Skip to main content
Top
Published in: BMC Cardiovascular Disorders 1/2019

Open Access 01-12-2019 | Type 2 Diabetes | Research article

Acute effect of healthy walking on arterial stiffness in patients with type 2 diabetes and differences by age and sex: a pre-post intervention study

Authors: Rosario Alonso-Domínguez, José I. Recio-Rodríguez, Maria C. Patino-Alonso, Natalia Sánchez-Aguadero, Luis García-Ortiz, Manuel A. Gómez-Marcos

Published in: BMC Cardiovascular Disorders | Issue 1/2019

Login to get access

Abstract

Background

Daily aerobic exercise such as healthy walking could have an immediate effect on parameters of arterial stiffness; however, there is little evidence in the diabetic population. Our aim, therefore, is to evaluate the association between healthy walking and acute effects on the parameters of arterial stiffness in subjects with type 2 diabetes.

Methods

The Effectiveness of a multifactorial intervention in diabetics study (EMID), is a study based on an application for smartphones, healthy walking and a nutritional workshop in patients with type 2 diabetes in primary care, is a randomized controlled trial of two parallel groups. This is a subanalysis of the intervention group to evaluate the response to the healthy walking according to age and sex, in 89 subjects with type 2 diabetes, aged between 40 and 70 years. The intervention was a 4 km of a healthy walking at low-moderate intensity. To value our aim, the main study variables were measured before and after it.

Results

The study population had an average age of 65.0 years (61.2–68.1). After the healthy walking, there was a decrease in the parameters of arterial stiffness: Cardio ankle vascular index (CAVI) of − 0.2 (95%CI:-0.4 to − 0.1) and pulse pressure (PP) of the lower extremities of − 3.9 mmHg (95%CI: -5.9 to − 2.0). Furthermore, in the lower extremities there was a decrease in systolic blood pressure of − 5.3 mmHg (95% CI: -7.3 mmHg to − 3.3 mmHg), in diastolic blood pressure of − 1.5 mmHg (95% CI: -2.6 mmHg to − 0.4 mmHg) (p < 0.05 for all). It is observed that males have an OR of 2.981 (IC = 95% 1.095 to 8.119) to achieve a reduction in the CAVI (p < 0.05) and an OR of 2.433 (95%CI: 0.871 to 6.794) in the ankle PP (p > 0.05), compared with females.

Conclusions

The findings of this study suggest that daily aerobic exercise at a low to moderate intensity, such as healthy walking, has an immediate beneficial effect on the cardio-ankle vascular index, especially in males.

Trial registration

ClinicalTrials.gov identifier: NCT02991079.
Literature
1.
go back to reference Olokoba AB, Obateru OA, Olokoba LB. Type 2 diabetes mellitus: a review of current trends. Oman Med J. 2012;27(4):269–73.CrossRef Olokoba AB, Obateru OA, Olokoba LB. Type 2 diabetes mellitus: a review of current trends. Oman Med J. 2012;27(4):269–73.CrossRef
2.
go back to reference Spinetti G, Kraenkel N, Emanueli C, Madeddu P. Diabetes and vessel wall remodelling: from mechanistic insights to regenerative therapies. Cardiovasc Res. 2008;78(2):265–73.CrossRef Spinetti G, Kraenkel N, Emanueli C, Madeddu P. Diabetes and vessel wall remodelling: from mechanistic insights to regenerative therapies. Cardiovasc Res. 2008;78(2):265–73.CrossRef
3.
go back to reference Shiroma EJ, Lee IM. Physical activity and cardiovascular health: lessons learned from epidemiological studies across age, gender, and race/ethnicity. Circulation. 2010;122(7):743–52.CrossRef Shiroma EJ, Lee IM. Physical activity and cardiovascular health: lessons learned from epidemiological studies across age, gender, and race/ethnicity. Circulation. 2010;122(7):743–52.CrossRef
4.
go back to reference Taylor BA, Zaleski AL, Capizzi JA, Ballard KD, Troyanos C, Baggish AL, et al. Influence of chronic exercise on carotid atherosclerosis in marathon runners. BMJ Open. 2014;4(2):e004498.CrossRef Taylor BA, Zaleski AL, Capizzi JA, Ballard KD, Troyanos C, Baggish AL, et al. Influence of chronic exercise on carotid atherosclerosis in marathon runners. BMJ Open. 2014;4(2):e004498.CrossRef
5.
go back to reference de Lade CG, Marins JC, Lima LM, de Carvalho CJ, Teixeira RB, Albuquerque MR et al. Effects of different exercise programs and minimal detectable changes in hemoglobin A1c in patients with type 2 diabetes. Diabetol Metabol Syndrome. 2016;8:13. de Lade CG, Marins JC, Lima LM, de Carvalho CJ, Teixeira RB, Albuquerque MR et al. Effects of different exercise programs and minimal detectable changes in hemoglobin A1c in patients with type 2 diabetes. Diabetol Metabol Syndrome. 2016;8:13.
6.
go back to reference Liu S, Goodman J, Nolan R, Lacombe S, Thomas SG. Blood pressure responses to acute and chronic exercise are related in prehypertension. Med Sci Sports Exerc. 2012;44(9):1644–52.CrossRef Liu S, Goodman J, Nolan R, Lacombe S, Thomas SG. Blood pressure responses to acute and chronic exercise are related in prehypertension. Med Sci Sports Exerc. 2012;44(9):1644–52.CrossRef
7.
go back to reference DeVan AE, Anton MM, Cook JN, Neidre DB, Cortez-Cooper MY, Tanaka H. Acute effects of resistance exercise on arterial compliance. J Appl Physiol (Bethesda, Md: 1985). 2005;98(6):2287–91.CrossRef DeVan AE, Anton MM, Cook JN, Neidre DB, Cortez-Cooper MY, Tanaka H. Acute effects of resistance exercise on arterial compliance. J Appl Physiol (Bethesda, Md: 1985). 2005;98(6):2287–91.CrossRef
8.
go back to reference Tabara Y, Yuasa T, Oshiumi A, Kobayashi T, Miyawaki Y, Miki T, et al. Effect of acute and long-term aerobic exercise on arterial stiffness in the elderly. Hypertens Res. 2007;30(10):895–902.CrossRef Tabara Y, Yuasa T, Oshiumi A, Kobayashi T, Miyawaki Y, Miki T, et al. Effect of acute and long-term aerobic exercise on arterial stiffness in the elderly. Hypertens Res. 2007;30(10):895–902.CrossRef
9.
go back to reference Wang H, Zhang T, Zhu W, Wu H, Yan S. Acute effects of continuous and interval low-intensity exercise on arterial stiffness in healthy young men. Eur J Appl Physiol. 2014;114(7):1385–92.CrossRef Wang H, Zhang T, Zhu W, Wu H, Yan S. Acute effects of continuous and interval low-intensity exercise on arterial stiffness in healthy young men. Eur J Appl Physiol. 2014;114(7):1385–92.CrossRef
10.
go back to reference Ibata J, Sasaki H, Kakimoto T, Matsuno S, Nakatani M, Kobayashi M, et al. Cardio-ankle vascular index measures arterial wall stiffness independent of blood pressure. Diabetes Res Clin Pract. 2008;80(2):265–70.CrossRef Ibata J, Sasaki H, Kakimoto T, Matsuno S, Nakatani M, Kobayashi M, et al. Cardio-ankle vascular index measures arterial wall stiffness independent of blood pressure. Diabetes Res Clin Pract. 2008;80(2):265–70.CrossRef
11.
go back to reference Carpio-Rivera E, Moncada-Jimenez J, Salazar-Rojas W, Solera-Herrera A. Acute effects of exercise on blood pressure: a meta-analytic investigation. Arq Bras Cardiol. 2016;106(5):422–33.PubMedPubMedCentral Carpio-Rivera E, Moncada-Jimenez J, Salazar-Rojas W, Solera-Herrera A. Acute effects of exercise on blood pressure: a meta-analytic investigation. Arq Bras Cardiol. 2016;106(5):422–33.PubMedPubMedCentral
12.
go back to reference Nickel KJ, Acree LS, Gardner AW. Effects of a single bout of exercise on arterial compliance in older adults. Angiology. 2011;62(1):33–7.CrossRef Nickel KJ, Acree LS, Gardner AW. Effects of a single bout of exercise on arterial compliance in older adults. Angiology. 2011;62(1):33–7.CrossRef
13.
go back to reference Tibana RA, Pereira GB, Navalta JW, Bottaro M, Prestes J. Acute effects of resistance exercise on 24-h blood pressure in middle aged overweight and obese women. Int J Sports Med. 2013;34(5):460–4.PubMed Tibana RA, Pereira GB, Navalta JW, Bottaro M, Prestes J. Acute effects of resistance exercise on 24-h blood pressure in middle aged overweight and obese women. Int J Sports Med. 2013;34(5):460–4.PubMed
14.
go back to reference Ciolac EG, Guimaraes GV, VM DA, Bortolotto LA, Doria EL, Bocchi EA. Acute effects of continuous and interval aerobic exercise on 24-h ambulatory blood pressure in long-term treated hypertensive patients. Int J Cardiol. 2009;133(3):381–7.CrossRef Ciolac EG, Guimaraes GV, VM DA, Bortolotto LA, Doria EL, Bocchi EA. Acute effects of continuous and interval aerobic exercise on 24-h ambulatory blood pressure in long-term treated hypertensive patients. Int J Cardiol. 2009;133(3):381–7.CrossRef
15.
go back to reference Terblanche E, Millen AM. The magnitude and duration of post-exercise hypotension after land and water exercises. Eur J Appl Physiol. 2012;112(12):4111–8.CrossRef Terblanche E, Millen AM. The magnitude and duration of post-exercise hypotension after land and water exercises. Eur J Appl Physiol. 2012;112(12):4111–8.CrossRef
16.
go back to reference Alonso-Dominguez R, Gomez-Marcos MA, Patino-Alonso MC, Sanchez-Aguadero N, Agudo-Conde C, Castano-Sanchez C, et al. Effectiveness of a multifactorial intervention based on an application for smartphones, heart-healthy walks and a nutritional workshop in patients with type 2 diabetes mellitus in primary care (EMID): study protocol for a randomised controlled trial. BMJ Open. 2017;7(9):e016191.CrossRef Alonso-Dominguez R, Gomez-Marcos MA, Patino-Alonso MC, Sanchez-Aguadero N, Agudo-Conde C, Castano-Sanchez C, et al. Effectiveness of a multifactorial intervention based on an application for smartphones, heart-healthy walks and a nutritional workshop in patients with type 2 diabetes mellitus in primary care (EMID): study protocol for a randomised controlled trial. BMJ Open. 2017;7(9):e016191.CrossRef
17.
go back to reference Krader CG. American Diabetes Association. Diabetes clinical practice recommendations focus attention on individualization of care. Med Econ. 2014;91(16):22.PubMed Krader CG. American Diabetes Association. Diabetes clinical practice recommendations focus attention on individualization of care. Med Econ. 2014;91(16):22.PubMed
18.
go back to reference Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000;32(9 Suppl):S498–504.CrossRef Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000;32(9 Suppl):S498–504.CrossRef
19.
go back to reference Shirai K, Hiruta N, Song M, Kurosu T, Suzuki J, Tomaru T, et al. Cardio-ankle vascular index (CAVI) as a novel indicator of arterial stiffness: theory, evidence and perspectives. J Atheroscler Thromb. 2011;18(11):924–38.CrossRef Shirai K, Hiruta N, Song M, Kurosu T, Suzuki J, Tomaru T, et al. Cardio-ankle vascular index (CAVI) as a novel indicator of arterial stiffness: theory, evidence and perspectives. J Atheroscler Thromb. 2011;18(11):924–38.CrossRef
20.
go back to reference Shirai K, Utino J, Otsuka K, Takata M. A novel blood pressure-independent arterial wall stiffness parameter; cardio-ankle vascular index (CAVI). J Atheroscler Thromb. 2006;13(2):101–7.CrossRef Shirai K, Utino J, Otsuka K, Takata M. A novel blood pressure-independent arterial wall stiffness parameter; cardio-ankle vascular index (CAVI). J Atheroscler Thromb. 2006;13(2):101–7.CrossRef
21.
go back to reference Yamashina A, Tomiyama H, Takeda K, Tsuda H, Arai T, Hirose K, et al. Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res. 2002;25(3):359–64.CrossRef Yamashina A, Tomiyama H, Takeda K, Tsuda H, Arai T, Hirose K, et al. Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res. 2002;25(3):359–64.CrossRef
22.
go back to reference Hu H, Cui H, Han W, Ye L, Qiu W, Yang H, et al. A cutoff point for arterial stiffness using the cardio-ankle vascular index based on carotid arteriosclerosis. Hypertens Res. 2013;36(4):334–41.CrossRef Hu H, Cui H, Han W, Ye L, Qiu W, Yang H, et al. A cutoff point for arterial stiffness using the cardio-ankle vascular index based on carotid arteriosclerosis. Hypertens Res. 2013;36(4):334–41.CrossRef
23.
go back to reference Sun CK. Cardio-ankle vascular index (CAVI) as an indicator of arterial stiffness. Integr Blood Press Control. 2013;6:27–38.CrossRef Sun CK. Cardio-ankle vascular index (CAVI) as an indicator of arterial stiffness. Integr Blood Press Control. 2013;6:27–38.CrossRef
24.
go back to reference Gomez-Sanchez L, Garcia-Ortiz L, Patino-Alonso MC, Recio-Rodriguez JI, Frontera G, Ramos R, et al. The association between the cardio-ankle vascular index and other parameters of vascular structure and function in Caucasian adults: MARK study. J Atheroscler Thromb. 2015;22(9):901–11.CrossRef Gomez-Sanchez L, Garcia-Ortiz L, Patino-Alonso MC, Recio-Rodriguez JI, Frontera G, Ramos R, et al. The association between the cardio-ankle vascular index and other parameters of vascular structure and function in Caucasian adults: MARK study. J Atheroscler Thromb. 2015;22(9):901–11.CrossRef
25.
go back to reference Pfutzner A, Demircik F, Ramljak S, Pfutzner AH, Berti F, Scuffi C, et al. Evaluation of system accuracy of the GlucoMen LX Plus blood glucose monitoring system with reference to ISO 15197:2013. J Diabetes Sci Technol. 2015;10(2):618–9.CrossRef Pfutzner A, Demircik F, Ramljak S, Pfutzner AH, Berti F, Scuffi C, et al. Evaluation of system accuracy of the GlucoMen LX Plus blood glucose monitoring system with reference to ISO 15197:2013. J Diabetes Sci Technol. 2015;10(2):618–9.CrossRef
26.
go back to reference Salas-Salvado J, Rubio MA, Barbany M, Moreno B. SEEDO 2007 consensus for the evaluation of overweight and obesity and the establishment of therapeutic intervention criteria. Med Clin. 2007;128(5):184–96 quiz 181 p following 200.CrossRef Salas-Salvado J, Rubio MA, Barbany M, Moreno B. SEEDO 2007 consensus for the evaluation of overweight and obesity and the establishment of therapeutic intervention criteria. Med Clin. 2007;128(5):184–96 quiz 181 p following 200.CrossRef
27.
go back to reference Ashor AW, Lara J, Siervo M, Celis-Morales C, Mathers JC. Effects of exercise modalities on arterial stiffness and wave reflection: a systematic review and meta-analysis of randomized controlled trials. PLoS One. 2014;9(10):e110034.CrossRef Ashor AW, Lara J, Siervo M, Celis-Morales C, Mathers JC. Effects of exercise modalities on arterial stiffness and wave reflection: a systematic review and meta-analysis of randomized controlled trials. PLoS One. 2014;9(10):e110034.CrossRef
28.
go back to reference Madden KM, Lockhart C, Cuff D, Potter TF, Meneilly GS. Short-term aerobic exercise reduces arterial stiffness in older adults with type 2 diabetes, hypertension, and hypercholesterolemia. Diabetes Care. 2009;32(8):1531–5.CrossRef Madden KM, Lockhart C, Cuff D, Potter TF, Meneilly GS. Short-term aerobic exercise reduces arterial stiffness in older adults with type 2 diabetes, hypertension, and hypercholesterolemia. Diabetes Care. 2009;32(8):1531–5.CrossRef
29.
go back to reference Yokoyama H, Emoto M, Fujiwara S, Motoyama K, Morioka T, Koyama H, et al. Short-term aerobic exercise improves arterial stiffness in type 2 diabetes. Diabetes Res Clin Pract. 2004;65(2):85–93.CrossRef Yokoyama H, Emoto M, Fujiwara S, Motoyama K, Morioka T, Koyama H, et al. Short-term aerobic exercise improves arterial stiffness in type 2 diabetes. Diabetes Res Clin Pract. 2004;65(2):85–93.CrossRef
30.
go back to reference Mc Clean CM, Mc Laughlin J, Burke G, Murphy MH, Trinick T, Duly E, et al. The effect of acute aerobic exercise on pulse wave velocity and oxidative stress following postprandial hypertriglyceridemia in healthy men. Eur J Appl Physiol. 2007;100(2):225–34.CrossRef Mc Clean CM, Mc Laughlin J, Burke G, Murphy MH, Trinick T, Duly E, et al. The effect of acute aerobic exercise on pulse wave velocity and oxidative stress following postprandial hypertriglyceridemia in healthy men. Eur J Appl Physiol. 2007;100(2):225–34.CrossRef
31.
go back to reference Khalil RA. Sex hormones as potential modulators of vascular function in hypertension. Hypertension (Dallas, Tex: 1979). 2005;46(2):249–54.CrossRef Khalil RA. Sex hormones as potential modulators of vascular function in hypertension. Hypertension (Dallas, Tex: 1979). 2005;46(2):249–54.CrossRef
32.
go back to reference Mendelsohn ME. Protective effects of estrogen on the cardiovascular system. Am J Cardiol. 2002;89(12a):12E–7E discussion 17E-18E.CrossRef Mendelsohn ME. Protective effects of estrogen on the cardiovascular system. Am J Cardiol. 2002;89(12a):12E–7E discussion 17E-18E.CrossRef
33.
go back to reference Coutinho T. Arterial stiffness and its clinical implications in women. Can J Cardiol. 2014;30(7):756–64.CrossRef Coutinho T. Arterial stiffness and its clinical implications in women. Can J Cardiol. 2014;30(7):756–64.CrossRef
34.
go back to reference Choi SY, Oh BH, Bae Park J, Choi DJ, Rhee MY, Park S. Age-associated increase in arterial stiffness measured according to the cardio-ankle vascular index without blood pressure changes in healthy adults. J Atheroscler Thromb. 2013;20(12):911–23.CrossRef Choi SY, Oh BH, Bae Park J, Choi DJ, Rhee MY, Park S. Age-associated increase in arterial stiffness measured according to the cardio-ankle vascular index without blood pressure changes in healthy adults. J Atheroscler Thromb. 2013;20(12):911–23.CrossRef
35.
go back to reference Nishiwaki M, Kurobe K, Kiuchi A, Nakamura T, Matsumoto N. Sex differences in flexibility-arterial stiffness relationship and its application for diagnosis of arterial stiffening: a cross-sectional observational study. PLoS One. 2014;9(11):e113646.CrossRef Nishiwaki M, Kurobe K, Kiuchi A, Nakamura T, Matsumoto N. Sex differences in flexibility-arterial stiffness relationship and its application for diagnosis of arterial stiffening: a cross-sectional observational study. PLoS One. 2014;9(11):e113646.CrossRef
36.
go back to reference World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4.
Metadata
Title
Acute effect of healthy walking on arterial stiffness in patients with type 2 diabetes and differences by age and sex: a pre-post intervention study
Authors
Rosario Alonso-Domínguez
José I. Recio-Rodríguez
Maria C. Patino-Alonso
Natalia Sánchez-Aguadero
Luis García-Ortiz
Manuel A. Gómez-Marcos
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Type 2 Diabetes
Published in
BMC Cardiovascular Disorders / Issue 1/2019
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-019-1039-x

Other articles of this Issue 1/2019

BMC Cardiovascular Disorders 1/2019 Go to the issue