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Training for a First-Time Marathon Reverses Age-Related Aortic Stiffening.

Bhuva, AN; D'Silva, A; Torlasco, C; Jones, S; Nadarajan, N; Van Zalen, J; Chaturvedi, N; Lloyd, G; Sharma, S; Moon, JC; et al. Bhuva, AN; D'Silva, A; Torlasco, C; Jones, S; Nadarajan, N; Van Zalen, J; Chaturvedi, N; Lloyd, G; Sharma, S; Moon, JC; Hughes, AD; Manisty, CH (2020) Training for a First-Time Marathon Reverses Age-Related Aortic Stiffening. J Am Coll Cardiol, 75 (1). pp. 60-71. ISSN 1558-3597 https://doi.org/10.1016/j.jacc.2019.10.045
SGUL Authors: Sharma, Sanjay

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Restricted to Repository staff only until 6 January 2021.
Available under License Creative Commons Attribution Non-commercial No Derivatives.

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Abstract

BACKGROUND: Aging increases aortic stiffness, contributing to cardiovascular risk even in healthy individuals. Aortic stiffness is reduced through supervised training programs, but these are not easily generalizable. OBJECTIVES: The purpose of this study was to determine whether real-world exercise training for a first-time marathon can reverse age-related aortic stiffening. METHODS: Untrained healthy individuals underwent 6 months of training for the London Marathon. Assessment pre-training and 2 weeks post-marathon included central (aortic) blood pressure and aortic stiffness using cardiovascular magnetic resonance distensibility. Biological "aortic age" was calculated from the baseline chronological age-stiffness relationship. Change in stiffness was assessed at the ascending (Ao-A) and descending aorta at the pulmonary artery bifurcation (Ao-P) and diaphragm (Ao-D). Data are mean changes (95% confidence intervals [CIs]). RESULTS: A total of 138 first-time marathon completers (age 21 to 69 years, 49% male) were assessed, with an estimated training schedule of 6 to 13 miles/week. At baseline, a decade of chronological aging correlated with a decrease in Ao-A, Ao-P, and Ao-D distensibility by 2.3, 1.9, and 3.1 × 10-3 mm Hg-1, respectively (p < 0.05 for all). Training decreased systolic and diastolic central (aortic) blood pressure by 4 mm Hg (95% CI: 2.8 to 5.5 mm Hg) and 3 mm Hg (95% CI: 1.6 to 3.5 mm Hg). Descending aortic distensibility increased (Ao-P: 9%; p = 0.009; Ao-D: 16%; p = 0.002), while remaining unchanged in the Ao-A. These translated to a reduction in "aortic age" by 3.9 years (95% CI: 1.1 to 7.6 years) and 4.0 years (95% CI: 1.7 to 8.0 years) (Ao-P and Ao-D, respectively). Benefit was greater in older, male participants with slower running times (p < 0.05 for all). CONCLUSIONS: Training for and completing a marathon even at relatively low exercise intensity reduces central blood pressure and aortic stiffness-equivalent to a ∼4-year reduction in vascular age. Greater rejuvenation was observed in older, slower individuals.

Item Type: Article
Additional Information: © 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: aging, aortic stiffness, blood pressure, cardiovascular magnetic resonance, exercise training, marathon, aging, aortic stiffness, blood pressure, cardiovascular magnetic resonance, exercise training, marathon, Cardiovascular System & Hematology, 1102 Cardiorespiratory Medicine and Haematology, 1117 Public Health and Health Services
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: J Am Coll Cardiol
ISSN: 1558-3597
Language: eng
Dates:
DateEvent
7 January 2020Published
6 January 2020Published Online
22 October 2019Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
Projects:
Project IDFunderFunder ID
FS/15/27/31465British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
FS/16/46/32187British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
PG/13/6/29934British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
MC_UU_12019/1Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
PubMed ID: 31918835
Web of Science ID: WOS:000505804800009
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/111569
Publisher's version: https://doi.org/10.1016/j.jacc.2019.10.045

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