Association of 'Tortoise' and 'Hare' movement behavior patterns with cardiometabolic health, body composition, and functional fitness in older adults.

We investigated the association of movement behavior patterns with cardiometabolic health, body composition, and functional fitness in older adults. A total of 242 older adults participated of this cross-sectional study. Sedentary time, light physical activity (LPA) and moderate-vigorous physical activity (MVPA), steps/day, and step cadence were assessed by accelerometry. The movement behavior patterns were derived by principal component analysis. Cardiometabolic health was defined by a metabolic syndrome score (cMetS). Body composition was determined by appendicular lean mass/body mass index (ALM/BMI). Functional fitness was assessed by a composite z-score from the Senior Fitness Test battery. Two patterns were identified: 'Tortoise' (low sedentary time, high LPA and steps/day) and 'Hare' (high MVPA, steps/day, and step cadence). 'Tortoise' and 'Hare' were associated with better cMetS. 'Hare' was positively associated with ALM/BMI and Functional Fitness. While 'Tortoise' and 'Hare' were associated with better cMetS, only 'Hare' was associated with better ALM/BMI and functional fitness.

COVID-19 pandemic and explicit processes towards physical activity in Brazilian older adults with hypertension.

This study investigated the initial three-month impact of the COVID-19 pandemic on the explicit processes towards physical activity (PA). In addition, we explored whether potential changes in explicit processes are associated with changes in PA and sedentary behavior (SB). Seventeen older adults (aged 65.7 ± 3.8 years; 76.5% women) with hypertension were included in this longitudinal study performed in Natal, Brazil. Explicit processes (explicit attitude [perceived benefits and cons perceived], social norms, social modeling, self-efficacy, intention and motivation) were evaluated through self-reported questionnaire before (January to March 2020) and during (June 2020) the COVID-19 pandemic. In addition, PA and SB were measured by accelerometry during seven days. Generalized linear and mixed models were used for data analysis. There was a decrease in the explicit attitudes (ß = - 4.8, p = 0.001) and moderate-vigorous PA (ß = - 4.8, p = 0.035) during the COVID-19. Changes in the explicit attitudes were associated with the changes in the moderate-vigorous PA (ß = - 1.6, 95% CI - 2.9, - 0.3, p = 0.034). No significant changes were found in the additional explicit process measures, time spent doing light PA and SB, and step count. Our findings may suggest that the COVID-19 pandemic has negatively impacted the explicit attitudes related to PA and contributed to decrease the time spent in the moderate-vigorous PA in older adults with hypertension.

Analysis of therapy monitoring in the International Congenital Adrenal Hyperplasia Registry.

OBJECTIVE: Congenital adrenal hyperplasia (CAH) requires exogenous steroid replacement. Treatment is commonly monitored by measuring 17-OH progesterone (17OHP) and androstenedione (D4). DESIGN: Retrospective cohort study using real-world data to evaluate 17OHP and D4 in relation to hydrocortisone (HC) dose in CAH patients treated in 14 countries. PATIENTS: Pseudonymized data from children with 21-hydroxylase deficiency (21OHD) recorded in the International CAH Registry. MEASUREMENTS: Assessments between January 2000 and October 2020 in patients prescribed HC were reviewed to summarise biomarkers 17OHP and D4 and HC dose. Longitudinal assessment of measures was carried out using linear mixed-effects models (LMEM). RESULTS: Cohort of 345 patients, 52.2% female, median age 4.3 years (interquartile range: 3.1-9.2) were taking a median 11.3 mg/m2 /day (8.6-14.4) of HC. Median 17OHP was 35.7 nmol/l (3.0-104.0). Median D4 under 12 years was 0 nmol/L (0-2.0) and above 12 years was 10.5 nmol/L (3.9-21.0). There were significant differences in biomarker values between centres (p < 0.05). Correlation between D4 and 17OHP was good in multiple regression with age (p < 0.001, R2 = 0.29). In longitudinal assessment, 17OHP levels did not change with age, whereas D4 levels increased with age (p < 0.001, R2 = 0.08). Neither biomarker varied directly with dose or weight (p > 0.05). Multivariate LMEM showed HC dose decreasing by 1.0 mg/m2 /day for every 1 point increase in weight standard deviation score. DISCUSSION: Registry data show large variability in 17OHP and D4 between centres. 17OHP correlates with D4 well when accounting for age. Prescribed HC dose per body surface area decreased with weight gain.

Associations of objectively measured movement behavior and cardiorespiratory fitness with mental health and quality of life in older adults with hypertension: an exploratory analysis during the COVID-19 pandemic.

Objectives: Herein, we explored the associations of pre-pandemic COVID-19 physical activity (PA), sedentary behavior (SB) and cardiorespiratory fitness (CRF) with mental health and quality of life in older adults with hypertension.Method: Objectively measured PA and SB, perceived stress, depression symptoms, and quality of life were assessed before and during the pandemic in seventeen older adults with hypertension. CRF was assessed before the pandemic by cardiopulmonary exercise testing. Longitudinal and cross-sectional associations were analyzed using the mixed linear model.Results: Pre-pandemic light PA (positive association) and SB (negative association) were associated with quality of life during the pandemic. Higher pre-pandemic CRF was associated with less negative changes in perceived stress, depression symptoms, and quality of life during the pandemic.Conclusion: Our preliminary findings suggest that a healthier pre-pandemic movement behavior (more PA, less SB) and better CRF can mitigate the negative impact of the COVID-19 pandemic on mental health and quality of life in older adults with hypertension.

Does Interrupting Prolonged Sitting With 10- or 20-Min Standing Attenuate Postprandial Glycemia and Blood Pressure in Middle-Aged and Older Adults With Type 2 Diabetes?

We carried out three types of 2-hr experimental sessions with middle-aged and older adults with Type 2 diabetes in order to examine the acute effect of interrupting prolonged sitting with varying periods of standing on postprandial glycemia and blood pressure (BP): (a) prolonged sitting after breakfast; (b) standing for 10 min, 30 min after breakfast; and (c) standing for 20 min, 30 min after breakfast. Glucose and BP were assessed before and after breakfast. A generalized linear model revealed no significant differences for the incremental area under the curve of glucose between standing for 10 min, 30 min after breakfast, versus prolonged sitting after breakfast (ß = -4.5 mg/dl/2 hr, 95% CI [-17.3, 8.4]) and standing for 20 min, 30 min after breakfast, versus prolonged sitting after breakfast (ß = 0.9 mg/dl/2 hr, 95% CI [-11.9, 13.7]). There was no difference in area under the curve of systolic and diastolic BP among the sessions. Interrupting prolonged sitting time with 10 or 20 min of standing 30 min after breakfast does not attenuate postprandial glycemia or BP in middle-aged and older adults with Type 2 diabetes.

Effect of Resistance Training on Arterial Stiffness in Healthy Subjects: A Systematic Review and Meta-Analysis.

PURPOSE OF REVIEW: The aim of this systematic review and meta-analysis was to investigate the effect of resistance training on arterial stiffness (AS) in healthy subjects. Two electronic databases (PubMed and Scielo) were searched for randomized controlled trials comparing the effect of dynamic and/or isometric resistance training stand-alone versus non-exercise control group on AS assessed by pulse wave velocity (PWV) in healthy subjects. Random-effects modeling was employed to compare delta changes (post-pre-intervention) in AS between the resistance training and control group. Data were reported as weighted mean difference (MD) and its 95% confidence intervals (CI). Statistical significance was set at 5%. RECENT FINDINGS: A total of 10 studies involving 310 participants (46.5% female; resistance training groups, n = 194; control groups, n = 116) were included in the meta-analysis. Comparing changes from pre- to post-resistance training groups versus control groups, no differences were observed in PWV (MD - 1.33 cm/s (95% CI - 34.58 to 31.91), p = 0.94, I2 = 91%). Resistance training stand-alone does not elicit changes (i.e., improvement or impairment) on AS in healthy subjects, but the high heterogeneity suggests influence of training protocol and/or personal characteristics that should be investigated in the future.

Short-Term Resistance Training Improves Cardiac Autonomic Modulation and Blood Pressure in Hypertensive Older Women: A Randomized Controlled Trial.

Oliveira-Dantas, FF, Brasileiro-Santos, MdS, Thomas, SG, Silva, AS, Silva, DC, Browne, RAV, Farias-Junior, LF, Costa, EC, and Santos, AdC. Short-term resistance training improves cardiac autonomic modulation and blood pressure in hypertensive older women: a randomized controlled trial. J Strength Cond Res 34(1): 37-45, 2020-This randomized controlled trial investigated the efficacy of short-term resistance training (RT) on cardiac autonomic modulation and peripheral hemodynamic parameters in hypertensive older women. Twenty-five hypertensive older women who were insufficiently active (64.7 ± 4.7 years) participated in this study. Subjects were randomly allocated to a 10-week RT program (2 d·wk in the first 5 weeks; 3 d·wk in the last 5 weeks) or a nonexercise control group. Linear reverse periodization was used for the RT program. Cardiac autonomic modulation, mean blood pressure (MBP), peripheral vascular resistance (PVR), and resting heart rate (RHR) were measured before and after 10 weeks. The RT group reduced cardiac sympathetic modulation (0V%; B = -6.6; 95% confidence interval [CI]: -12.9 to -0.2; p = 0.045; Cohen's d = 0.88) and showed a trend for increased parasympathetic modulation (2V%; B = 12.5; 95% CI: 0-25; p = 0.050; Cohen's d = 0.87) compared with the control group. The RT group reduced MBP (B = -8.5 mm Hg; 95% CI: -13.6 to -3.4; p = 0.001; Cohen's d = 1.27), PVR (B = -14.1 units; 95% CI: -19.9 to -8.4; p < 0.001; Cohen's d = 1.86), and RHR (B = -8.8 b·min; 95% CI: -14.3 to -3.3; p = 0.002; Cohen's d = 1.20) compared with the control group. In the RT group, the changes in 2V% patterns and low-frequency components showed a correlation with changes in MBP (r = -0.60; p = 0.032) and RHR (r = 0.75; p = 0.0003). In conclusion, 10 weeks of RT improved cardiac autonomic modulation and reduced MBP and PVR in hypertensive older women. These results reinforce the importance of RT for this population.

Acute Effect of High-Intensity Interval Versus Moderate-Intensity Continuous Exercise on Blood Pressure and Arterial Compliance in Middle-Aged and Older Hypertensive Women With Increased Arterial Stiffness.

Costa, EC, Kent, DE, Boreskie, KF, Hay, JL, Kehler, DS, Edye-Mazowita, A, Nugent, K, Papadopoulos, J, Stammers, AN, Oldfield, C, Arora, RC, Browne, RAV, and Duhamel, TA. Acute effect of high-intensity interval versus moderate-intensity continuous exercise on blood pressure and arterial compliance in middle-aged and older hypertensive women with increased arterial stiffness. J Strength Cond Res 34(5): 1307-1316, 2020-Hypertension and arterial stiffness are common in middle-aged and older women. This study compared the acute effect of high-intensity interval exercise (HIIE) and moderate-intensity continuous exercise (MICE) on blood pressure (BP) and arterial compliance in middle-aged and older hypertensive women with increased arterial stiffness. Nineteen women (67.6 ± 4.7 years) participated in this randomized controlled crossover trial. Subjects completed a control, MICE (30 minutes at 50-55% of heart rate reserve [HRR]), and HIIE (10 × 1 minute at 80-85% of HRR, 2 minutes at 40-45% of HRR) session in random order. Blood pressure and large and small arterial compliance (radial artery pulse wave analysis) were measured at baseline and 30, 60, 90, and 120 minutes after sessions. A p < 0.05 was considered statistically significant. Systolic BP was reduced in ∼10 mm Hg after MICE at 30 minutes and after HIIE at all time points (30, 60, 90, and 120 minutes) after exercise compared with the control session (p < 0.05). Only HIIE showed lower systolic BP levels at 60, 90, and 120 minutes after exercise compared with the control session (∼10 mm Hg; p < 0.05). No changes were observed in diastolic BP, or in large and small arterial compliance (p > 0.05). High-intensity interval exercise elicited a longer systolic postexercise hypotension than MICE compared with the control condition, despite the absence of acute modifications in large and small arterial compliance.

A 46,XX testicular disorder of sex development caused by a Wilms' tumour Factor-1 (WT1) pathogenic variant.

Molecular diagnosis is rarely established in 46,XX testicular (T) disorder of sex development (DSD) individuals with atypical genitalia. The Wilms' tumour factor-1 (WT1) gene is involved in early gonadal development in both sexes. Classically, WT1 deleterious variants are associated with 46,XY disorders of sex development (DSD) because of gonadal dysgenesis. We report a novel frameshift WT1 variant identified in an SRY-negative 46,XX testicular DSD girl born with atypical genitalia. Target massively parallel sequencing involving DSD-related genes identified a novel heterozygous WT1 c.1453_1456del; p.Arg485Glyfs*14 variant located in the fourth zinc finger of the protein which is absent in the population databases. Segregation analysis and microsatellite analysis confirmed the de novo status of the variant that is predicted to be deleterious by in silico tools and to increase WT1 target activation in crystallographic model. This novel and predicted activating frameshift WT1 variant leading to the 46,XX testicular DSD phenotype includes the fourth zinc-finger DNA-binding domain defects in the genetic aetiology of 46,XX DSD.

Effect of Low-Volume High-Intensity Interval Exercise and Continuous Exercise on Delayed-Onset Muscle Soreness in Untrained Healthy Males.

Farias Junior, LF, Browne, RAV, Frazão, DT, Dantas, TCB, Silva, PHM, Freitas, RPA, Aoki, MS, and Costa, EC. Effect of low-volume high-intensity interval exercise and continuous exercise on delayed-onset muscle soreness in untrained healthy males. J Strength Cond Res 33(3): 774-782, 2019-The aim of this study was to compare the effect of a single session of a low-volume high-intensity interval exercise (HIIE) and a continuous exercise (CE) on the magnitude of delayed-onset muscle soreness (DOMS) in untrained healthy males. Fifteen participants (25.1 ± 4.4 years) completed 2 experimental sessions in a randomized order: (a) low-volume HIIE: 10 × 60 seconds at 90% of maximal velocity (MV) interspersed with 60 seconds of active recovery at 30% of MV and (b) CE: 20 minutes at 60% of MV. Pressure-pain threshold (PPT), pressure-pain tolerance (PPTol), and perceived pain intensity (PPI) were assessed in the rectus femoris, biceps femoris, and gastrocnemius before and 24 hours after exercise. There was a decrease of PPT in the rectus femoris (-0.5 kg·cm) and PPTol in the gastrocnemius (-1.4 kg·cm) and an increase of PPI in the rectus femoris (14.4 mm) and in the biceps femoris (11.7 mm) 24 hours after the low-volume HIIE session (p ≤ 0.05). There was a decrease of PPT (rectus femoris: -0.8 kg·cm; biceps femoris: -0.5 kg·cm; gastrocnemius: -0.9 kg·cm) and PPTol (rectus femoris: -1.9 kg·cm; biceps femoris: -2.7 kg·cm; gastrocnemius: -1.6 kg·cm) and an increase of PPI (rectus femoris: 8.1 mm; biceps femoris: 10.3 mm; gastrocnemius: 17.5 mm) in all muscles 24 hours after the CE session (p ≤ 0.05). No difference was observed between HIIE and CE sessions in any DOMS-related parameter (p > 0.05). In conclusion, a single session of low-volume HIIE and CE elicited a similar mild DOMS 24 hours after exercise in untrained healthy males.

Effect of Acute Dietary Nitrate Supplementation on the Post-Exercise Ambulatory Blood Pressure in Obese Males: A Randomized, Controlled, Crossover Trial.

This study aimed to verify the effect of beetroot juice on post-exercise ambulatory blood pressure (BP) in obese individuals. Fourteen non-hypertensive obese males were randomly assigned to three experimental sessions: 1) Beetroot juice with exercise (BJE, 200ml with ≈ 800mg nitrate and 40 minutes of moderate-intensity aerobic exercise at an intensity of 50% of the heart rate reserve), 2) fruit soda with exercise (FSE, 200ml of a low-nitrate drink and the same exercise session) and 3) control (CON, 200ml of water, an insignificant nitrate drink without exercise). The concentration of total nitrites and nitrates in plasma (NOx) after the drinks and the 24-hour ambulatory BP were evaluated. A two-way (condition vs. time) ANOVA for repeated measures, with a Bonferroni post hoc was used to analyze variables. The plasma NOx concentration increased significantly after ingestion of beetroot juice (from 9.9 ± 8.4 µM to 47.0 ± 16.9 µM, p < 0.001) and remained elevated until 1 hour post-intervention (54.7 ± 10.1 µM, p < 0.001), while it did not change in FSE and CON groups. The BJE session decreased ambulatory systolic BP in 5.3 mmHg (IC95%, -10.1 to -0.6, p = 0.025) in the period of 1-6 h after the BJE session compared to the CON session and reduction of 3.8 mmHg (IC95%, -7.5 to -0.007, p = 0.05) compared to the FSE session. No significant changes were observed for ambulatory diastolic BP (p > 0.05). BJE enhanced the reduction of systolic ambulatory BP up to 6 hours following a moderate-intensity aerobic exercise in obese individuals with an elevated cardiovascular risk profile.

Effects of High-Intensity Interval and Moderate-Intensity Continuous Exercise on Physical Activity and Sedentary Behavior Levels in Inactive Obese Males: A Crossover Trial.

A total of 17 participants (30.2 ± 4.8 years; 35.4 ± 4 kg/m2; 38.2 ± 3.6 % body fat) were enrolled in this randomized crossover trial to analyze the effects of a single session of high-intensity interval (HIIE) and moderate-intensity continuous exercise (MICE) on the physical activity and sedentary behavior levels in inactive obese males. The participants performed two exercise sessions and one control session (no exercise): i) low-volume HIIE (10 x 60 s at 90% of maximal aerobic velocity [MAV] interspaced by 60 s at 30% of MAV); ii) MICE (20 min at 70% of maximum heart rate); and iii) control (25 min in a seated position). After all sessions, the physical activity and sedentary behavior levels were monitored by accelerometer over seven consecutive days. No differences in the physical activity (activity counts, and time spent at light, moderate, and vigorous intensities) and sedentary behavior (time spent at sedentary behavior, breaks, and bouts) levels were found among the sessions (HIIE, MICE and control) (p > 0.05). In summary, a single session of HIIE and MICE does not change the physical activity and sedentary behavior levels in inactive obese males. Therefore, low-volume of both high- and moderate-intensity exercise should be considered for inactive obese males given that it does not reduce the physical activity level or increase the time spent at sedentary behavior.

A Single Session of Low-Volume High-Intensity Interval Exercise Reduces Ambulatory Blood Pressure in Normotensive Men.

Dantas, TCB, Farias Junior, LF, Frazão, DT, Silva, PHM, Sousa Junior, AE, Costa, IBB, Ritti-Dias, RM, Forjaz, CLM, Duhamel, TA, and Costa, EC. A single session of low-volume high-intensity interval exercise reduces ambulatory blood pressure in normotensive men. J Strength Cond Res 31(8): 2263-2269, 2017-The magnitude and duration of postexercise hypotension (PEH) may provide valuable information on the efficacy of an exercise approach to blood pressure (BP) control. We investigated the acute effect of a time-efficient high-intensity interval exercise (HIIE) on ambulatory BP. Twenty-one normotensive men (23.6 ± 3.6 years) completed 2 experimental sessions in a randomized order: (a) control (no exercise) and (b) low-volume HIIE: 10 × 1 minute at 100% of maximal treadmill velocity interspersed with 1 minute of recovery. After each experimental session, an ambulatory BP monitoring was initiated. Paired sample t-test was used to compare BP averages for awake, asleep, and 20-hour periods between the control and the low-volume HIIE sessions. A 2-way repeated measures analysis of variance was used to analyze hourly BP after both experimental sessions. Blood pressure averages during the awake (systolic: 118 ± 6 vs. 122 ± 6 mm Hg; diastolic: 65 ± 7 vs. 67 ± 7 mm Hg) and 20-hour (systolic: 115 ± 7 vs. 118 ± 6 mm Hg; diastolic: 62 ± 7 vs. 64 ± 7 mm Hg) periods were lower after the low-volume HIIE compared with the control (p ≤ 0.05). Systolic and diastolic PEH presented medium (Cohen's d = 0.50-0.67) and small (Cohen's d = 0.29) effect sizes, respectively. Systolic PEH occurred in a greater magnitude during the first 5 hours (3-5 mm Hg). No changes were found in asleep BP (p > 0.05). In conclusion, a single session of low-volume HIIE reduced ambulatory BP in normotensive men. The PEH occurred mainly in systolic BP during the first 5 hours postexercise.

Let's Walk Outdoors! Self-Paced Walking Outdoors Improves Future Intention to Exercise in Women With Obesity.

In order to examine whether environmental settings influence psychological and physiological responses of women with obesity during self-paced walking, 38 women performed two exercise sessions (treadmill and outdoors) for 30 min, where oxygen uptake, heart rate, ratings of perceived exertion, affect, attentional focus, enjoyment, and future intentions to walk were analyzed. Physiological responses were similar during both sessions. However, during outdoor exercise, participants displayed higher externally focused attention, positive affect, and lower ratings of perceived exertion, followed by greater enjoyment and future intention to participate in outdoor walking. The more externally focused attention predicted greater future intentions to participate in walking. Therefore, women with obesity self-selected an appropriate exercise intensity to improve fitness and health in both environmental settings. Also, self-paced outdoor walking presented improved psychological responses. Health care professionals should consider promoting outdoor forms of exercise to maximize psychological benefits and promote long-term adherence to a physically active lifestyle.

Rating of perceived exertion and affective responses during Tai Chi Chuan.

Ratings of perceived exertion (RPE) and affective responses were assessed during Tai Chi Chuan. A total of 16 women (M age = 61.2 yr., SD = 8.8) participated in this study. Individuals practiced Tai Chi Chuan three times/week during seven weeks, and were assessed session-by-session (21 Wu Tai Chi Chuan sessions) in three moments (15, 30, and 45 min.) using Borg's scale (CR 0-10) and the Feeling Scale (+5/-5). With regard to RPE, there was a difference between 15 and 30 min. and between 15 and 45 min. The same pattern of differences was observed for the affective response. The RPE during the seven weeks ranged from "fairly light" to "moderate" and the affective response from "good" to "very good." Thus, Tai Chi Chuan was perceived as a low-moderate intensity and pleasurable (positive affect) exercise by middle-aged and elderly women.

Monitoring external and internal loads of brazilian soccer referees during official matches.

This study aimed to assess the external and internal loads of Brazilian soccer referees during official matches. A total of 11 field referees (aged 36.2 ± 7.5 years) were monitored during 35 matches. The external (distance covered, mean and maximal speed) and internal load parameters (session ratings of perceived exertion [RPE] training load [TL], Edwards' TL, and time spent in different heart rate [HR] zones) were assessed in 3-4 matches per referee. External load parameters were measured using a wrist Global Positioning System (GPS) receiver. No differences in distance covered (5.219 ± 205 vs. 5.230 ± 237 m) and maximal speed (19.3 ± 1.0 vs. 19.4 ± 1.4 km·h(-1)) were observed between the halves of the matches (p > 0.05). However, the mean speed was higher in the first half of the matches (6.6 ± 0.4 vs. 6.4 ± 0.3 km·h(-1)) (p < 0.05) than in the second half. The mean HR during the matches was ~89% of HRmax. In ~95% of the matches, the referees demonstrated a HR ≥ 80% of HRmax. Nonetheless, the time spent at 90-100% of HRmax was higher in the first half (59.9 vs. 52.3%) (p < 0.05). Significant correlations between session RPE TL and distance covered at 90-100% of HRmax (r = 0.62) and session RPE TL and maximal speed (r = 0.54) (p < 0.05) were noted. Furthermore, there was a positive correlation between session RPE TL and Edwards' TL (r = 0.61) (p < 0.05). Brazilian soccer referees demonstrated high external and internal load demands during official matches. The portable GPS/HR monitors and session RPE method can provide relevant information regarding the magnitude of the physiological strain during official matches. Key PointsHigh external and internal loads were imposed on Brazilian soccer referees during official matches.There was a high positive correlation between a subjective marker of internal load (session RPE) and parameters of external load (distance covered between 90-100% of HRmax and maximal speed).There was a high positive correlation between session RPE method and Edwards' method.Session RPE seems to be a reliable marker of internal load.The portable GPS/HR monitors and the session RPE method can provide relevant information regarding the magnitude of external and internal loads of soccer referees during official matches.

Association of daily step volume and intensity with cardiometabolic risk in older adults.

BACKGROUND: To investigate the association of daily step volume and intensity with cardiometabolic risk in older adults. METHODS: This cross-sectional study included 248 community-dwelling older adults (66.0 ± 4.6 years; 78 % females). The daily step volume and intensity were assessed using accelerometry. Cardiometabolic risk was defined using a continuous metabolic syndrome score (cMetS). The participants were categorized according to their daily step volume (inactive <5000; low active 5000-7499; active 7500-9999; highly active 10,000+ steps/day), and intensity (peak 30-min cadence; lowest, < 40; low, 40-59; average, 60-79; high, 80-99; highest, 100+ steps/min). Generalized linear models were used for data analyses. RESULTS: The active (ß = -0.29, p = 0.040) and the highly active (ß = -0.40, p = 0.026) groups had lower cMetS compared to the inactive group. No significant difference was found between the low active and inactive groups (ß = -0.21, p = 0.098). Every increment of 1000 steps/day was associated with a decrease of 0.06 in cMetS (p < 0.001). The average (ß = -0.37, p = 0.028), high (ß = -0.42, p = 0.015), and highest (ß = -0.81, p = 0.001) groups had lower cMetS than the lowest group. No significant difference was observed between the low and lowest groups (ß = -0.22, p = 0.192). Every increment of 10 steps/min in the peak 30-min cadence was associated with a decrease of 0.07 in cMetS (p = 0.003). CONCLUSIONS: Daily step volume and intensity were inversely associated with cardiometabolic risk in community-dwelling older adults in a dose-response manner.

Long-term cardiometabolic morbidity in young adults with classic 21-hydroxylase deficiency congenital adrenal hyperplasia.

PURPOSE: To study the current practice for assessing comorbidity in adults with 21-hydroxylase CAH and to assess the prevalence of comorbidity in these adults. METHODS: A structured questionnaire was sent to 46 expert centres managing adults with CAH. Information collected included current therapy and surveillance practice with a particular focus on osteoporosis/osteopaenia, hyperlipidaemia, type 2 diabetes/hyperinsulinaemia, hypertension, CV disease, obesity. RESULTS: Of the 31 (67%) centres from 15 countries that completed the survey, 30 (97%) screened for hypertension by measuring blood pressure, 30 (97%) screened for obesity, 26 (84%) screened for abnormal glucose homoeostasis mainly by using Hb1Ac (73%), 25 (81%) screened for osteoporosis mainly by DXA (92%), 20 (65%) screened for hyperlipidaemia and 6 (19%) screened for additional CV disease. Of the 31 centres, 13 provided further information on the six co-morbidities in 244 patients with a median age of 33 yrs (range 19, 94). Of these, 126 (52%) were females and 174 (71%) received fludrocortisone in addition to glucocorticoids. Of the 244 adults, 73 (30%) were treated for at least one comorbidity and 15 (21%) for more than 2 co-morbidities. Of 73, the patients who were treated for osteoporosis/osteopaenia, hyperlipidaemia, type 2 diabetes/hyperinsulinaemia, hypertension, CV disease, obesity were 43 (59%), 17 (23%), 16 (22%), 10 (14%), 8 (11), 3 (4%) respectively. CONCLUSION: Cardiometabolic and bone morbidities are not uncommon in adults with CAH. There is a need to standardise the screening for these morbidities from early adulthood and to explore optimal therapy through routine collection of standardised data.

Immediate post-exercise blood pressure and arterial stiffness in hypertensive and normotensive older females.

Although it has been suggested that increased arterial stiffness is linked to exaggerated blood pressure (BP) from brief moderate exercise, it is not clear whether this occurs in older adults with and without hypertension. This study investigates whether the immediate post-exercise systolic BP following brief moderate exercise is associated with arterial stiffness in older females with different BP status. This cross-sectional study included 191 older females aged 60-80 years without known cardiovascular disease (CVD). Arterial stiffness was determined by aortic pulse wave velocity (aPWV). Systolic BP was measured before and immediately following a 3-min moderate walking test (stage 1 Bruce protocol). Specific quartile-based thresholds were used to define an exaggerated immediate post-exercise systolic BP for hypertensive and normotensive older females (quartile 4 as an exaggerated response). Traditional CVD risk factors were assessed (covariates). Older females from the highest quartile of immediate post-exercise absolute systolic BP showed higher aPWV compared to their peers from the lowest quartile (ß = .22 m/s, p = .018). The quartile-based threshold to define the exaggerated post-exercise systolic BP was higher in hypertensive than in normotensive older females (174 vs. 172 mmHg). In summary, exaggerated immediate post-exercise systolic BP following a brief moderate exercise is associated with higher arterial stiffness in older females with different BP status.