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Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Study protocol

Physical exercise, fitness and dietary pattern and their relationship with circadian blood pressure pattern, augmentation index and endothelial dysfunction biological markers: EVIDENT study protocol

Authors: Luis García-Ortiz, José I Recio-Rodríguez, Carlos Martín-Cantera, Alfredo Cabrejas-Sánchez, Amparo Gómez-Arranz, Natividad González-Viejo, Eguskiñe Iturregui-San Nicolás, Maria C Patino-Alonso, Manuel A Gómez-Marcos, the EVIDENT Group

Published in: BMC Public Health | Issue 1/2010

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Abstract

Background

Healthy lifestyles may help to delay arterial aging. The purpose of this study is to analyze the relationship of physical activity and dietary pattern to the circadian pattern of blood pressure, central and peripheral blood pressure, pulse wave velocity, carotid intima-media thickness and biological markers of endothelial dysfunction in active and sedentary individuals without arteriosclerotic disease.

Methods/Design

Design: A cross-sectional multicenter study with six research groups.
Subjects: From subjects of the PEPAF project cohort, in which 1,163 who were sedentary became active, 1,942 were sedentary and 2,346 were active. By stratified random sampling, 1,500 subjects will be included, 250 in each group.
Primary measurements: We will evaluate height, weight, abdominal circumference, clinical and ambulatory blood pressure with the Radial Pulse Wave Acquisition Device (BPro), central blood pressure and augmentation index with Pulse Wave Application Software (A-Pulse) and SphymgoCor System Px (Pulse Wave Analysis), pulse wave velocity (PWV) with SphymgoCor System Px (Pulse Wave Velocity), nutritional pattern with a food intake frequency questionnaire, physical activity with the 7-day PAR questionnaire and accelerometer (Actigraph GT3X), physical fitness with the cycle ergometer (PWC-170), carotid intima-media thickness by ultrasound (Micromax), and endothelial dysfunction biological markers (endoglin and osteoprotegerin).

Discussion

Determining that sustained physical activity and the change from sedentary to active as well as a healthy diet improve circadian pattern, arterial elasticity and carotid intima-media thickness may help to propose lifestyle intervention programs. These interventions could improve the cardiovascular risk profile in some parameters not routinely assessed with traditional risk scales. From the results of this study, interventional approaches could be obtained to delay vascular aging that combine physical exercise and diet.

Trial Registration

Clinical Trials.gov Identifier: NCT01083082
Literature
1.
Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, Pannier B, Vlachopoulos C, Wilkinson I, Struijker-Boudier H: Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006, 27 (21): 2588-2605. 10.1093/eurheartj/ehl254.CrossRefPubMed
2.
Shargorodsky M, Boaz M, Luckish A, Matas Z, Gavish D, Mashavi M: Osteoprotegerin as an independent marker of subclinical atherosclerosis in osteoporotic postmenopausal women. Atherosclerosis. 2009, 204 (2): 608-611. 10.1016/j.atherosclerosis.2008.10.024.CrossRefPubMed
3.
Tanaka H, Dinenno FA, Monahan KD, Clevenger CM, DeSouza CA, Seals DR: Aging, habitual exercise, and dynamic arterial compliance. Circulation. 2000, 102 (11): 1270-1275.CrossRefPubMed
4.
Garcia-Ortiz L, Gomez-Marcos MA, Martin-Moreiras J, Gonzalez-Elena LJ, Recio-Rodriguez JI, Castano-Sanchez Y, Grandes G, Martinez-Salgado C: Pulse pressure and nocturnal fall in blood pressure are predictors of vascular, cardiac and renal target organ damage in hypertensive patients (LOD-RISK study). Blood Press Monit. 2009, 14 (4): 145-151. 10.1097/MBP.0b013e32832e062f.CrossRefPubMed
5.
Dolan E, Stanton A, Thijs L, Hinedi K, Atkins N, McClory S, Den Hond E, McCormack P, Staessen JA, O'Brien E: Superiority of ambulatory over clinic blood pressure measurement in predicting mortality: the Dublin outcome study. Hypertension. 2005, 46 (1): 156-161. 10.1161/01.HYP.0000170138.56903.7a.CrossRefPubMed
6.
Fagard RH, Broeke Van Den C, De Cort P: Prognostic significance of blood pressure measured in the office, at home and during ambulatory monitoring in older patients in general practice. J Hum Hypertens. 2005, 19 (10): 801-807. 10.1038/sj.jhh.1001903.CrossRefPubMed
7.
Kikuya M, Ohkubo T, Asayama K, Metoki H, Obara T, Saito S, Hashimoto J, Totsune K, Hoshi H, Satoh H, et al: Ambulatory blood pressure and 10-year risk of cardiovascular and noncardiovascular mortality: the Ohasama study. Hypertension. 2005, 45 (2): 240-245. 10.1161/01.HYP.0000152079.04553.2c.CrossRefPubMed
8.
Sega R, Facchetti R, Bombelli M, Cesana G, Corrao G, Grassi G, Mancia G: Prognostic value of ambulatory and home blood pressures compared with office blood pressure in the general population: follow-up results from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study. Circulation. 2005, 111 (14): 1777-1783. 10.1161/01.CIR.0000160923.04524.5B.CrossRefPubMed
9.
Tatasciore A, Renda G, Zimarino M, Soccio M, Bilo G, Parati G, Schillaci G, De Caterina R: Awake systolic blood pressure variability correlates with target-organ damage in hypertensive subjects. Hypertension. 2007, 50 (2): 325-332. 10.1161/HYPERTENSIONAHA.107.090084.CrossRefPubMed
10.
Mattace-Raso FU, Cammen van der TJ, Hofman A, van Popele NM, Bos ML, Schalekamp MA, Asmar R, Reneman RS, Hoeks AP, Breteler MM, et al: Arterial stiffness and risk of coronary heart disease and stroke: the Rotterdam Study. Circulation. 2006, 113 (5): 657-663. 10.1161/CIRCULATIONAHA.105.555235.CrossRefPubMed
11.
Willum-Hansen T, Staessen JA, Torp-Pedersen C, Rasmussen S, Thijs L, Ibsen H, Jeppesen J: Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population. Circulation. 2006, 113 (5): 664-670. 10.1161/CIRCULATIONAHA.105.579342.CrossRefPubMed
12.
Roman MJ, Devereux RB, Kizer JR, Lee ET, Galloway JM, Ali T, Umans JG, Howard BV: Central pressure more strongly relates to vascular disease and outcome than does brachial pressure: the Strong Heart Study. Hypertension. 2007, 50 (1): 197-203. 10.1161/HYPERTENSIONAHA.107.089078.CrossRefPubMed
13.
Lacy PS, O'Brien DG, Stanley AG, Dewar MM, Swales PP, Williams B: Increased pulse wave velocity is not associated with elevated augmentation index in patients with diabetes. J Hypertens. 2004, 22 (10): 1937-1944. 10.1097/00004872-200410000-00016.CrossRefPubMed
14.
Sever PS, Dahlof B, Poulter NR, Wedel H, Beevers G, Caulfield M, Collins R, Kjeldsen SE, Kristinsson A, McInnes GT, et al: Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet. 2003, 361 (9364): 1149-1158. 10.1016/S0140-6736(03)12948-0.CrossRefPubMed
15.
Williams B, Lacy PS, Thom SM, Cruickshank K, Stanton A, Collier D, Hughes AD, Thurston H, O'Rourke M: Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation. 2006, 113 (9): 1213-1225. 10.1161/CIRCULATIONAHA.105.595496.CrossRefPubMed
16.
Galluzzi F, Stagi S, Salti R, Toni S, Piscitelli E, Simonini G, Falcini F, Chiarelli F: Osteoprotegerin serum levels in children with type 1 diabetes: a potential modulating role in bone status. Eur J Endocrinol. 2005, 153 (6): 879-885. 10.1530/eje.1.02052.CrossRefPubMed
17.
Knudsen ST, Foss CH, Poulsen PL, Andersen NH, Mogensen CE, Rasmussen LM: Increased plasma concentrations of osteoprotegerin in type 2 diabetic patients with microvascular complications. Eur J Endocrinol. 2003, 149 (1): 39-42. 10.1530/eje.0.1490039.CrossRefPubMed
18.
Vik A, Mathiesen EB, Noto AT, Sveinbjornsson B, Brox J, Hansen JB: Serum osteoprotegerin is inversely associated with carotid plaque echogenicity in humans. Atherosclerosis. 2007, 191 (1): 128-134. 10.1016/j.atherosclerosis.2006.03.002.CrossRefPubMed
19.
Arthur HM, Ure J, Smith AJ, Renforth G, Wilson DI, Torsney E, Charlton R, Parums DV, Jowett T, Marchuk DA, et al: Endoglin, an ancillary TGFbeta receptor, is required for extraembryonic angiogenesis and plays a key role in heart development. Dev Biol. 2000, 217 (1): 42-53. 10.1006/dbio.1999.9534.CrossRefPubMed
20.
Blair SN, Kohl HW, Barlow CE, Paffenbarger RS, Gibbons LW, Macera CA: Changes in physical fitness and all-cause mortality. A prospective study of healthy and unhealthy men. Jama. 1995, 273 (14): 1093-1098. 10.1001/jama.273.14.1093.CrossRefPubMed
21.
Gulati M, Pandey DK, Arnsdorf MF, Lauderdale DS, Thisted RA, Wicklund RH, Al-Hani AJ, Black HR: Exercise capacity and the risk of death in women: the St James Women Take Heart Project. Circulation. 2003, 108 (13): 1554-1559. 10.1161/01.CIR.0000091080.57509.E9.CrossRefPubMed
22.
Varo Cenarruzabeitia JJ, Martinez Hernandez JA, Martinez-Gonzalez MA: [Benefits of physical activity and harms of inactivity]. Med Clin (Barc). 2003, 121 (17): 665-672. 10.1157/13054307.CrossRef
23.
Galetta F, Franzoni F, Plantinga Y, Ghiadoni L, Rossi M, Prattichizzo F, Carpi A, Taddei S, Santoro G: Ambulatory blood pressure monitoring and endothelium-dependent vasodilation in the elderly athletes. Biomed Pharmacother. 2006, 60 (8): 443-447. 10.1016/j.biopha.2006.07.013.CrossRefPubMed
24.
Park S, Jastremski CA, Wallace JP: Time of day for exercise on blood pressure reduction in dipping and nondipping hypertension. J Hum Hypertens. 2005, 19 (8): 597-605. 10.1038/sj.jhh.1001901.CrossRefPubMed
25.
Vaitkevicius PV, Fleg JL, Engel JH, O'Connor FC, Wright JG, Lakatta LE, Yin FC, Lakatta EG: Effects of age and aerobic capacity on arterial stiffness in healthy adults. Circulation. 1993, 88 (4 Pt 1): 1456-1462.CrossRefPubMed
26.
Lakka TA, Laukkanen JA, Rauramaa R, Salonen R, Lakka HM, Kaplan GA, Salonen JT: Cardiorespiratory fitness and the progression of carotid atherosclerosis in middle-aged men. Ann Intern Med. 2001, 134 (1): 12-20.CrossRefPubMed
27.
Tanaka H, DeSouza CA, Seals DR: Absence of age-related increase in central arterial stiffness in physically active women. Arterioscler Thromb Vasc Biol. 1998, 18 (1): 127-132.CrossRefPubMed
28.
Ferrier KE, Waddell TK, Gatzka CD, Cameron JD, Dart AM, Kingwell BA: Aerobic exercise training does not modify large-artery compliance in isolated systolic hypertension. Hypertension. 2001, 38 (2): 222-226.CrossRefPubMed
29.
Miyachi M, Donato AJ, Yamamoto K, Takahashi K, Gates PE, Moreau KL, Tanaka H: Greater age-related reductions in central arterial compliance in resistance-trained men. Hypertension. 2003, 41 (1): 130-135. 10.1161/01.HYP.0000047649.62181.88.CrossRefPubMed
30.
Rakobowchuk M, McGowan CL, de Groot PC, Bruinsma D, Hartman JW, Phillips SM, MacDonald MJ: Effect of whole body resistance training on arterial compliance in young men. Exp Physiol. 2005, 90 (4): 645-651. 10.1113/expphysiol.2004.029504.CrossRefPubMed
31.
Kawano H, Tanaka H, Miyachi M: Resistance training and arterial compliance: keeping the benefits while minimizing the stiffening. J Hypertens. 2006, 24 (9): 1753-1759. 10.1097/01.hjh.0000242399.60838.14.CrossRefPubMed
32.
Seals DR, Desouza CA, Donato AJ, Tanaka H: Habitual exercise and arterial aging. J Appl Physiol. 2008, 105 (4): 1323-1332. 10.1152/japplphysiol.90553.2008.CrossRefPubMedPubMedCentral
33.
Hambrecht R, Fiehn E, Weigl C, Gielen S, Hamann C, Kaiser R, Yu J, Adams V, Niebauer J, Schuler G: Regular physical exercise corrects endothelial dysfunction and improves exercise capacity in patients with chronic heart failure. Circulation. 1998, 98 (24): 2709-2715.CrossRefPubMed
34.
Moe IT, Hoven H, Hetland EV, Rognmo O, Slordahl SA: Endothelial function in highly endurance-trained and sedentary, healthy young women. Vasc Med. 2005, 10 (2): 97-102. 10.1191/1358863x05vm592oa.CrossRefPubMed
35.
Cuevas AM, Germain AM: Diet and endothelial function. Biol Res. 2004, 37 (2): 225-230. 10.4067/S0716-97602004000200008.CrossRefPubMed
36.
Esposito K, Ciotola M, Giugliano D: Mediterranean diet, endothelial function and vascular inflammatory markers. Public Health Nutr. 2006, 9 (8A): 1073-1076. 10.1017/S1368980007668529.CrossRefPubMed
37.
Fuentes F, Lopez-Miranda J, Perez-Martinez P, Jimenez Y, Marin C, Gomez P, Fernandez JM, Caballero J, Delgado-Lista J, Perez-Jimenez F: Chronic effects of a high-fat diet enriched with virgin olive oil and a low-fat diet enriched with alpha-linolenic acid on postprandial endothelial function in healthy men. Br J Nutr. 2008, 100 (1): 159-165. 10.1017/S0007114508888708.CrossRefPubMed
38.
Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, Bray GA, Vogt TM, Cutler JA, Windhauser MM, et al: A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med. 1997, 336 (16): 1117-1124. 10.1056/NEJM199704173361601.CrossRefPubMed
39.
Estruch R, Martinez-Gonzalez MA, Corella D, Salas-Salvado J, Ruiz-Gutierrez V, Covas MI, Fiol M, Gomez-Gracia E, Lopez-Sabater MC, Vinyoles E, et al: Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. Ann Intern Med. 2006, 145 (1): 1-11.CrossRefPubMed
40.
Buil-Cosiales P, Irimia P, Berrade N, Garcia-Arellano A, Riverol M, Murie-Fernandez M, Martinez-Vila E, Martinez-Gonzalez MA, Serrano-Martinez M: Carotid intima-media thickness is inversely associated with olive oil consumption. Atherosclerosis. 2008, 196 (2): 742-748. 10.1016/j.atherosclerosis.2006.12.028.CrossRefPubMed
41.
Miyaki A, Maeda S, Yoshizawa M, Misono M, Saito Y, Sasai H, Endo T, Nakata Y, Tanaka K, Ajisaka R: Effect of weight reduction with dietary intervention on arterial distensibility and endothelial function in obese men. Angiology. 2008
42.
Grandes G, Sanchez A, Torcal J, Sanchez-Pinilla RO, Lizarraga K, Serra J: Targeting physical activity promotion in general practice: characteristics of inactive patients and willingness to change. BMC Public Health. 2008, 8: 172-10.1186/1471-2458-8-172.CrossRefPubMedPubMedCentral
43.
Grandes G, Sanchez A, Torcal J, Ortega Sanchez-Pinilla R, Lizarraga K, Serra J: [Protocol for the multi-centre evaluation of the Experimental Programme Promotion of Physical Activity (PEPAF)]. Aten Primaria. 2003, 32 (8): 475-480. 10.1157/13054004.CrossRefPubMed
44.
O'Brien E, Asmar R, Beilin L, Imai Y, Mancia G, Mengden T, Myers M, Padfield P, Palatini P, Parati G, et al: Practice guidelines of the European Society of Hypertension for clinic, ambulatory and self blood pressure measurement. J Hypertens. 2005, 23 (4): 697-701. 10.1097/01.hjh.0000163132.84890.c4.CrossRefPubMed
45.
Nair D, Tan SY, Gan HW, Lim SF, Tan J, Zhu M, Gao H, Chua NH, Peh WL, Mak KH: The use of ambulatory tonometric radial arterial wave capture to measure ambulatory blood pressure: the validation of a novel wrist-bound device in adults. J Hum Hypertens. 2008, 22 (3): 220-222. 10.1038/sj.jhh.1002306.CrossRefPubMed
46.
Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, Grassi G, Heagerty AM, Kjeldsen SE, Laurent S, et al: 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2007, 25 (6): 1105-1187. 10.1097/HJH.0b013e3281fc975a.CrossRefPubMed
47.
Touboul PJ, Hennerici MG, Meairs S, Adams H, Amarenco P, Bornstein N, Csiba L, Desvarieux M, Ebrahim S, Fatar M, et al: Mannheim carotid intima-media thickness consensus (2004-2006). An update on behalf of the Advisory Board of the 3rd and 4th Watching the Risk Symposium, 13th and 15th European Stroke Conferences, Mannheim, Germany, 2004, and Brussels, Belgium, 2006. Cerebrovasc Dis. 2007, 23 (1): 75-80. 10.1159/000097034.CrossRefPubMed
48.
Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, Hiratzka LF, Murphy WR, Olin JW, Puschett JB, et al: ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation. 2006, 113 (11): e463-654. 10.1161/CIRCULATIONAHA.106.174526.CrossRefPubMed
49.
Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A: Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007, 39 (8): 1423-1434. 10.1249/mss.0b013e3180616b27.CrossRefPubMed
50.
Melanson EL, Freedson PS: Validity of the Computer Science and Applications, Inc. (CSA) activity monitor. Med Sci Sports Exerc. 1995, 27 (6): 934-940.CrossRefPubMed
51.
Freedson PS, Melanson E, Sirard J: Calibration of the Computer Science and Applications, Inc. accelerometer. Med Sci Sports Exerc. 1998, 30 (5): 777-781. 10.1097/00005768-199805000-00021.CrossRefPubMed
52.
Martin-Moreno JM, Boyle P, Gorgojo L, Maisonneuve P, Fernandez-Rodriguez JC, Salvini S, Willett WC: Development and validation of a food frequency questionnaire in Spain. Int J Epidemiol. 1993, 22 (3): 512-519. 10.1093/ije/22.3.512.CrossRefPubMed
Metadata
Title
Physical exercise, fitness and dietary pattern and their relationship with circadian blood pressure pattern, augmentation index and endothelial dysfunction biological markers: EVIDENT study protocol
Authors
Luis García-Ortiz
José I Recio-Rodríguez
Carlos Martín-Cantera
Alfredo Cabrejas-Sánchez
Amparo Gómez-Arranz
Natividad González-Viejo
Eguskiñe Iturregui-San Nicolás
Maria C Patino-Alonso
Manuel A Gómez-Marcos
the EVIDENT Group
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-233

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