None listed
Conditions
Brief summary
Cardiovascular disease (CVD) is a significant health and life-threatening chronic disease in New Zealand women. CVD is associated with a diminished exercise capacity, which is particularly profound in women. A low exercise capacity has severe clinical consequences as it is strongly associated with the development of chronic disease (heart failure, stroke, obesity, some forms of cancer), and cardiovascular-related and all-cause mortality. Although women with CVD have a high risk of poor clinical outcomes, there has been scarce research examining cardiovascular function in this patient population. Regular exercise increases exercise capacity and cardiovascular function in healthy young adults. Young and older healthy females demonstrate a blunted cardiovascular adaptation to dynamic (endurance) exercise training compared to their male peers. Despite evidence that suggests that women have a unique response to dynamic exercise training, there is very limited data comprehensively describing the cardiovascular adaptations to exercise training in late middle-aged and older women with and without CVD. Understanding how women with CVD respond to exercise training has important implications for prescribing exercise programmes to women in cardiac rehabilitation to achieve optimal health outcomes. Thus, the global objective of this study is to examine the effects of CVD and dynamic (endurance) exercise training on cardiovascular function and circulatory control in late middle-aged and older (50-80 yr) women. Secondary outcomes include physical activity levels and physical and health-related quality of life. A comprehensive array of physiological measurements will be collected to examine the effects of CVD and a 16-week exercise-based intervention on cardiac and blood vessel function. This testing will include sub-maximal and maximal exercise testing, and resting and exercise cardiac and vascular function measurements. There are two main hypotheses attached to this project; Hypothesis 1: It is hypothesized that women with CVD will have a markedly impaired exercise capacity, cardiovascular function during exercise, quality of life and physical activity levels compared to aged-similar healthy controls. Hypothesis 2: It is hypothesized that four-months of dynamic exercise training will improve exercise capacity, cardiovascular function during exercise, quality of life and physical activity levels in women with CVD.
Interventions
Women aged 50-80 years with and without cardiovascular disease will perform a 16-week supervised, group-based dynamic endurance exercise programme. The exercise prescription will be individualised and we aim to keep the training flexible and alter mode, duration or intensity if necessary (e.g. to suit fitness level or any limitations to particular modes of exercise).
The programme includes a combination of cycling, rowing and walking/jogging exercise. During the first 4 weeks, exercise prescrip
Women aged 50-80 years with and without cardiovascular disease will perform a 16-week supervised, group-based dynamic endurance exercise programme. The exercise prescription will be individualised and we aim to keep the training flexible and alter mode, duration or intensity if necessary (e.g. to suit fitness level or any limitations to particular modes of exercise). The programme includes a combination of cycling, rowing and walking/jogging exercise. During the first 4 weeks, exercise prescription will include 3 moderate-intensity (50-75% of VO2peak) continuous exercise sessions with a duration of 45 minutes. Once tolerated (generally within the first 4 weeks), exercise duration will be increased to 60 minutes for the remainder of the intervention. At week 4 and 8, a moderate intensity continuous training session will be substituted for an interval type session. Following a 10 minute moderate intensity warm-up, the participant will perform two minutes of vigorous-intensity (80-95% VO2peak) exercise followed by three minutes of active recovery (40-60%VO2 peak). This work-recovery protocol will be repeated five times. Exercise sessions will be supervised by exercise physiologists. A strategy to promote adherence to the exercise programme will be implemented. Researchers will stay in contact with participants throughout the exercise programme and exercise sessions will be monitored when changes are made to the programme, or as requested by the participant. Participants will be encouraged to contact the researchers if they have any queries or concerns about their exercise programme, and we aim to keep the programme flexible and individualised. Heart rate will be monitored during all exercise sessions using a provided Polar heart rate monitor and watch. This data will be used to quantify exercise training volume and adherence to the exercise programme.
Sponsors
The University of Auckland
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
50 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
Cardiovascular disease cohort Women aged 50-80 years Have had a documented prior event or surgical intervention associated with coronary heart disease including but not limited to myocardial infarction, percutaneous coronary intervention and/or coronary artery bypass graft. Performing less than 150 minutes per week of moderate-intensity dynamic exercise over the prior 6 months. Healthy control (without cardiovascular disease) cohort. Women aged 50-80 years Performing less than 150 minutes per week of moderate-intensity dynamic exercise over the prior 6 months.
Exclusion criteria
Heart failure Significant cardiac arrhythmia or severe valvular disease Cerebrovascular disease (as evidenced by previous stroke or transient ischemic attack) Severe obesity (BMI>40kg/m2) High levels of frailty (assessed by clinical frailty scale) Chronic obstructive pulmonary disease Renal disease Recent (<4 wk) hospital admission with a cardiac event
Outcome results
None listed