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）： 目前研究小组的重点是研究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。本拨款申请中提出的研究旨在确定短期有氧训练对 CKD 患者动脉僵硬度和血压 (BP) 的影响。动脉僵硬度被选为因变量，因为它是 CV 并发症最重要的预测因子之一，而众所周知，高血压在 CV 的发生和 CKD 的进展中发挥着关键作用{{604 O'Rourke, M.F. 2002；243 阿加瓦尔，拉吉夫 2005； }}。该研究的具体目的是：(a) 确定短期有氧训练对 CKD 患者动脉僵硬度的影响，(b) 确定短期有氧训练对静息血压和动态血压 (ABP) 的影响(c) 确定短期有氧训练对 CKD 患者运动后急性血压反应的影响，因为急性反应可能与一段时间的慢性运动后的变化有关。 训练。本研究将招募 50 名 35-70 岁、糖尿病或高血压为 CKD 主要原因的 3 期 CKD 患者。受试者将被随机分配到运动组 (ExG=25) 或对照组 (CG = 25)。研究开始时，每个受试者将参加 4 次研究会议。在第一次治疗期间，将记录静息和 24 小时 ABP 读数。在第二次会议中，将测量人体测量、峰值摄氧量 (VO2peak) 和 ABP 值。第 3 节和第 4 节将按随机顺序进行。在这些会议期间，将在休息期后在基线上测量脉搏波速度 (PWV)、增强指数 (AIx) 和血压。然后，受试者要么以 VO2peak 的 50-60% 步行 30 分钟，要么安静地坐同样的时间。运动后恢复期间将监测 60 分钟血压，并在随后的 24 小时内测量 ABP。 ExG 将在监督下进行 45-50 分钟的有氧训练，每周 3 次，强度适中，持续 16 周。 CG 将继续进行日常生活活动，但不会进行锻炼计划。所有受试者将在第 8 周重新测试血压、ABP 和动脉僵硬度，并在第 16 周重新测试所有变量。研究 16 周后，两组将使用与基线相同的程序重新进行测试。以年龄、基线 PWV、AIx 和 BP 作为协变量的一系列 2 X 3 协方差分析将用于确定 16 周干预期对主要结果变量的影响。将使用 2 X 7 X 2 混合因子重复测量方差分析来分析运动后数据，同时计算皮尔逊矩相关系数来检查运动后急性反应与长期训练后血压变化之间的关系。所有分析都将使用 0.05 的 alpha 水平。公共卫生相关性：叙述相关性。大约 2600 万美国人患有慢性肾病，由于人口老龄化以及美国人口中肥胖、糖尿病和高血压的高发病率，预计这种疾病的患病率在未来将会增加。患有慢性肾脏疾病的人死于心血管疾病的风险显着增加。目前的提案支持《2010 年健康人》的目标 4-2，并符合将于今年晚些时候发布的美国体育活动指南，旨在确定为期 4 个月的有氧训练计划是否会降低动脉壁的硬度。肾脏病患者，因为硬度增加与心脏事件相关。