Cardiorespiratory Fitness Suppresses Age‐Related Arterial Stiffening in Healthy Adults: A 2‐Year Longitudinal Observational Study

Cardiorespiratory fitness is negatively associated with arterial stiffness, although it is unclear whether it is associated with prospective arterial stiffness changes. The authors examined cardiorespiratory fitness and arterial stiffness progression in a 2‐year follow‐up study of 470 healthy men and women aged 26 to 69 years. Peak oxygen uptake (V˙O2peak) was measured at baseline using a graded cycle exercise test. Arterial stiffness was assessed using brachial‐ankle pulse wave velocity (baPWV) at baseline and after 2 years. Two‐year changes in baPWV were significantly higher in patients in the lowest V˙O2peak tertile (28.8±7.6 cm/s) compared with those in the highest V˙O2peak tertile (−1.4±7.5 cm/s) (P=.024) and were inversely correlated with V˙O2peak (r=−.112, P=.015). Stepwise multiple regression analysis revealed that age, glucose, baPWV, V˙O2peak, and sex were independent correlates of 2‐year changes in baPWV, suggesting that higher cardiorespiratory fitness is associated with age‐related arterial stiffening suppression.

Arterial stiffness increases progressively with advancing age, even in healthy individuals.¹ This arterial stiffening is associated with future hypertension² and cardiovascular (CV) events³ and is recognized as a surrogate marker for CV disease. Therefore, the prevention of arterial stiffening is of great clinical importance.Carotid‐femoral pulse wave velocity (cfPWV) is a standard method for assessing aortic stiffness.⁴ cfPWV is used in clinical practice mainly in Europe, and in the United States to a lesser extent. Recently, brachial‐ankle pulse wave velocity (baPWV) was proposed as an alternative method for assessing arterial stiffness in Asian populations.⁵ A major advantage of baPWV is its measurement method, which simply involves wrapping the four extremities in blood pressure (BP) cuffs.⁶, ⁷ Moreover, the use of either cfPWV or baPWV is accepted by the Japanese guidelines for the management of hypertension as a tool for assessing subclinical target organ damage.⁸ In addition, baPWV has been shown to be associated with an increased risk of total CV events and all‐cause mortality,⁹, ¹⁰ as is cfPWV.¹¹ Cardiorespiratory fitness (CRF) is independently associated with a lower risk of all‐cause mortality and CV events.¹² Thus, previous studies have investigated the relationship between CRF and arterial stiffness as a surrogate marker for CV disease in cross‐sectional research and have suggested that higher CRF was associated with lower arterial stiffness.¹³, ¹⁴, ¹⁵, ¹⁶ To our knowledge, only Ferreira and colleagues¹⁷, ¹⁸ have reported longitudinal research from adolescence to young adulthood. There is no information regarding middle‐aged and elderly populations. In addition, there has been no previous study on whether CRF is associated with the progression of arterial stiffness as assessed by baPWV in longitudinal research.Previous studies have demonstrated that regular aerobic exercise is effective in preventing and reversing arterial stiffening in healthy adults.¹⁹ Regular aerobic exercise results in higher CRF,²⁰ and, consequently, CRF may be associated with a lower CV disease risk. Therefore, we hypothesized that higher CRF would be associated with less progression of age‐related arterial stiffening in healthy adults. To test our hypothesis, we examined the relationship between CRF and the progression of arterial stiffening with a 2‐year follow‐up study.