentary; Healthy and sedentary old subjects (age 65 - 75)	Behavioral: Exercise History; The groups will be divided based on their exercise history
Old Endurance Trained; Healthy old subjects ( age 65 - 75) who participated in endurance sports for ≥30 years, ≥5 hours per week and ≥4 sessions per week	Behavioral: Exercise History; The groups will be divided based on their exercise history
Old Strength Trained; Healthy old subjects ( age 65 - 75) who participated in resistance training/sports for ≥30 years, ≥5 hours per week and ≥4 sessions per week	Behavioral: Exercise History; The groups will be divided based on their exercise history

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean Arterial Blood Pressure (MAP)	Difference in MAP between groups to post-exercise cuff occlusion	1 week after recruitment of the subject - We will measure the changes from baseline to the steady state response ( average of 3rd minute)
Heart Rate (HR)	Difference in heart rate between groups to passive leg movement (PLM)	1 week after recruitment of the subject - We will measure the change from baseline to peak (peak response in HR due to PLM)
Muscle Sympathetic Nerve Activity - Microneurography	Difference in muscle sympathetic nerve activity between groups to the different stimulations	1 week after recruitment - We will measure the change from baseline to mean value (during stimulation)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Muscle oxidative capacity in vivo / blood pressure response	Linear regression to check whether an abnormal blood pressure response is explained by the different muscle oxidative capacity measured by NIRS in vivo	10 days after recruitment - Cross-sectional comparison at one time point only

Collaborators and Investigators

• Sponsor: Universita di Verona

Publications and helpful links

General Publications

• Milia R, Roberto S, Mulliri G, Loi A, Marcelli M, Sainas G, Milia N, Marongiu E, Crisafulli A. Effect of aging on hemodynamic response to metaboreflex activation. Eur J Appl Physiol. 2015 Aug;115(8):1693-703. doi: 10.1007/s00421-015-3153-5. Epub 2015 Mar 24.
• Groot HJ, Rossman MJ, Garten RS, Wang E, Hoff J, Helgerud J, Richardson RS. The Effect of Physical Activity on Passive Leg Movement-Induced Vasodilation with Age. Med Sci Sports Exerc. 2016 Aug;48(8):1548-57. doi: 10.1249/MSS.0000000000000936.
• Boushel R. Muscle metaboreflex control of the circulation during exercise. Acta Physiol (Oxf). 2010 Aug;199(4):367-83. doi: 10.1111/j.1748-1716.2010.02133.x. Epub 2010 Mar 27.
• Murphy MN, Mizuno M, Mitchell JH, Smith SA. Cardiovascular regulation by skeletal muscle reflexes in health and disease. Am J Physiol Heart Circ Physiol. 2011 Oct;301(4):H1191-204. doi: 10.1152/ajpheart.00208.2011. Epub 2011 Aug 12.
• Markel TA, Daley JC 3rd, Hogeman CS, Herr MD, Khan MH, Gray KS, Kunselman AR, Sinoway LI. Aging and the exercise pressor reflex in humans. Circulation. 2003 Feb 11;107(5):675-8. doi: 10.1161/01.cir.0000055190.81716.ab.

Study record dates

Study Major Dates

• Study Start (Anticipated): August 1, 2019
• Primary Completion (Anticipated): November 29, 2021
• Study Completion (Anticipated): November 29, 2021

Study Registration Dates

• First Submitted: June 21, 2019
• First Submitted That Met QC Criteria: July 6, 2019
• First Posted (Actual): July 9, 2019

Study Record Updates

• Last Update Posted (Actual): July 9, 2019
• Last Update Submitted That Met QC Criteria: July 6, 2019
• Last Verified: July 1, 2019

More Information

Terms related to this study

• Keywords: Exercise Pressor Reflex; Metaboreflex; Mechanoreflex; Lifelong exercise training
• Other Study ID Numbers: 30444

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No