Exercise Strategies For Targeting Central Arterial Stiffness, Central Haemodynamics And Cardiovascular Risk Factors In Diabetes

Abstract

Chapter 1: reviews the literature regarding “traditional” cardiovascular risk factors, central arterial stiffness and central haemodynamics, and their cardiovascular health implications and assessment methods. The pathology of arterial stiffness and hypertension and the utility of exercise as a therapy for reducing arterial stiffness and central haemodynamics in adults is critically reviewed. Chapter 2: reports a systematic review and meta-analysis examing the effect of high intensity interval training (HIIT) and moderate intensity continuous training (MICT) on arterial stiffness and 24 h blood pressure. HIIT was superior to MICT for improving 24 h blood pressure outcomes. Chapter 3: presents the findings of an acute study on the effect of HIIT versus MICT versus control on central arterial stiffness and haemodynamics in adults with diabetes. A significant and near-significant group x time interaction was observed in central systolic blood pressure and arterial stiffness, respectively. Chapter 4: reports a systematic review and meta-analysis examining the effect of regular exercise versus control on arterial stiffness and vascular function in adults with T2D. Aerobic exercise significantly improves endothelium independent dilation and a near-significant reduction in pulse wave velocity. Chapter 5: presents the findings of an 12-week randomised, placebo-controlled trial on the efficacy of MICT and low volume HIIT compared to a sham-exercise placebo control on central arterial stiffness and central haemodynamics, as well as other cardiovascular risk factors in inactive, obese adults with type 2 diabetes. No significant changes were observed in central arterial stiffness and central haemodynamics. Chapter 6: summarises the key findings from all of the Chapters in this thesis. This chapter also addresses limitations of the thesis, proposes implications of these results for clinical practice, as well as future directions for research.