January 06, 2020
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First-time marathon runners experience improved BP, aortic stiffness

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Individuals who trained for and completed their first marathon experienced improved BP and aortic stiffness equivalent to an approximate 4-year reduction in vascular age, according to research published in the Journal of the American College of Cardiology.

These effects were more prominent for older individuals who ran at lower intensity, researchers reported.

This publication confirms findings that were previously presented and reported on by Healio.

In 138 individuals (aged 21 to 69 years; 49% men) who trained for and completed their first marathon, systolic BP decreased by 4 mm Hg (95% CI, 2.8-5.5) and aortic BP decreased by 3 mm Hg (95% CI, 1.6-3.5). The researchers also found that descending aortic distensibility increased (descending aorta at the pulmonary artery bifurcation, 9%; P = .009; descending aorta at the diaphragm, 16%; P = .002) while remaining unchanged in the ascending aorta.

Moreover, these changes in BP and aortic distensibility effectively resulted in a reduction in “aortic age” of the descending aorta at the pulmonary artery bifurcation by 3.9 years (95% CI, 1.1-7.6) and 4 years of the descending aorta at the diaphragm (95% CI, 1.7-8).

“In healthy individuals, chronological aging leads to a gradual increase in aortic stiffness and elevated CV risk,” Anish N. Bhuva, MBBS, British Heart Foundation clinical research training fellow, and colleagues wrote. “However, chronological age is not the same as the biological process, which captures life course influences and frames how we make choices that can accelerate or rejuvenate the vasculature.”

In other findings, researchers found that the benefits of training for and completing a marathon for the first time were greater in older, male participants with slower overall running times (P < .05).

“What are the potential mechanisms by which exercise training reduces descending aortic stiffness? The aorta is not homogeneous in composition, with a progressively increasing vascular smooth muscle cell and decreasing elastin content from proximal to distal segments,” Julio A. Chirinos, MD, PhD, of the division of cardiovascular medicine at the Hospital of the University of Pennsylvania and University of Pennsylvania Perelman School of Medicine, wrote in a related editorial. “Given the selective change in more distal thoracic aortic segments reported by Bhuva et al, it is reasonable to suspect effects on vascular smooth muscle cells, which may be prone to modifications within a 6-month period. Furthermore, wall shear stress, a known stimulus for nitric oxide production by the endothelium, is normally higher in the descending aorta compared with the ascending aorta.

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“Furthermore, although discrete periods of exercise training are beneficial, a much larger impact could be accomplished through societal measures to promote physical activity across the life span, which should start in childhood and must address our urban and suburban environment, in which bike paths tend to be vastly outnumbered by fast food restaurants, and stairs tend to be hidden or inaccessible alongside prominently displayed elevators,” Chirinos wrote. “Perhaps the contemporary marathon can teach us some lessons about exploiting the confluence of interests of the general public, media, industry, scientific community and government to accomplish worthy goals at the individual and societal levels.” – by Scott Buzby

Disclosures: Bhuva reports he is supported by a doctoral research fellowship from the British Heart Foundation. Please see the study for all other authors’ relevant financial disclosures. Chirinos reports he is supported by NIH grants, has served as a consultant for Akros Pharma, Bayer, Bristol-Myers Squibb, Edwards Lifesciences, Fukuda-Denshi, Ironwood, Merck, Microsoft, OPKO Healthcare, Pfizer and Sanifit; and received research grants from the American College of Radiology Network, Bristol-Myers Squibb, Fukuda-Denshi, Microsoft and the NIH.