Cardiovascular Disease, Aging, Endothelial Dysfunction, Physical Activity
Conditions
Keywords
Aging, Cardiovascular disease, Endothelial function, Physical activity, Advanced Glycation Endproducts, AGE crosslink breakers
Brief summary
Healthy but sedentary aging leads to increased morbidity and mortality of cardiovascular disease. This is partly due to the accumulation of Advanced Glycation Endproducts (AGEs) and the stiffening of the myocardium and arteries. New medication has been developed to break these AGE-crosslinks to improve cardiovascular compliance. The positive influence of regular physical activity is well known for cardiovascular disease and aging. Therefore, what is the most effective intervention, physical exercise and/or new medication AGE-crosslink breakers, in improving the cardiovascular and cerebrovascular compliance and improving the endothelial function in healthy sedentary elderly.
Interventions
DRUGAlt-711
Alt-711, also known as Alagebrium, an AGE-crosslink breaker, will be given twice daily 100mg
BEHAVIORALPhysical exercise training
Exercise training will be given three times a week for 45 minutes per training session. The heart rate reserve will be slowly increased from 70% to 85%.
Sponsors
Dutch Heart Foundation
Synvista Therapeutics, Inc
Radboud University Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Healthy sedentary elderly * Age 65 yrs and older
Exclusion criteria
* Cardiovascular disease * Cerebrovascular disease * Changes on ECG indicating cardiomyopathy or ischemia * No cardiovascular medication * Diabetes Mellitus * Hypercholesterolemia * BMI \> 33 kg/m2 * Intensive exercise \> 1 hour a week
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Examine the combined effects of one year exercise training and the AGE-crosslink breaker Alagebrium on vascular endothelial function. | 0 and 12 months | At baseline and 12 months the endothelial function will be measured with an invasive vascular function measurement using the leg model. Via an arterial line in the common femoral artery acethylcholine, sodium nitroprusside and LNMMA will be infused at different dosages. Vascular response will be measured using venous occlusion plethysmography. Non-invasive vascular measurements, e.g.flow mediated dilation and pulse wave velocity, using ultrasound techniques will be performed at 0, 6 and 12 months. Also, cardiopulmonary fitness level will be tested at 0, 3, 6 and 12 months with an ergometer. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Examine the individual effects of one year exercise training and the AGE-crosslink breaker Alagebrium on vascular endothelial function. | 0 and 12 months | At baseline and 12 months the endothelial function will be measured with an invasive vascular function measurement using the leg model. Via an arterial line in the common femoral artery acethylcholine, sodium nitroprusside and LNMMA will be infused at different dosages. Vascular response will be measured using venous occlusion plethysmography. Non-invasive vascular measurements, e.g.flow mediated dilation and pulse wave velocity, using ultrasound techniques will be performed at 0, 6 and 12 months. Also, cardiopulmonary fitness level will be tested at 0, 3, 6 and 12 months with an ergometer. |
| Examine the combined effects of one year exercise training and the AGE-crosslink breaker Alagebrium on cardiac function. | 0, 6 and 12 months | An echocardiogram will be performed at baseline, 6 and 12 months. Measures such as strain, strain rate and myocardial velocity, together with the diastolic function parameters (e.g. E/A, S/D, and E/E' ratio) will be specifically evaluated. Also, the common measures such as wall thickness, volumes, etc, will be examined. |
| Examine the individual effects of one year exercise training and the AGE-crosslink breaker Alagebrium on cardiac function. | 0, 6 and 12 months | An echocardiogram will be performed at baseline, 6 and 12 months. Measures such as strain, strain rate and myocardial velocity, together with the diastolic function parameters (e.g. E/A, S/D, and E/E' ratio) will be specifically evaluated. Also, the common measures such as wall thickness, volumes, etc, will be examined. |
| Examine the combined effects of one year exercise training and the AGE-crosslink breaker Alagebrium on cerebral perfusion and cognitive function. | 0 and 12 months | A cerebral perfusion measurement will be performed at baseline and after 12 months with transcranial doppler, near infra-red spectroscopy and continuous beat to beat blood pressure monitoring using the Finameter during different posture maneuvers and hypo- and hypercapnia. Dynamic cerebral autoregulation and vasoreactivity will be examined. Cognitive function will be measured at baseline, 6 and 12 months using the CANTAB. |
| Examine the individual effects of one year exercise training and the AGE-crosslink breaker Alagebrium on cerebral perfusion and cognitive function. | 0 and 12 months | A cerebral perfusion measurement will be performed at baseline and after 12 months with transcranial doppler, near infra-red spectroscopy and continuous beat to beat blood pressure monitoring using the Finameter during different posture maneuvers and hypo- and hypercapnia. Dynamic cerebral autoregulation and vasoreactivity will be examined. Cognitive function will be measured at baseline, 6 and 12 months using the CANTAB. |
Countries
Netherlands
Outcome results
None listed