Impact of acute and chronic regular exercise on arterial stiffness and reflection measures in coronary artery disease patients

Cardiovascular disease (CVD) is predicted as theleading cause of death worldwide until 2030 with measures for early detectionand progress monitoring essential to manage the condition and its associatedhealth costs. In the developed world, much progress has alreadybeen made in the fight against heart disease. However, death ratedue to cardiovascular diseases continuously increasing in the developing partof the world since last 50 years.  InIndia, many studies had reported soar in the cardiovascular disease incomparison to last 60 years from 1% to 9-10% in urban areas and <1% to 4%-6%in rural locations. Further, coronary heart disease is still theleading cause-of-death for both men and women in India. In contrast to 1990,mortality among men and women has raised by 31% and 13% in 2015. For men and women, coronary heart disease is listed at number one, followed bypulmonary disorders and cancer respectively. Vascular stiffness dueto arteriosclerosis may reduce arterial elasticity which is as an independent, non-invasive predictor of future incidence of coronary heart disease, stroke, andmortality. Further, greater vascular stiffness has been considered asone of the leading signs of vascular damage leading to CVD. 

This current project willdetermine the acute and chronic effects of 8-weeks of aerobic, resistance andcombined exercise on arterial hemodynamic function (i.e. PWV, AIx) in thosewith coronary artery disease.

AIMS

1.     Toexamine the impact of acute aerobic exercise on arterial stiffness measures inpatients with CAD;

2.     Toexamine the impact of chronic exercise training on resting and post-exercise arterialstiffness measures in patients with CAD;

3.     Toidentify the mechanisms (e.g. blood pressure, heart rate, NO availability,endothelial function) by which acute/chronic aerobic exercise alters arterialstiffness in patients with CAD;

EXPECTED RESEARCH CONTRIBUTION

Our research will help to identify whether long term exercise canbeneficially modify hemodynamic profile especially PVW and AIx in subjects withCAD. In addition, it will investigate the mechanisms for such benefits toimprove CVD risk for patients with CAD.

This study will be a prospective,single-blind, randomised controlled study examining the effects of exercise onarterial stiffness. Patients with CAD (n=60-80; 15-20 per group) will berandomised to one of four treatment groups (aerobic exercise, resistance exercise,combined aerobic and resistance exercise, and no exercise).  The three exercise groups will undertake 8weeks of supervised training, three times a week in accordance with recommendedguidelines (ACSM). The non-exercise groups will undertake no exercise training.