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BACKGROUND: Sedentary behavior has been shown to negatively affect parameters of endothelial function and central hemodynamics, both of which are closely associated with vascular health. Exercise prior to sedentary behavior has demonstrated potential as a preventive strategy to mitigate these detrimental effects. To evaluate the impact of exercise prior to sedentary behavior on vascular health parameters in the adult population, a systematic review and meta-analysis were conducted, synthesizing the available body of knowledge. METHODS: A literature search was carried out in 6 databases. For each outcome, standard error and mean difference or standardized mean difference were calculated, as appropriate. An analysis was performed using a random effects model with a 95% confidence interval, using the inverse variance statistical method. Risk of bias assessment was performed using ROB2 and considerations for crossover trials. The quality of evidence was assessed using the GRADE system. RESULTS: Exercise performed prior to prolonged sedentary behavior resulted in increased flow-mediated vasodilation at the first and third hours of sedentary time, compared with the control condition of sedentary behavior without prior exercise [MD: 1.51% (95% CI: 0.57 to 2.45) and MD: 1.36% (95% CI: 0.56 to 2.16), respectively]. Moreover, prior exercise led to increased shear rate at the first and third hours of sedentary time [MD: 7.70 s^-1 (95% CI: 0.79 to 14.61) and MD: 5.21 s^-1 (95% CI: 1.77 to 8.43), respectively]. Furthermore, it increased blood flow at the third hour [SMD: 0.40 (95%CI: 0.07 to 0.72)], compared with the control condition of prolonged sedentary behavior without prior exercise. Regarding hemodynamic parameters, exercise prior to prolonged sedentary behavior decreased mean arterial pressure during the first and third hours of sedentary behavior [MD: -1.94 mmHg (95% CI: -2.77 to -1.11) and MD: -1.90 mmHg (95% CI: -3.27 to -0.53), respectively], and an increase in heart rate during the first hour [MD: 4.38 beats per minute (95%CI: 2.78 to 5.98)] compared with the control condition of prolonged sedentary behavior without prior exercise. CONCLUSIONS: The findings of this research suggest that prior exercise may prevent the impairment of vascular health parameters caused by sedentary behavior. However, the quality of the evidence was estimated as moderate. Therefore, further experimental studies and high-quality clinical trials are needed in this field to strengthen the results and conclusions drawn. PROSPERO REGISTRATION NUMBER: CRD42023393686.

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The present study aimed to investigate the associations between nature-based intervention and peripheral pulse characteristics of patients with PAOD using new smart technology specifically designed for this purpose. A longitudinal panel study performed between 1 January 2022 and 31 December 2022 included 32 patients diagnosed with peripheral arterial occlusive disease (PAOD) who were treated in the vascular surgeons' hospital "Dobb" in Valjevo. These patients were exposed for six months to moderate-intensity physical activity (MPA) in a nature-based environment. They practiced 150 to 300 min of walking 6 km/h and cycling activities (16-20 km/h) weekly as recommended for patients with chronic conditions and those living with disability. Univariate logistic regression analysis was used to identify factors associated with major improvements in peripheral pulse characteristics of patients with PAOD. After six months of MPA, half of the patients (50%, 16/32) achieved minor, and half of them major improvements in peripheral pulse characteristics. The major improvements were associated with current smoking (OR = 9.53; 95%CI = 1.85-49.20), diabetes (OR = 4.84; 95%CI = 1.09-21.58) and cardiac failure, and concurrent pulmonary disease and diabetes (OR = 2.03; 95%CI = 1.01-4.11). Our pilot study showed that patients with PAOD along with other chronic conditions and risk factors benefited more from continuous physical activity in a nature-based environment.

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Arterial stiffness may be associated with glucose metabolism parameters, such as HbA1c, mainly via insulin resistance. We aimed to investigate the association between arterial stiffness and HbA1c and explore the mediator effect of insulin resistance. In this cross-sectional study, arterial stiffness (pulse-wave velocity; PWV), HbA1c, and insulin resistance (METS-IR) were determined in Hispanic adults. In addition to sex and age, various biochemical measurements (glucose, lipid profile, etc.) and adipose tissue (fat mass and visceral fat mass) were considered as potential confounding variables. A multivariate regression analysis shows that HbA1c is associated with PWV, even after adjusting for several confounding variables. Importantly, the results show that insulin resistance mediated 17.9% of the effect of HbA1c over PWV. In conclusion, HbA1c may be a potential resource for predicting arterial stiffness due to the influence of insulin resistance in Hispanic subjects.

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Although it has been suggested that increased arterial stiffness is linked to exaggerated blood pressure (BP) from brief moderate exercise, it is not clear whether this occurs in older adults with and without hypertension. This study investigates whether the immediate post-exercise systolic BP following brief moderate exercise is associated with arterial stiffness in older females with different BP status. This cross-sectional study included 191 older females aged 60-80 years without known cardiovascular disease (CVD). Arterial stiffness was determined by aortic pulse wave velocity (aPWV). Systolic BP was measured before and immediately following a 3-min moderate walking test (stage 1 Bruce protocol). Specific quartile-based thresholds were used to define an exaggerated immediate post-exercise systolic BP for hypertensive and normotensive older females (quartile 4 as an exaggerated response). Traditional CVD risk factors were assessed (covariates). Older females from the highest quartile of immediate post-exercise absolute systolic BP showed higher aPWV compared to their peers from the lowest quartile (ß = .22 m/s, p = .018). The quartile-based threshold to define the exaggerated post-exercise systolic BP was higher in hypertensive than in normotensive older females (174 vs. 172 mmHg). In summary, exaggerated immediate post-exercise systolic BP following a brief moderate exercise is associated with higher arterial stiffness in older females with different BP status.

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The current recommendation for reducing person-to-person Coronavirus 2019 (COVID-19) transmission is social distancing, including remote work and school, and home confinement. However, confinement may cause negative feelings, such as frustration, anger, boredom, and stress, in quarantined people. Furthermore, unhealthy diet and physical inactivity behaviors are commonly linked to home confinement, leading to weight gain, metabolic disorders, smoking, and exacerbated alcohol consumption. As a result, these unhealthy behaviors are typically linked to vascular endothelium damage (endothelial dysfunction), which is a first step for the development of cardiovascular disease (CVD). Given that CVD is the main cause of morbidity and mortality worldwide, attenuating the progression of endothelial dysfunction is very important for the control of CVD. Consuming vegetable rich in nitrate, such as beetroots, may be an effective way to prevent endothelial dysfunction. Several emerging studies have recommended beetroot juice in order to improve endothelial function in hypertensive, hypercholesterolemic individuals, as well as in those with CVD risk factors. Therefore, nitrate-rich vegetable consumption, such as beetroot, should be encouraged to be included in the diet during confinement from COVID-19 outbreaks in order to alleviate the potential negative effect of home confinement on cardiovascular health.

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BACKGROUND/AIMS: Elderly patients with normal systemic arterial blood pressure associated with femoral carotid pulse velocity (cf-PWV) less than 7.6 m/s and without associated comorbidities are considered to have good vascular health. The aim of the current study was to verify the probability that elderly patients with good vascular health have at least one blood pressure measurement above the different thresholds for systolic blood pressure (120, 130 and 140 mmHg) during two years of follow-up. METHODS: We selected 72 normotensive patients (< 140/90 mmHg) without comorbidities and divided them into group A, with cf-PWV < 7.6 m/s (n = 27; 65 ± 4 years), and group B, with cf-PWV ≥ 7.6 m/s (n = 45; 66± 8 years). These patients were followed for two years and were observed in 3 outpatient visits (0, 12 and 24 months). At each visit, the brachial pressures were indirectly measured in triplicate, and applanation tonometry was performed. RESULTS: When group A and group B were compared, the odds ratio (OR) of having a systolic pressure measurement ≥ 140 mmHg in two years of follow-up was 0.22 (P < 0.0001); ≥ 130 mmHg, the OR was 0.49 (P < 0.0007), and ≥ 120 mmHg, the OR was 0.54 (P < 0.001). Group A and group B showed increased values of cf-PWV during the two years of follow-up (P < 0.05). Changes in the average systolic brachial pressure were not significant during the two years in groups A or B. CONCLUSION: Vascular health in elderly individuals seems to protect against occasional elevations in systemic arterial pressure.

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