Summary Association of measures of vascular health and physical function: a prospective analysis in the Framingham Heart Study Background Dysfunction in blood vessel dynamics can contribute to changes in muscle measurements. Therefore, we examined associations of vascular health measures with grip strength and gait speed in adults from the Framingham Heart Study. Methods The cross-sectional study (1998-2001) included participants with 1 measure of grip strength (kg, dynamometer) or gait speed (4 m walk, m/s) and at least 1 measure of aortic stiffness (carotid pulse wave -femoral) brachial artery, brachial pulse pressure, and brachial flow pulsatility index) or brachial artery structure and function (resting flow velocity, resting brachial artery diameter, % flow-mediated dilation, hyperemic brachial blood flow and mean arterial pressure [MAP]) assessed by brachial artery tonometry and ultrasound. The longitudinal study included participants with ≥1 follow-up measure of gait speed or grip strength. Multivariable linear regression estimated the association of a 1 standard deviation (SD) higher level of each vascular measure with annualized percent change in grip strength and gait speed, adjusting for covariates. Results In cross-sectional analyzes (n = 2498, age 61 ± 10 years; 56% women), larger brachial artery diameter at rest (β ± standard error [SE] per 1 SD: 0.59 ± 0.24, p = 0.01) and PAM (β ± SE: 0.39 ± 0.17, p = 0.02) were associated with greater grip strength. Higher brachial pulse pressure (β ± SE: −0.02 ± 0.01, p = 0.07) was marginally associated with slower walking speed. In longitudinal analyzes (n = 2,157), higher brachial pulse pressure (β ± SE: −0.19 ± 0.07, p = 0.005) was associated with decreased gait speed, but not with grip strength. Conclusions Higher brachial artery pulse pressure (a measure of aortic stiffness) was associated with loss of physical function over ~11 years, although we found no evidence that microvascular function contributed to the relationship. |
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Managing risk factors for cardiovascular disease (CVD) may play a role in preserving physical function during the aging process, according to new research published today by The Journals of Gerontology , Series A: Life Sciences and Sciences medical.
“Approximately 10% of older adults have muscle weakness and decreased physical function leading to adverse health outcomes and physical disability,” said lead author Dr. Shivani Sahni. “Given that loss of physical function contributes to reduced mobility, disability, institutionalization, and mortality, managing CVD risk factors may help preserve physical function with age,” said Dr. .Sahni.
This study showed that vascular measures are associated with grip strength in cross-sectional analyzes and change in gait speed (a measure of physical function) in longitudinal analyses.
This is one of the first community-based studies to comprehensively examine the relationships of aortic stiffness and vascular function with age-related declines in physical function. Greater aortic stiffness was associated with loss of physical function for ~11 years, said Dr. Sahni, associate professor of medicine at Harvard Medical School and associate scientist at the Hinda and Arthur Marcus Institute for Aging Research. at Hebrew SeniorLife. He directs the Nutrition Program at the Marcus Institute.
Blood flow decreases with aging, partly due to arterial stiffness. The resulting dysfunction in blood vessel dynamics can contribute to organ pathology and decreased muscle mass, explains Dr. Sahni. However, few studies have specifically evaluated the role of vascular function and changes in functional muscle measures, such as mobility and muscle strength.
The current study used data from a large cohort of relatively healthy men and women and extends previous research using a longitudinal study design.
Most previously published studies have used cross-sectional study designs with modest sample sizes. The authors believe that future studies should evaluate whether interventions targeting vascular health can reduce age-related declines in physical function. This is important because one-third of older adults experience physical limitations that contribute to reduced mobility, disability, institutionalization, and mortality. Therefore, there is a need to develop novel interventions aimed at preventing physical limitations in older adults.
