Training for a First-Time Marathon Reverses Age-Related Aortic Stiffening

• Published in: Journal of the American College of Cardiology 2020-01, Vol.75 (1), p.60-71
• Main Authors: Bhuva, Anish N., D’Silva, Andrew, Torlasco, Camilla, Jones, Siana, Nadarajan, Niromila, Van Zalen, Jet, Chaturvedi, Nish, Lloyd, Guy, Sharma, Sanjay, Moon, James C., Hughes, Alun D., Manisty, Charlotte H.
• Format: Article
• Language: English
• Subjects: Adult; Aerobics; Age; Aged; Aging; Aging - pathology; Aging - physiology; Anthropomorphism; Aorta; aortic stiffness; Bifurcations; Blood pressure; Blood Pressure - physiology; Cardiology; Cardiovascular disease; Cardiovascular diseases; cardiovascular magnetic resonance; Cohort Studies; Confidence intervals; Coronary vessels; Diaphragm; Exercise; exercise training; Family medical history; Female; Fitness training programs; Follow-Up Studies; Health risks; Humans; London - epidemiology; Longitudinal Studies; Magnetic resonance; Male; marathon; Marathons; Middle Aged; Physical Conditioning, Human - methods; Physical Conditioning, Human - physiology; Physical fitness; Physical training; Prospective Studies; Pulmonary arteries; Pulmonary artery; Reduction; Regression analysis; Running - physiology; Schedules; Stiffening; Stiffness; Studies; Training; Vascular Stiffness - physiology; Veins & arteries; Velocity; Young Adult
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2019.10.045

Aging increases aortic stiffness, contributing to cardiovascular risk even in healthy individuals. Aortic stiffness is reduced through supervised training programs, but these are not easily generalizable. The purpose of this study was to determine whether real-world exercise training for a first-time marathon can reverse age-related aortic stiffening. Untrained healthy individuals underwent 6 months of training for the London Marathon. Assessment pre-training and 2 weeks post-marathon included central (aortic) blood pressure and aortic stiffness using cardiovascular magnetic resonance distensibility. Biological “aortic age” was calculated from the baseline chronological age-stiffness relationship. Change in stiffness was assessed at the ascending (Ao-A) and descending aorta at the pulmonary artery bifurcation (Ao-P) and diaphragm (Ao-D). Data are mean changes (95% confidence intervals [CIs]). A total of 138 first-time marathon completers (age 21 to 69 years, 49% male) were assessed, with an estimated training schedule of 6 to 13 miles/week. At baseline, a decade of chronological aging correlated with a decrease in Ao-A, Ao-P, and Ao-D distensibility by 2.3, 1.9, and 3.1 × 10−3 mm Hg−1, respectively (p