Although exercise has well-documented health benefits on cardiovascular disease (CVD), the benefit of combination exercise on CVD risk factors in individuals with elevated risk has not been fully elucidated. We compared the effects of aerobic, resistance, and a combination of both aerobic and resistance training on CVD risk factors including peripheral and central BP, cardiorespiratory fitness (CRF), muscular strength, body composition, blood glucose and lipids. Sixty-nine adults (58±7 years) with an elevated blood pressure or hypertension, overweight/obesity, and sedentary lifestyle were randomized to one of the three 8-week exercise programs or a non-exercise control group. Participants in all three exercise groups had an equal total exercise time, 3 days/week (aerobic: 60 minutes/session vs. resistance: 60 minutes/session vs. combination: aerobic 30 minutes/session plus resistance 30 minutes/session). Combined training provided significant reductions in peripheral (-4 mmHg) and central diastolic BP (-4 mmHg), increase in CRF (4.9 ml/kg/min), increase in upper (4 kg) and lower (11 kg) body strength, and increase in lean body mass (0.8 kg) (p <0.05). Aerobic training only increased CRF (7.7 ml/kg/min), and reduced body weight (-1.0 kg) and fat mass (-0.9 kg) (p <0.05). Resistance training only increased lower body strength (13 kg) and reduced waist circumference (-1.7 cm) (p 0.05). Furthermore, a composite score of CVD risk factors indicated a greater reduction with combination training compared to the control group. In conclusion, among individuals at an increased risk for CVD, as little as 8-weeks of combined training may provide more comprehensive CVD benefits compared to time-matched aerobic or resistance training alone.

This study evaluates whether a health club membership is associated with meeting the US physical activity (PA) guidelines and/or favorable cardiovascular health. Using cross-sectional data of health club members (n = 204) and non-members (n = 201) from April to August 2013, this is the first study to our knowledge to examine a health club membership in relation to objectively measured cardiovascular health indicators including resting blood pressure, resting heart rate, body mass index, waist circumference, and cardiorespiratory fitness based on a non-exercise test algorithm. To determine the total PA and sedentary time, this study used a comprehensive PA questionnaire about both aerobic and resistance activities at the health club, as well as lifestyle activities in other settings, which was developed based on the International Physical Activity Questionnaire (IPAQ). The odds ratios (95% confidence interval) of meeting either the aerobic, resistance, or both aerobic and resistance PA guidelines for members compared to non-members were 16.5 (9.8–27.6), 10.1 (6.2–16.3), and 13.8 (8.5–22.4), respectively. Significant associations of health club membership with more favorable cardiovascular health outcomes and sedentary behavior were observed for resting heart rate (B: -4.8 b/min, p<0.001), cardiorespiratory fitness (B: 2.1 ml/kg/min, p<0.001), and sedentary time (B: -1.4 hours, p1 year had more favorable health outcomes, with a smaller waist circumference (men, B: -4.0 cm, p = 0.04; women, B: -3.4 cm, p = 0.06), compared to non-members. Health club membership is associated with significantly increased aerobic and resistance physical activity levels and more favorable cardiovascular health outcomes compared to non-members. However, longitudinal, randomized controlled trials would be clearly warranted as cross-sectional data prohibits causal inferences.

To evaluate changes in arterial stiffness with positional change and whether the stiffness changes are due to hydrostatic pressure alone or if physiological changes in vasoconstriction of the conduit arteries play a role in the modulation of arterial stiffness. Thirty participants’ (male = 15, 24 ± 4 years) upper bodies were positioned at 0, 45, and 72° angles. Pulse wave velocity (PWV), cardio-ankle vascular index, carotid beta-stiffness index, carotid blood pressure (cBP), and carotid diameters were measured at each position. A gravitational height correction was determined using the vertical fluid column distance (mmHg) between the heart and carotid artery. Carotid beta-stiffness was calibrated using three methods: nonheight corrected cBP of each position, height corrected cBP of each position, and height corrected cBP of the supine position (theoretical model). Low frequency systolic blood pressure variability (LFSAP) was analyzed as a marker of sympathetic activity. PWV and cardio-ankle vascular index increased with position (P < 0.05). Carotid beta-stiffness did not increase if not corrected for hydrostatic pressure. Arterial stiffness indices based on Method 2 were not different from Method 3 (P = 0.65). LFSAP increased in more upright positions (P < 0.05) but diastolic diameter relative to diastolic pressure did not (P > 0.05). Arterial stiffness increases with a more upright body position. Carotid beta-stiffness needs to be calibrated accounting for hydrostatic effects of gravity if measured in a seated position. It is unclear why PWV increased as this increase was independent of blood pressure. No difference between Methods 2 and 3 presumably indicates that the beta-stiffness increases are only pressure dependent, despite the increase in vascular sympathetic modulation.

Individuals with intellectual disability have a high prevalence of obesity and low physical activity levels, which are risk factors for hypertension. This study estimated the prevalence of hypertension in a global data set of adults with intellectual disability participating in Special Olympics and investigated the role of physical activity and obesity in hypertension risk. A total of 33,122 individuals aged ≥18 years with intellectual disability who participated in Special Olympic events from 2014 to 2018 had their brachial blood pressure, BMI, and self-reported physical activity assessed. Hypertension was classified using 2017 American College of Cardiology/American Heart Association guidelines (systolic blood pressure≥130 mmHg and diastolic blood pressure≥80 mmHg). Data were analyzed in 2019. Participants were aged 31 (SD=11) years, 64% male, and had a resting blood pressure of 121 (SD=16)/76 (SD=12) mmHg. The population was 48% (95% CI=47.5%, 48.6%) hypertensive. Male participants had a higher prevalence of hypertension (50.7%, 95% CI=50.1%, 51.4%) than female participants (43.1%, 95% CI=42.2%, 44.0%), with prevalence increasing with age. Odds of hypertension increased when performing no or insufficient physical activity and with increasing obesity (p<0.01), tripling (OR=3.06, 3.66) for all individuals who performed no physical activity except for those of normal weight (OR=1.72), and doubling (OR=2.13-3.87) for individuals who were obese or morbidly obese across all physical activity levels. This study is the first to determine population-based prevalence rates of hypertension in individuals with intellectual disability. It highlights the similarity in prevalence to the general population. The results emphasize the importance of population-wide screening, increasing physical activity, and reducing obesity in decreasing cardiovascular risk in this population.

Whether the COVID-19 pandemic has long-lasting effects on physical activity (PA) and sedentary behavior in the vulnerable older adult population is uncertain. A total of 387 older adults (75 ± 6 years) completed a retrospective questionnaire on time spent sitting, walking, and performing aerobic and muscle-strengthening PA before, during the first three months, and one year into the COVID-19 pandemic. Whether the participants met the aerobic and muscle-strengthening PA guidelines was then determined. Of the 387 older adults, 376 (97%) were vaccinated. The participants completed 361 ± 426, 293 ± 400, and 454 ± 501 min/week of moderate-to-vigorous aerobic PA before, during the first three months, and one year into the pandemic, respectively. During the same time periods, the participants performed muscle-strengthening PA 87 ± 157, 68 ± 163, and 90 ± 176 min/week, walked 2.4 ± 1.7, 2.3 ± 1.7, and 2.6 ± 1.9 h/day, and sat 6.2 ± 2.9, 7.4 ± 3.1, and 6.1 ± 2.9 h/day, respectively. Aerobic PA, muscle-strengthening PA, and walking time decreased, whereas sitting time increased, during the first three months of the pandemic (p < 0.05), and then returned to pre-pandemic levels after one year (p < 0.05). The percentage of participants meeting both aerobic and muscle-strengthening PA guidelines decreased during the first three months of the pandemic (48.9% to 33.5%, p < 0.001), but returned to pre-pandemic levels one year later (p < 0.001). In conclusion, the COVID-19 pandemic significantly decreased PA and increased sitting time in older adults; however, both PA and sitting time returned to pre-pandemic levels after one year.

Reductions in cerebral blood flow and increases in flow pulsatility with aging are associated to cerebrovascular disease; however, little is known about how an acute hypertensive stimulus effects cerebral blood flow regulation in an aged population. Following the hypertensive stimulus, older adults elicit an attenuated increase in cerebral blood velocity and greater transmission of pulsatile velocity to the brain compared with young adults, demonstrating reduced cerebral blood flow regulation to elevated blood pressure responses with aging.