Clinical trial NCT04013022: Exercise Pressor Reflex and Lifelong Training
Official title: The Effects of Lifelong Endurance and Strength Training on the Central and Peripheral Cardiovascular Responses
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Healthy Aging
Cardiovascular Risk Factor
Keywords: Exercise Pressor Reflex
Metaboreflex
Mechanoreflex
Lifelong exercise training
Lead sponsor: Universita di Verona
Sponsor class: OTHER
First posted: 2019-07-09
Enrollment: 48
Sex: MALE
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_CONTROL
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Healthy population from different age groups and different exercise training history

Brief summary: Cardiovascular diseases represent the first mortality cause in the world. Ageing is considered as the most prominent risk factor for this kind of diseases. Also, hypertension represents one of the modifiable risk factors. Blood pressure response to exercise is governed by three systems: central command, baroreflex, and a feedback mechanism originating in the skeletal muscle. An abnormal cardiovascular response to exercise facilitates the occurrence of cardiovascular events. The goal of the study is to characterize the cardiovascular response in lifelong trained individuals and explore the potential benefits of endurance and strength training on cardiovascular regulation to exercise onset.

Detailed description: Population ageing represents a problem both for health outcomes and for social dynamics in the social welfare states. Currently, the over 60 represents the fastest growing segment of the population. Despite a downward trend in the incidence of cardiovascular diseases, they remain the main culprits for what concern mortality rates in the world. Increasing age is considered the major risk factor for cardiovascular mortality.

One of the main components of the cardiovascular response to exercise is dictated by the exercise pressor reflex originating in the exercising muscle and responding to metabolic and mechanical stimuli. Research indicates that at least 20% of the regulation of blood pressure could be ascribed to these cardiovascular reflexes. A dysfunctional reflex-mediated response increases the chances of cardiovascular events that may end up in severe consequences.

Chronic exercise training is recognized to be an important tool to control blood pressure. The mechanisms through which exercise exerts its effect are multiple. Among these, an improvement of the neural control of the reflex originating in the muscle seems a likely contributor. However, at present, the effect of chronic exercise training on the EPR response in the elderly has not been elucidated. The aim of the study is to characterize the central and peripheral cardiovascular response in the lifelong endurance and strength trained elders population.

Eligibility criteria: Inclusion Criteria

General:

* Young: 18 - 30, males, non smokers
* Old Sedentary: 65 -75, males, non smokers
* Old Endurance Trained: 65 -75, males, non smokers
* Old Strength Trained: 65 - 75, males, non smokers

Exercise history (different for each group):

* Young: ≤ 5 h/week
* Old Sedentary: ≤ 2h/week
* Old Endurance Trained: ≥ 5 h/week, ≥ 30 years of practice, ≥ 4 sessions/week
* Old Strength Trained: ≥ 5 h/week, ≥ 30 years of practice, ≥ 4 sessions/week

Exclusion Criteria:

* History of cardiovascular events/diseases
* Respiratory, musculoskeletal, renal, and insulin-resistant diseases
* Hypercholesterolemia
* Use of beta-blockers
* BMI ≥ 30

Primary outcomes:
measure: Mean Arterial Blood Pressure (MAP)
timeFrame: 1 week after recruitment of the subject - We will measure the changes from baseline to the steady state response ( average of 3rd minute)
measure: Heart Rate (HR)
timeFrame: 1 week after recruitment of the subject - We will measure the change from baseline to peak (peak response in HR due to PLM)
measure: Muscle Sympathetic Nerve Activity - Microneurography
timeFrame: 1 week after recruitment - We will measure the change from baseline to mean value (during stimulation)
Secondary outcomes:
measure: Muscle oxidative capacity in vivo / blood pressure response
timeFrame: 10 days after recruitment - Cross-sectional comparison at one time point only
Other outcomes:
Locations:
city: Verona
country: Italy
facility: University of Verona
Study officials:
affiliation: Universita di Verona
name: Massimo Venturelli, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Milia R, Roberto S, Mulliri G, Loi A, Marcelli M, Sainas G, Milia N, Marongiu E, Crisafulli A. Effect of aging on hemodynamic response to metaboreflex activation. Eur J Appl Physiol. 2015 Aug;115(8):1693-703. doi: 10.1007/s00421-015-3153-5. Epub 2015 Mar 24.
citation: Groot HJ, Rossman MJ, Garten RS, Wang E, Hoff J, Helgerud J, Richardson RS. The Effect of Physical Activity on Passive Leg Movement-Induced Vasodilation with Age. Med Sci Sports Exerc. 2016 Aug;48(8):1548-57. doi: 10.1249/MSS.0000000000000936.
citation: Boushel R. Muscle metaboreflex control of the circulation during exercise. Acta Physiol (Oxf). 2010 Aug;199(4):367-83. doi: 10.1111/j.1748-1716.2010.02133.x. Epub 2010 Mar 27.
citation: Murphy MN, Mizuno M, Mitchell JH, Smith SA. Cardiovascular regulation by skeletal muscle reflexes in health and disease. Am J Physiol Heart Circ Physiol. 2011 Oct;301(4):H1191-204. doi: 10.1152/ajpheart.00208.2011. Epub 2011 Aug 12.
citation: Markel TA, Daley JC 3rd, Hogeman CS, Herr MD, Khan MH, Gray KS, Kunselman AR, Sinoway LI. Aging and the exercise pressor reflex in humans. Circulation. 2003 Feb 11;107(5):675-8. doi: 10.1161/01.cir.0000055190.81716.ab.