The effect of short-term aerobic training on arterial stiffness and blood pressur

短期有氧训练对动脉僵硬度和血压的影响

• 批准号: 8078365
• 负责人: SAMUEL A HEADLEY
• 金额: $ 2.34万
• 依托单位: SPRINGFIELD COLLEGE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8078365
• 关键词: Academic Research Enhancement Awards; Activities of Daily Living; Acute; Address; Aerobic; Age; Aging; American; Applications Grants; Blood; Blood Pressure; Cardiac; Cardiovascular Diseases; Cardiovascular system; Chronic; Chronic Kidney Failure; Clinical Research; Clinical Sciences; Control Groups; Coronary Arteriosclerosis; Data; Development; Diabetes Mellitus; Diet Modification; Disease; Doctor of Philosophy; Educational process of instructing; Environment; Event; Exercise; Exercise Physiology; Funding; Future; Guidelines; Healthy People 2010; High Prevalence; Hypertension; Hypotension; Individual; Institution; Intervention; Kidney; Kidney Transplantation; Lead; Link; Measures; Monitor; Obesity; Oxygen; Patients; Physical Education; Physical activity; Physiologic pulse; Play; Population; Prevalence; Procedures; Psychology; Publishing; Quality of life; Randomized; Reading; Recovery; Recruitment Activity; Renal Replacement Therapy; Renal function; Research; Rest; Risk; Risk Factors; Role; Sampling; Savings; Series; Sports; Staging; Testing; Time; Training; Training Programs; United States; United States National Institutes of Health; Walking; arterial stiffness; college; design; economic cost; graduate student; indexing; lifestyle intervention; primary outcome; programs; public health relevance; response; stem; uptake

DESCRIPTION (provided by applicant): The focus of the current research group is to examine the impact of lifestyle interventions on the development of cardiovascular disease (CV) in chronic kidney disease (CKD) patients. The study being proposed in this grant application is designed to determine the effect of short-term aerobic training on arterial stiffness and blood pressure (BP) in CKD patients. Arterial stiffness has been chosen as a dependent variable since it is one of the most important predictors of CV complications while hypertension is known to play a critical role both in the development of CV and in the progression of CKD {{604 O'Rourke, M.F. 2002;243 Agarwal,Rajiv 2005; }}. The specific aims of the study are: (a) to determine the effect of short-term aerobic training on arterial stiffness in CKD patients,(b) to determine the effect of short-term aerobic training on resting and ambulatory blood pressures (ABP) in CKD patients and (c) to determine the effect of short-term aerobic training on the acute post-exercise blood pressure response in CKD patients since acute responses may be related to changes following a period of chronic training. Fifty, 35-70 yr old, stage 3 CKD patients, with either diabetes or hypertension as the primary cause of their CKD will be recruited for this study. Subjects will be randomly assigned to either the exercise group (ExG=25) or to the control group (CG = 25). At the start of the study, each subject will attend 4 research sessions. During the first session, resting and 24 hr ABP readings will be recorded. In the second session, anthropometric measures, peak oxygen uptake (VO2peak), and ABP values will be measured. Sessions 3 & 4 will be performed in random order. During these sessions pulse wave velocity (PWV), augmentation index (AIx) and BP will be measured at baseline after a rest period. Subjects will then either walk for 30 min at 50-60% of VO2peak, or sit quietly for an equal period of time. BP will be monitored for 60 min in recovery following exercise and ABP will be taken during the subsequent 24 hrs. ExG will perform supervised aerobic training for 45-50 min, 3 times per week, at a moderate intensity, for 16 weeks. CG will continue their activities of daily living but will not be given an exercise program. All subjects will be retested at week 8 for BP, ABP, and arterial stiffness and at week 16 for all variables. After 16 weeks of the study, both groups will be retested using identical procedures as at baseline. A series of 2 X 3 analyses of covariance with age, baseline PWV, AIx and BP as the covariates, will be used to determine the effect of the 16 week intervention period on the primary outcome variables. A 2 X 7 X 2, mixed factorial repeated measures ANOVA will be used to analyze the post-exercise data while a Pearson Moment Correlation Coefficient will be computed to examine the relationship between post-exercise acute responses and BP changes following chronic training. An alpha level of 0.05 will be used for all analyses. PUBLIC HEALTH RELEVANCE: Narrative Relevance. Approximately 26 million Americans have chronic kidney disease and the prevalence of this disease is projected to increase in the future due to the aging of the population and because of the high rates of obesity, diabetes, and hypertension within the US population. Individuals who have chronic kidney disease dramatically increase their risk of dying from cardiovascular disease. The current proposal, which supports objective 4-2 of Healthy People 2010 and complies with the U.S. Physical Activity Guidelines that are to be published later this year, is designed to determine whether a 4-month aerobic training program reduces the stiffness of arterial walls in kidney patients since increased stiffness is associated with cardiac events.

描述（由申请人提供）： 当前研究小组的重点是检查生活方式干预对慢性肾脏病（CKD）患者心血管疾病（CV）发展的影响。该赠款申请中提出的研究旨在确定CKD患者中短期有氧训练对动脉僵硬和血压（BP）的影响。由于它是CV并发症的最重要预测指标之一，因此已选择动脉刚度，而已知高血压在CV的发展和CKD的发展中都起着关键作用，{{604 O'Rourke，M.F。 2002; 243 Agarwal，Rajiv 2005; }}。该研究的具体目的是：（a）确定短期有氧训练对CKD患者动脉僵硬的影响，（b）确定短期有氧训练对CKD患者的静止和卧床血压（ABP）的影响，并在（C）中（C）确定短期训练对急性血液疾病的影响，因为急性血液训练对CKD的影响可能会在CKD后施加反应，因为CKD的影响是CKD的影响。慢性训练。这项研究将招募五十，35 - 70年的35-70岁患者，患有糖尿病或高血压是其CKD的主要原因。受试者将随机分配给运动组（EXG = 25）或对照组（CG = 25）。在研究开始时，每个学科将参加4个研究课程。在第一个会话中，将记录休息和24小时ABP读数。在第二节中，将测量人体测量指标，峰值氧摄取（VO2PEAK）和ABP值。会议3和4将以随机顺序进行。在这些会话期间，脉冲波速度（PWV），在休息后基线时将测量增强指数（AIX）和BP。然后，受试者将以VO2PEAK的50-60％的50-60％行走30分钟，或者安静地坐着相等的时间。锻炼后的恢复后将对BP进行60分钟的监测，随后的24小时将进行ABP。 EXG将以中等强度进行监督的有氧训练，进行45-50分钟，3次，持续16周。 CG将继续他们的日常生活活动，但不会进行锻炼计划。 BP，ABP和动脉刚度将在第8周重新测试所有受试者，并在第16周对所有变量进行重新测试。研究16周后，两组将使用与基线相同的程序进行重新测试。一系列与年龄，基线PWV，AIX和BP作为协变量的2 x 3分析将用于确定16周干预期对主要结果变量的影响。 2 x 7 x 2的混合阶乘重复测量方差分析将用于分析运动后数据，同时将计算出皮尔森力矩相关系数，以检查运动后急性反应与长期训练后的BP变化之间的关系。 α水平为0.05，用于所有分析。公共卫生相关性：叙事相关性。大约有2600万美国人患有慢性肾脏疾病，由于人口的老龄化以及肥胖，糖尿病和美国人群中高血压的率很高，因此未来这种疾病的患病率预计将来会增加。患有慢性肾脏疾病的个体大大增加了死于心血管疾病的风险。当前的提案支持2010年健康人的目标4-2，并符合今年晚些时候将发布的美国体育活动指南，旨在确定由于僵硬增加与心脏事件相关的肾脏患者，肾脏患者动脉壁的僵硬是否会减少肾脏壁的僵硬。