Long-term endurance exercise staves off stiffening of the heart

Shelley Wood

September 17, 2004

Fri, 17 Sep 2004 19:00:00

Dallas, TX - "Is getting stiff and slower an unavoidable consequence of aging, or is it in fact related to something else?"

This was the question that a spurred Dr Benjamin Levine (Institute for Exercise and Environmental Medicine, Dallas, TX) and his coinvestigators to examine the hearts of 12 sedentary seniors, 12 elite Masters athletes also in their late 60s, and a group of sedentary adults less than half the age of the older subjects. They found the elite athletes by scanning race records for Masters events in track and field, duathlon, cycling, etc, choosing subjects over age 65 who consistently were the victors in their races. The researchers gambled that these types of older athletes, who had kept fit with sustained, endurance exercise over several decades, might have been able to prevent the so-called "stiffening" of the heart and to preserve left ventricular compliance as they aged, potentially avoiding diastolic heart failure.

Turns out they picked a winner.

"Prolonged, sustained endurance training preserves ventricular compliance with aging and may be an important approach to reduce the probability of heart failure with aging," Dr Armin Arbab-Zadeh (UT Southwestern, Dallas) et al write in a paper available online September 14, 2004 in Circulation.

Levine, the senior author on the study, elaborated to heartwire : "There has never been, until this study, a quality investigation of what happens to the heart as it ages normally, without disease. And this study convincingly shows that as humans become progressively more sedentary as they ageas do all animalsthe heart atrophies and stiffens. It fills less well or only at a higher pressures, and that is a pathophysiological setup for the most common disease of the elderly: congestive heart failure."

Athletes end up ahead

Levine's group measured left ventricular pressure-volume curves in the 12 Masters-level athletes (mean age 70) as well as 12 age-matched, healthy but sedentary men and women. Their test results were compared with 14 younger, sedentary control subjects (mean age 29). The researchers found that while contractility was the same in all of the seniors, stroke volume was greater in the Masters athletes. Left ventricular stiffness was greater in the sedentary seniors compared with the young adults, whereas the Masters athletes had LV compliance nearly identical to that of the younger controls. The findings, say the authors, confirm that cardiac compliance decreases with age but that it can be preserved through regular endurance exercise.

"If you exercise for your whole life, you can prevent the stiffening and atrophy of the heart with aging," Levine stated. "Lifelong exercise completely preserves the compliance of the heart."

Levine's group has already put their findings to use, devising endurance-exercise programs for the sedentary seniors who participated in the study. They've already seen results, Levine says.

Two thirds of the originally sedentary adults have trained for a year: "We've measured their cardiac compliance and, while it doesn't match that of the Masters athletes, it gets a lot better," Levine told heartwire .

Making exercise a daily habit

He adds that benefits can accrue even when sedentary adults take up regular exercise later in life. In the case of the Masters athletes in this study, most did not start training until they were in their 30s, he noted.

Levine says his group's findings underscore the importance of exercise in heart-failure management, but even more so, they add greater weight to programs aimed at getting people exercising before they get sick.

"If we want people to be able to live vigorous lifestyles as they age, we must make regular exercise a component of daily life," Levine says. "We do lots of other things for our health daily: we brush our teeth, take showers, wear shoes, and eat regular meals, and regular exercise must become like these. And if it does, there is good evidence that we can delay or offset many of the 'degenerative' diseases of aging that may not in fact be degenerative at all and may rather be a complication of a sedentary lifestyle."

Levine and colleagues do not yet know just how much exercise people need to be doing, what "minimum dose" will translate into maximum benefit. "Those are the next studies that need to be done," he says.

Related links

1. [HeartWire > News; Jan 19, 2004]

2. [HeartWire > News; Mar 3, 2003]

3. [HeartWire > News; Jun 20, 2000]

4. [HeartWire > MediaPulse; Oct 31, 2001]


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