The Clinical Utility of Resistance Training for Improving Cardiovascular Disease Risk in Post-Menopausal Women
Condition: Cardiovascular Risk Factor; Menopause Related Conditions; Neuromuscular Function; Aerobic Capacity; Inflammation
MeSH terms: Cardiovascular Diseases; Inflammation
Study type: Interventional

Summary: 
      Given the heightened cardiovascular disease (CVD) risk in post-menopausal women, studies are
      needed to explore novel, feasible methods for reducing risk in this population. Based on
      prior data, primarily in other populations, progressive resistance training is a promising
      candidate. This project will test the effectiveness of a practical, progressive resistance
      training regimen for lowering numerous CVD risk factors compared to both aerobic training and
      no exercise in post-menopausal women.
    

Detailed description: 
      The number of women living with cardiovascular disease (CVD) is greater than for men and CVD
      is the leading cause of death for women. Post-menopausal women are a particularly vulnerable
      population in terms of adverse cardiovascular indicators and outcomes. Specifically, they
      exhibit greater visceral adipose tissue, fasting and postprandial glucose, total cholesterol
      (Total-C), fasting insulin, and systolic blood pressure, and are at increased risk for
      coronary heart disease compared to pre-menopausal women. There is also evidence that
      cardiovascular indicators (i.e., triglycerides, low high-density lipoprotein cholesterol
      (HDL-C), etc) are stronger risk predictors in women than men. Despite the staggering rates of
      CVD in post-menopausal women, as noted by the American Heart Association (AHA), CVD remains
      understudied in this population. Numerous studies have demonstrated the cardioprotective
      effects of exercise. However, these studies have largely featured younger individuals,
      primarily men, undergoing aerobic exercise training. Findings in recent years have indicated
      the potential benefits of resistance training beyond improving muscular size or strength,
      such as improved aerobic fitness, central adiposity, glycemic control, and cholesterol
      profiles. However, large clinical gaps have been noted for women with regard to the effects
      of resistance training on cardiovascular health. Thus, there is a clear need to assess the
      cardioprotective effects of progressive exercise training in post-menopausal women.

      SPECIFIC AIMS:

        1. To test the hypothesis that realistic full-body progressive resistance training improves
           markers of (a) cardiovascular health and (b) body composition and muscular health in
           post-menopausal women versus a low physical-activity control.

           A. The primary markers of cardiovascular health to be assessed are aerobic capacity,
           fasting and postprandial metabolic and inflammatory responses, vascular function via
           flow-mediated dilation (FMD) and markers of angiogenesis.

           B. The primary body composition and muscle function variables to be assessed are muscle
           size, isometric and dynamic muscle strength, lean body mass, percent body fat, and
           abdominal adiposity.

        2. To compare the effects of realistic, full-body progressive resistance training in
           post-menopausal women versus moderate-intensity aerobic exercise, the standard exercise
           prescription for cardiovascular health, on the cardiovascular, body composition, and
           muscular health outcomes listed above in 1A. and B.
    

Intervention name(s): Resistance Exercise; Aerobic Exercise
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Women assigned to the resistance exercise training group will complete progressive, full-body resistance exercise 3 times per week for 16 weeks.; Women assigned to the aerobic exercise training group will complete progressive, aerobic exercise 5 times per week for 16 weeks. The aerobic training will progress first in duration, and then in intensity.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Following enrollment, participants will complete familiarization and be randomly assigned to an aerobic training (AT; n = 20), a resistance training (RT; n = 20), or a control (CON; n = 20) group.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: post-menopause; women; post-prandial; metabolic function; cardiovascular function; muscle; body composition; angiogenesis