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Training for a First-Time Marathon Reverses Age-Related Aortic Stiffening

Bhuva, AN; D'Silva, A; Torlasco, C; Jones, S; Nadarajan, N; Van Zalen, J; Chaturvedi, N; ... Manisty, CH; + view all (2020) Training for a First-Time Marathon Reverses Age-Related Aortic Stiffening. Journal of the American College of Cardiology , 75 (1) pp. 60-71. 10.1016/j.jacc.2019.10.045. Green open access

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Abstract

Background: Aging increases aortic stiffness, contributing to cardiovascular risk even in healthy individuals. Aortic stiffness is reduced through supervised training programs, but these are not easily generalizable. / Objectives: The purpose of this study was to determine whether real-world exercise training for a first-time marathon can reverse age-related aortic stiffening. / Methods: Untrained healthy individuals underwent 6 months of training for the London Marathon. Assessment pre-training and 2 weeks post-marathon included central (aortic) blood pressure and aortic stiffness using cardiovascular magnetic resonance distensibility. Biological “aortic age” was calculated from the baseline chronological age-stiffness relationship. Change in stiffness was assessed at the ascending (Ao-A) and descending aorta at the pulmonary artery bifurcation (Ao-P) and diaphragm (Ao-D). Data are mean changes (95% confidence intervals [CIs]). / Results: A total of 138 first-time marathon completers (age 21 to 69 years, 49% male) were assessed, with an estimated training schedule of 6 to 13 miles/week. At baseline, a decade of chronological aging correlated with a decrease in Ao-A, Ao-P, and Ao-D distensibility by 2.3, 1.9, and 3.1 × 10−3 mm Hg−1, respectively (p < 0.05 for all). Training decreased systolic and diastolic central (aortic) blood pressure by 4 mm Hg (95% CI: 2.8 to 5.5 mm Hg) and 3 mm Hg (95% CI: 1.6 to 3.5 mm Hg). Descending aortic distensibility increased (Ao-P: 9%; p = 0.009; Ao-D: 16%; p = 0.002), while remaining unchanged in the Ao-A. These translated to a reduction in “aortic age” by 3.9 years (95% CI: 1.1 to 7.6 years) and 4.0 years (95% CI: 1.7 to 8.0 years) (Ao-P and Ao-D, respectively). Benefit was greater in older, male participants with slower running times (p < 0.05 for all). / Conclusions: Training for and completing a marathon even at relatively low exercise intensity reduces central blood pressure and aortic stiffness—equivalent to a ∼4-year reduction in vascular age. Greater rejuvenation was observed in older, slower individuals.

Type: Article
Title: Training for a First-Time Marathon Reverses Age-Related Aortic Stiffening
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jacc.2019.10.045
Publisher version: http://dx.doi.org/10.1016/j.jacc.2019.10.045
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: agingaortic stiffness, blood pressure, cardiovascular magnetic resonance, exercise training, marathon
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
URI: https://discovery.ucl.ac.uk/id/eprint/10090709
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