Elizabeth C. Schroeder

We identified beneficial associations between higher cardiorespiratory fitness and lower structural, but not load-dependent, aortic stiffness in older adults. By distinguishing structural and load-dependent components, we determined a more precise understanding of how cardiorespiratory fitness may attenuate vascular aging than analyses relying on total pulse wave velocity alone. Maintaining fitness (e.g., through exercise), particularly in later life, may therefore be an effective way to slow vascular aging and preserve cardiovascular health.

The present study investigated the association between relative handgrip strength and large artery stiffness in women across the lifespan. Greater relative handgrip strength was not associated with large artery stiffness in young or middle-aged women but was associated with lower large artery stiffness in older women. This age-moderating effect suggests the impact of muscular strength on large artery stiffness changes across the lifespan and becomes more important for vascular health in women following midlife.

Purpose: Brachial blood pressure (BP) is the current gold standard for BP assessment; however, measures of pulse wave velocity (PWV) and central blood pressure (CBP) may contribute uniquely to assessment of cardiovascular health status. As of yet, standards for assessment of CBP and PWV have not addressed the impact of hydration status on proper measurement. To understand the impact of hydration, PWV and CBP should be measured in a euhydrated and hypohydrated state.Methods: Forty‐three young, healthy participants (21 ± 2 years) completed a dehydration protocol utilizing moderate aerobic activity until they lost 1%–2% of their body weight. PWV and CBP were measured before and following the dehydration protocol. Linear regression was utilized to assess change in hydration status and change in PWV and CBP.Results: No significant relationships were observed between the change in hydration status (% body weight lost) and PWV (β = 0.05, p = 0.78) or central diastolic BP (β = −3.8, p = 0.10), however, a significant relationship was observed with central systolic BP (β = −5.0, p = 0.03).Discussion: In conclusion, the assessment of hydration status before measurement of CBP or PWV may not be necessary in young, healthy individuals.

Background: Survivors of cancer have elevated risk of cardiovascular disease, likely stemming from the negative impact of anticancer therapies on vascular function. Arterial stiffness is a strong indicator of vascular function and independent predictor of cardiovascular disease. The American Heart Association recommends Life's Essential 8 for optimal cardiovascular health. It is currently unknown, however, whether greater adherence to Life's Essential 8 is associated with low arterial stiffness in survivors of cancer. Methods and Results: This cross‐sectional study included 172 older adult (≥65 years) survivors of cancer (74±6 years; 58% female). Life's Essential 8 100‐point cardiovascular health score, with higher scores indicative of better cardiovascular health, was calculated based on 8 components: diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure. Participants were classified as having low (P <0.001). Conclusions: Greater adherence to the American Heart Association's Life's Essential 8 was associated with lower prevalence of high arterial stiffness in older adult survivors of cancer. Prospective studies with larger samples are needed.

Objectives: The aim of the study is to determine if law enforcement officers develop subclinical atherosclerotic cardiovascular disease (ASCVD) earlier than nonofficers and, if so, the extent to which conventional risk factors explain this difference. Methods: Estimated pulse wave velocity (ePWV) was the marker of subclinical ASCVD. EPWV, ASCVD risk factors, metabolic syndrome (MetS), and 10-year risk for ASCVD were compared among 408 law enforcement officers and a civilian cohort. Results: EPWV, 10-year ASCVD risk, and MetS prevalence increased significantly with age. All but the officers age 55 and older had higher ePWV cohort than the civilian cohort (P < 0.001). Ten-year ASCVD risk explained the most variability of ePWV (R ² = 0.49, P < 0.001). Conclusions: Officers develop subclinical ASCVD earlier than nonofficers. Conventional ASCVD risk factors only explain about half of this increase. Occupational factors may play a role in contributing to this increased ASCVD risk.

Acute inflammation impairs vascular function in an age-dependent manner and affects cardiovascular event risk. Regular aerobic exercise preserves vascular function with aging and potentially modifies how acute inflammation affects the vasculature. We hypothesize high cardiorespiratory fitness may accompany greater arterial responsiveness post-acute inflammation in older adults.

Sex differences in resting cerebral hemodynamics decline with advancing age as females experience larger reductions in cerebral blood velocity and steeper pulsatility increases than males. However, an exercise-mediated hypertensive stimulus might reveal sex differences in cerebral hemodynamics not apparent at rest. Following high-intensity resistance exercise, older females but not males exhibit increases in cerebral blood velocity, despite similar increases in cerebral pulsatility. The susceptibility to cerebrovascular abnormalities following exercise-mediated hypertensive stimulus appears similar between sexes.

Increasing daily steps by an additional 3000 steps/day on 5 days/week equates to ~150 min/week of aerobic physical activity to meet the physical activity guidelines; however, its effectiveness for blood pressure control in older adults with hypertension is unknown. A 20-week, single-arm, pilot e-health lifestyle walking intervention was conducted in 21 sedentary older adults (73 ± 5 years old) with hypertension (13 female, 8 male) to investigate the effectiveness of increasing daily steps by an additional 3000 steps/day for blood pressure control. The intervention consisted of two phases, with behavior change assistance provided during the first active phase (weeks 1–10) to help reach step goals and minimal assistance provided during the second self-maintenance phase (weeks 11–20). Nineteen participants (91%) completed both the 10- and 20-week assessments. The participants wore the pedometer for ≥10 h on 97% of the days over 20 weeks. They significantly increased average steps/day from 3899 ± 2198 at baseline to 6512 ± 2633 at 10 weeks and 5567 ± 2587 at 20 weeks. After 20 weeks, both systolic (137 ± 10 to 130 ± 11 mm Hg, p < 0.001) and diastolic (81 ± 6 to 77 ± 6 mm Hg, p = 0.01) blood pressure improved. The response was consistent in participants with (n = 8) and without (n = 13) anti-hypertensive medication. The results of our lifestyle walking intervention are encouraging for reducing blood pressure in older adults with hypertension; however, larger randomized, controlled trials need to be performed to confirm these findings.

Examine the independent and joint associations of cardiorespiratory fitness (CRF) and body mass index (BMI) with the prevalence of diverticulitis in older adults. 476 older adults (61% Female; 71 ± 5 years) with no history of myocardial infarction, stroke, cancer, inflammatory bowel disease, or diabetes were included in this cross-sectional study. Diverticulitis cases were identified by self-reported physician diagnosis from the medical history questionnaire. Logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of the prevalence of diverticulitis by tertiles of CRF and BMI category. CRF and BMI were further dichotomized into either “unfit” (the lowest one-third of CRF), “fit” (the upper two-thirds of CRF), “overweight/obese” (BMI ≥25.0 kg/m²), or “normal-weight” (BMI 2) to investigate the joint association of CRF and BMI with diverticulitis. Thirty-five (7.4%) participants were identified as having diverticulitis. Compared with the lowest CRF tertile, the ORs (95% CIs) of diverticulitis were 0.52 (0.22–1.22) and 0.33 (0.12–0.94) in the middle and upper CRF tertiles, respectively, after adjusting for potential confounders. After further adjustment for BMI, the association was no longer significant with ORs (95% CIs) of 0.55 (0.23–1.33) and 0.37 (0.12–1.10) in middle and upper CRF tertiles, respectively. Compared with the normal-weight group, the ORs (95% CIs) of diverticulitis were 2.86 (1.05–7.79) and 2.98 (0.95–9.35) in the overweight and obese groups, respectively, after adjusting for possible confounders and CRF. Compared with the “unfit and overweight/obese” group in the joint analysis, the OR (95% CI) of diverticulitis was 0.16 (0.04–0.61) in the “fit and normal-weight” group. Older adults who maintain higher CRF and lower BMI may have significantly lower odds of diverticulitis, with the lowest odds found in the normal-weight and fit older adults.

Cerebral hemodynamics and pulsatility are important mechanisms of cerebrovascular and brain health. Cardiorespiratory fitness may improve cerebrovascular pulsatility in healthy females, but not in males. Whether cardiovascular disease (CVD) risk factors modify sex-specific associations of fitness with cerebral hemodynamics and vascular contributors to cerebral hemodynamics is unknown. We assessed V̇o_2peak and cerebrovascular hemodynamics in 157 adults without (42 ± 13 yr, BMI 24.5 ± 2.7 kg/m²), and 66 adults with modifiable CVD risk factors (54 ± 8 yr, BMI 29.9 ± 4.0 kg/m²). Intracranial [middle cerebral artery (MCA) pulsatility index (PI), mean velocity, conductance, and pulsatile damping] and extracranial hemodynamics [carotid artery wave transmission/reflection, PI, pulse wave velocity (PWV)-β, and carotid-femoral PWV] were assessed via transcranial Doppler/ultrasound and tonometry. Cardiorespiratory fitness was assessed via V̇o_2peak during an incremental exercise test. Multiple regression was used to assess contributions of V̇o_2peak to cerebrovascular outcomes after adjustment for relevant covariates. V̇o_2peak was inversely associated with MCA PI among females (β = −0.39, P = 0.01) but not males (β = −0.16, P = 0.25) without CVD risk factors. V̇o_2peak was positively associated with MCA PI among females (β = 0.44, P = 0.01) and not associated in males with CVD risk factors (β = −0.06, P = 0.079). V̇o_2peak was beneficially associated with vascular contributors to cerebral hemodynamics but had sex-specific associations with carotid stiffness and pulse pressure in females without CVD risk factors only. These results suggest that sex-specific associations between fitness and cerebral pulsatility among females without CVD risk factors may relate to the differential effects of fitness on carotid stiffness and pulse pressure. In addition, the presence of modifiable CVD risk factors may influence the protective relations of fitness on cerebrovascular hemodynamics. NEW & NOTEWORTHY We identify beneficial associations between cardiorespiratory fitness and lower carotid stiffness and pulse pressure as potential mechanisms underlying sex-specific associations of fitness and cerebral pulsatility in females without modifiable risk factors. Greater fitness is beneficially associated with conductance, pulsatile damping, and forward wave energy among adults without risk factors; however, associations are attenuated among adults with modifiable risk factors. These data suggest sex and risk factors may alter cerebrovascular sensitivity to cardiorespiratory fitness.