Effects Of Lifestyle Modification On Cardiovascular Function In Those At Risk For Cardiovascular Diseases
Bibliographic record
Abstract
An epidemic of cardiovascular morbidity and mortality in North America is coincident with increased prevalence of sedentary lifestyle, obesity, and concomitant hypertension and diabetes. Effects of exercise and/or diet on blood pressure (BP) have been well-documented; however, their combined effects on overall cardiovascular functioning in those who have preclinical risk factors for cardiovascular diseases are still unclear. PURPOSE To examine the effects of lifestyle (exercise and diet) modification on clinical outcome measures of exercise capacity (VO2max), left ventricular diastolic function (LVDF), arterial distensibility (AD), and BP (clinic and 24 hour) in individuals with either high-normal BP (HNBP) or impaired glucose tolerance (IGT). METHODS These preliminary findings are from a larger randomized trial of Staged Nutrition and Activity Counseling (SNAC) vs usual care lifestyle counseling. SNAC matches a Mediterranean diet with physical exercise prescription as per a tailored physiological and behavioral assessment in the primary care setting. Twenty seven subjects with either HNBP or IGT (11 M and 16 F, 53.6 ± 7.4 yrs) have participated in the preliminary analysis of the study cohort. Before and after 8 weeks of intervention, measures of VO2max by exercise treadmill test, LVDF [early filling flow velocity (E), late filling flow velocity (A), E/A ratio, isovolumic relaxation time (IVRT) and deceleration time (DT)], left ventricular mass (LVM), and AD in carotid and brachial arteries assessed using GE/VingMed System FiVe cardiac imaging system at rest, were determined. Clinic BP using an automated device (BpTRUTM) and 24-h ambulatory BP using a SpacelabsTM ABPM were also recorded. RESULTS VO2max improved significantly following the intervention (32.1 ± 9.5 vs 35.3 ± 10.1 ml/min/kg, p <.05). AD in the carotid artery also changed significantly following the intervention (0.85 ± .28 vs 0.99 ± .28 l/mmHgx10−1, p <.05). These improvements were accompanied by the reduction of body weight and BMI (95.7 ± 18.3 vs 93.9 ± 17.9 kg, 33.7 ± 5.8 vs 33.0 ± 5.6 kg/m2, p <.01, respectively). Clinic DBP tended to be lower following the intervention (83.7 ± 11.1 vs 79.9 ± 9.4 mmHg, p = .053). No changes were observed in LVDF indices, LVM, AD in the brachial artery, clinic SBP, and 24-h BP indices. CONCLUSION These preliminary data suggest that our lifestyle modification significantly improved VO2max and AD in the carotid artery with the reduction of body weight. Further study will determine whether these changes are maintained and whether changes in clinical measures including BP and LVDF are observed compared to usual care. Supported by CIHR and HSF.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".