Healthy aging and physical activity: a systematic review on the effects of exercise on cardiovascular diseases
DOI:
https://doi.org/10.15448/1980-6108.2017.1.25837Keywords:
aging, cardiovascular diseases, exercise, aerobic, physical education and training.Abstract
DOI: 10.15448/1980-6108.2017.1.25837
Aims: To perform a systematic review of randomized controlled trials that assess the benefits of physical exercise (regular or competitive) for the health of the elderly and prevention of cardiovascular diseases.
Methods: Publications in PubMed, Web of Science, Library of Congress, Cochrane, and in databases with records of clinical trials between 2005 and 2016, and also in the proceedings of major congresses on cardiovascular diseases in the elderly were investigated using the terms defined in accordance with the "patient, intervention, comparison, and outcome" methodology. The following key words were used: physical effort, exercise, exercise therapy, physical activity, physical fitness, resistance training, cardiovascular disease, C-reactive protein, dyslipidemia, heart failure, cardiac insufficiency, revascularization, cardiac stent and heart transplant. Only randomized clinical trials with individuals aged over 60 years were included. The articles were assessed independently by two reviewers.
Results: A total of 3,672 studies were assessed and 24 that met the inclusion criteria were selected. Most of these studies had small sample sizes and showed physical exercise as health-promoting. Only 16 studies reported the relationship of adherence to physical exercise as a preventive factor against cardiovascular diseases. The outcome measures included quality of life, physical ability or fitness status, muscle strength, heart rate, psychological aspects, inflammatory and nutritional markers, and progression of cardiovascular diseases. There is strong evidence that aerobic exercise improves physical fitness, muscle strength, and the quality of life of elderly patients with cardiovascular disease.
Conclusions: The benefits of exercise training for elderly patients with cardiovascular disease are well established, supporting the prescription of exercise training for their regular treatments. Interventions that use exercise need to be progressively included in cardiovascular treatment regimens, although the best exercise protocol for patients with cardiovascular disease is not yet fully established.Downloads
References
Partridge L. The new biology of ageing. Philos Trans R Soc Lond B Biol Sci. 2010 Jan 12;365(1537):147-54. https://doi.org/10.1098/rstb.2009.0222
Flicker L. Cardiovascular risk factors, cerebrovascular disease burden, and healthy brain aging. Clin Geriatr Med. 2010 Feb;26(1):17-27. https://doi.org/10.1016/j.cger.2009.12.005
Huffman DM. Exercise as a calorie restriction mimetic: implications for improving healthy aging and longevity. Interdiscip Top Gerontol. 2010;37:157-74. https://doi.org/10.1159/000320000
Ji LL, Dickman JR, Kang C, Koenig R. Exercise-induced hormesis may help healthy aging. Dose Response. 2010 Jan 28;8(1):73-9. https://doi.org/10.2203/dose-response.09-048.Ji
Muscari A, Giannoni C, Pierpaoli L, Berzigotti A, Maietta P, Foschi E, Ravaioli C, Poggiopollini G, Bianchi G, Magalotti D, Tentoni C, Zoli M. Chronic endurance exercise training prevents aging-related cognitive decline in healthy older adults: a randomized controlled trial. Int J Geriatr Psychiatry. 2010 Oct;25(10):1055-64. https://doi.org/10.1002/gps.2462
Rolland Y, Abellan van Kan G, Vellas B. Healthy brain aging: role of exercise and physical activity. Clin Geriatr Med. 2010 Feb;26(1):75-87. https://doi.org/10.1016/j.cger.2009.11.002
Davis JW, Chung R, Juarez DT. Prevalence of comorbid conditions with aging among patients with diabetes and cardiovascular disease. Int J Geriatr Psychiatry. 2010 Oct;25(10):1055-64.
Partridge L. Diet and healthy aging. N Engl J Med. 2012 Dec 27;367(26):2550-1. https://doi.org/10.1056/NEJMcibr1210447
Santos-Parker JR, LaRocca TJ, Seals DR. Aerobic exercise and other healthy lifestyle factors that influence vascular aging. Adv Physiol Educ. 2014 Dec;38(4):296-307. https://doi.org/10.1152/advan.00088.2014
van Empel VP, Kaye DM, Borlaug BA. Effects of healthy aging on the cardiopulmonary hemodynamic response to exercise. Am J Cardiol. 2014 Jul 1;114(1):131-5. https://doi.org/10.1016/j.amjcard.2014.04.011
Lesniewski LA, Zigler ML, Durrant JR, Nowlan MJ, Folian BJ, Donato AJ, Seals DR. Aging compounds western diet-associated large artery endothelial dysfunction in mice: prevention by voluntary aerobic exercise. Exp Gerontol. 2013 Nov;48(11):1218-25. https://doi.org/10.1016/j.exger.2013.08.001
Willcox DC, Scapagnini G, Willcox BJ. Healthy aging diets other than the Mediterranean: a focus on the Okinawan diet. Mech Ageing Dev. 2014 Mar-Apr;136-137:148-62. https://doi.org/10.1016/j.mad.2014.01.002
Bolduc V, Thorin-Trescases N, Thorin E. Endothelium-dependent control of cerebrovascular functions through age: exercise for healthy cerebrovascular aging. American journal of physiology Am J Physiol Heart Circ Physiol. 2013 Sep 1;305(5):H620-33. https://doi.org/10.1152/ajpheart.00624.2012
Joyner MJ. Buying into healthy blood vessels: exercise and aging. J Appl Physiol (1985). 2014 Sep 1;117(5):421-2.
Wister AV. Population pressures, system-level inertia and healthy aging policy revisited. Healthc Pap. 2011;11(1):41-5; discussion 86-91. https://doi.org/10.12927/hcpap.2011.22251
Bori Z, Zhao Z, Koltai E, Fatouros IG, Jamurtas AZ, Douroudos II, Terzis G, Chatzinikolaou A, Sovatzidis A, Draganidis D, Boldogh I, Radak Z. The effects of aging, physical training, and a single bout of exercise on mitochondrial protein expression in human skeletal muscle. Exp Gerontol. 2012 Jun;47(6):417-24. https://doi.org/10.1016/j.exger.2012.03.004
North BJ, Sinclair DA. The intersection between aging and cardiovascular disease. Circ Res. 2012 Apr 13;110(8):1097-108. https://doi.org/10.1161/CIRCRESAHA.111.246876
Gast U, Belavý DL, Armbrecht G, Kusy K, Lexy H, Rawer R, Rittweger J, Winwood K, Zieliński J, Felsenberg D. Bone density and neuromuscular function in older competitive athletes depend on running distance. Osteoporos Int. 2013 Jul;24(7):2033-42. https://doi.org/10.1007/s00198-012-2234-0
Heo J, Culp B, Yamada N, Won Y. Promoting successful aging through competitive sports participation: insights from older adults. Qual Health Res. 2013 Jan;23(1):105-13. https://doi.org/10.1177/1049732312457247
Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Reprint--preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Phys Ther. 2009 Sep;89(9):873-80.
Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol. 2009 Oct;62(10):1006-12. https://doi.org/10.1016/j.jclinepi.2009.06.005
Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA; Cochrane Bias Methods Group; Cochrane Statistical Methods Group. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011 Oct 18;343:d5928. https://doi.org/10.1136/bmj.d5928
de Souto Araujo ZT, de Miranda Silva Nogueira PA, Cabral EE, de Paula Dos Santos L, da Silva IS, Ferreira GM. Effectiveness of low-intensity aquatic exercise on COPD: a randomized clinical trial. Respir Med. 2012 Nov;106(11):1535-43. https://doi.org/10.1016/j.rmed.2012.06.022
Fayh AP, Lopes AL, da Silva AM, Reischak-Oliveira A, Friedman R. Effects of 5 % weight loss through diet or diet plus exercise on cardiovascular parameters of obese: a randomized clinical trial. Eur J Nutr. 2013 Aug;52(5):1443-50. https://doi.org/10.1007/s00394-012-0450-1
Taylor JD, Fletcher JP, Mathis RA, Cade WT. Effects of moderate- versus high-intensity exercise training on physical fitness and physical function in people with type 2 diabetes: a randomized clinical trial. Phys Ther. 2014 Dec;94(12):1720-30. https://doi.org/10.2522/ptj.20140097
Lakoski SG, Savage PD, Berkman AM, Penalosa L, Crocker A, Ades PA, Kahn SR, Cushman M. The safety and efficacy of early-initiation exercise training after acute venous thromboembolism: a randomized clinical trial. J Thromb Haemost. 2015 Jul;13(7):1238-44. https://doi.org/10.1111/jth.12989
Schneider KL, Pagoto SL, Handschin B, Panza E, Bakke S, Liu Q, Blendea M, Ockene IS, Ma Y. Design and methods for a pilot randomized clinical trial involving exercise and behavioral activation to treat comorbid type 2 diabetes and major depressive disorder. Ment Health Phys Act. 2011 Jun 1;4(1):13-21. https://doi.org/10.1016/j.mhpa.2011.04.001
Winter MM, van der Bom T, de Vries LC, Balducci A, Bouma BJ, Pieper PG, van Dijk AP, van der Plas MN, Picchio FM, Mulder BJ. Exercise training improves exercise capacity in adult patients with a systemic right ventricle: a randomized clinical trial. Eur Heart J. 2012 Jun;33(11):1378-85. https://doi.org/10.1093/eurheartj/ehr396
Redfield MM, Chen HH, Borlaug BA, Semigran MJ, Lee KL, Lewis G, LeWinter MM, Rouleau JL, Bull DA, Mann DL, Deswal A, Stevenson LW, Givertz MM, Ofili EO, O'Connor CM, Felker GM, Goldsmith SR, Bart BA, McNulty SE, Ibarra JC, Lin G, Oh JK, Patel MR, Kim RJ, Tracy RP, Velazquez EJ, Anstrom KJ, Hernandez AF, Mascette AM, Braunwald E; RELAX Trial. Effect of phosphodiesterase-5 inhibition on exercise capacity and clinical status in heart failure with preserved ejection fraction: a randomized clinical trial. JAMA. 2013 Mar 27;309(12):1268-77. https://doi.org/10.1001/jama.2013.2024
Santaularia N, Caminal J, Arnau A, Perramon M, Montesinos J, Trapé J, Abenoza-Guardiola M, Guiteras-Val P, Jaarsma T. Randomized clinical trial to evaluate the effect of a supervised exercise training program on readmissions in patients with myocardial ischemia: a study protocol. BMC Cardiovasc Disord. 2013 Apr 25;13:32. https://doi.org/10.1186/1471-2261-13-32
Jakubseviciene E, Vasiliauskas D, Velicka L, Kubilius R, Milinaviciene E, Vencloviene J. Effectiveness of a new exercise program after lower limb arterial blood flow surgery in patients with peripheral arterial disease: a randomized clinical trial. Int J Environ Res Public Health. 2014 Aug 7;11(8):7961-76. https://doi.org/10.3390/ijerph110807961
Bø E, Bergland A, Stranden E, Jørgensen JJ, Sandbaek G, Grøtta OJ, Hisdal J. Effects of 12 Weeks of Supervised Exercise After Endovascular Treatment: A Randomized Clinical Trial. Physiother Res Int. 2015 Sep;20(3):147-57. https://doi.org/10.1002/pri.1608
Cesa CC, Barbiero SM, Petkowicz Rde O, Martins CC, Marques Rd, Andreolla AA, Pellanda LC. Effectiveness of physical exercise to reduce cardiovascular risk factors in youths: a randomized clinical trial. J Clin Med Res. 2015 May;7(5):348-55. https://doi.org/10.14740/jocmr1700w
Chrysohoou C, Angelis A, Tsitsinakis G, Spetsioti S, Nasis I, Tsiachris D, Rapakoulias P, Pitsavos C, Koulouris NG, Vogiatzis I, Dimitris T. Cardiovascular effects of high-intensity interval aerobic training combined with strength exercise in patients with chronic heart failure. A randomized phase III clinical trial. Int J Cardiol. 2015 Jan 20;179:269-74. https://doi.org/10.1016/j.ijcard.2014.11.067
Jung CH, Park CY, Ahn KJ, Kim NH, Jang HC, Lee MK, Park JY, Chung CH, Min KW, Sung YA, Park JH, Kim SJ, Lee HJ, Park SW. A randomized, double-blind, placebo-controlled, phase II clinical trial to investigate the efficacy and safety of oral DA-1229 in patients with type 2 diabetes mellitus who have inadequate glycaemic control with diet and exercise. Diabetes Metab Res Rev. 2015 Mar;31(3):295-306. https://doi.org/10.1002/dmrr.2613
Li X, Xu S, Zhou L, Li R, Wang J. Home-Based Exercise in Older Adults Recently Discharged From the Hospital for Cardiovascular Disease in China: Randomized Clinical Trial. Nurs Res. 2015 Jul-Aug;64(4):246-55. https://doi.org/10.1097/NNR.0000000000000102
Motahari-Tabari N, Ahmad Shirvani M, Shirzad EAM, Yousefi-Abdolmaleki E, Teimourzadeh M. The effect of 8 weeks aerobic exercise on insulin resistance in type 2 diabetes: a randomized clinical trial. Glob J Health Sci. 2014 Aug 14;7(1):115-21. https://doi.org/10.5539/gjhs.v7n1p115
Mazari FA, Khan JA, Carradice D, Samuel N, Abdul Rahman MN, Gulati S, Lee HL, Mehta TA, McCollum PT, Chetter IC. Randomized clinical trial of percutaneous transluminal angioplasty, supervised exercise and combined treatment for intermittent claudication due to femoropopliteal arterial disease. Br J Surg. 2012 Jan;99(1):39-48. https://doi.org/10.1002/bjs.7710
Taylor-Piliae RE, Boros D, Coull BM. Strategies to improve recruitment and retention of older stroke survivors to a randomized clinical exercise trial. J Stroke Cerebrovasc Dis. 2014 Mar;23(3):462-8. https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.03.031
Meid AD, Quinzler R, Freigofas J, Saum KU, Schöttker B, Holleczek B, Heider D, König HH, Brenner H, Haefeli WE. Medication Underuse in Aging Outpatients with Cardiovascular Disease: Prevalence, Determinants, and Outcomes in a Prospective Cohort Study. PLoS One. 2015 Aug 19;10(8):e0136339. https://doi.org/10.1371/journal.pone.0136339
Gencer B, Auer R, de Rekeneire N, Butler J, Kalogeropoulos A, Bauer DC, Kritchevsky SB, Miljkovic I, Vittinghoff E, Harris T0, Rodondi N. Association between resistin levels and cardiovascular disease events in older adults: The health, aging and body composition study. Atherosclerosis. 2016 Feb;245:181-6. https://doi.org/10.1016/j.atherosclerosis.2015.12.004
Ortega R, Garcia-Ortiz L, Torcal J, Echevarria P, Vargas-Machuca C, Gomez A, Salcedo F, Lekuona I, Montoya I, Grandes G; ESCAP Group. Supervised exercise for acute coronary patients in primary care: a randomized clinical trial. Fam Pract. 2014 Feb;31(1):20-9. https://doi.org/10.1093/fampra/cmt059
Abd El-Kader S, Gari A, Salah El-Den A. Impact of moderate versus mild aerobic exercise training on inflammatory cytokines in obese type 2 diabetic patients: a randomized clinical trial. Afr Health Sci. 2013 Dec;13(4):857-63. https://doi.org/10.4314/ahs.v13i4.1
McDermott MM, Liu K, Guralnik JM, Criqui MH, Spring B, Tian L, Domanchuk K, Ferrucci L, Lloyd-Jones D, Kibbe M, Tao H, Zhao L, Liao Y, Rejeski WJ. Home-based walking exercise intervention in peripheral artery disease: a randomized clinical trial. JAMA. 2013 Jul 3;310(1):57-65. https://doi.org/10.1001/jama.2013.7231
Tousignant M, Corriveau H, Kairy D, Berg K, Dubois MF, Gosselin S, Swartz RH, Boulanger JM, Danells C. Tai Chi-based exercise program provided via telerehabilitation compared to home visits in a post-stroke population who have returned home without intensive rehabilitation: study protocol for a randomized, non-inferiority clinical trial. Trials. 2014 Jan 30;15:42. https://doi.org/10.1186/1745-6215-15-42
Fakhry F, Spronk S, van der Laan L, Wever JJ, Teijink JA, Hoffmann WH, Smits TM, van Brussel JP, Stultiens GN, Derom A, den Hoed PT, Ho GH, van Dijk LC, Verhofstad N, Orsini M, van Petersen A, Woltman K, Hulst I, van Sambeek MR, Rizopoulos D, Rouwet EV, Hunink MG. Endovascular Revascularization and Supervised Exercise for Peripheral Artery Disease and Intermittent Claudication: A Randomized Clinical Trial. JAMA. 2015 Nov 10;314(18):1936-44. https://doi.org/10.1001/jama.2015.14851
Barcellos FC, Santos IS, Umpierre D, Bohlke M, Hallal PC. Effects of exercise in the whole spectrum of chronic kidney disease: a systematic review. Clin Kidney J. 2015 Dec;8(6):753-65. https://doi.org/10.1093/ckj/sfv099