Tiffany Potter

Short-Term Aerobic Exercise Reduces Arterial Stiffness in Older Adults With Type 2 Diabetes, Hypertension, and Hypercholesterolemia

OBJECTIVE The relationship between increased arterial stiffness and cardiovascular mortality is well established in type 2 diabetes. We examined whether aerobic exercise could reduce arterial stiffness in older adults with type 2 diabetes complicated by comorbid hypertension and hyperlipidemia. RESEARCH DESIGN AND METHODS A total of 36 older adults (mean age 71.4 ± 0.7 years) with diet-controlled or oral hypoglycemic–controlled type 2 diabetes, hypertension, and hypercholesterolemia were recruited. Subjects were randomly assigned to one of two groups: an aerobic group (3 months vigorous aerobic exercise) and a nonaerobic group (no aerobic exercise). Exercise sessions were supervised by a certified exercise trainer three times per week, and a combination of cycle ergometers and treadmills was used. Arterial stiffness was measured using the Complior device. RESULTS When the two groups were compared, aerobic training resulted in a decrease in measures of both radial (−20.7 ± 6.3 vs. +8.5 ± 6.6%, P = 0.005) and femoral (−13.9 ± 6.7 vs. +4.4 ± 3.3%, P = 0.015) pulse-wave velocity despite the fact that aerobic fitness as assessed by Vo2max did not demonstrate an improvement with training (P = 0.026). CONCLUSIONS Our findings indicate that a relatively short aerobic exercise intervention in older adults can reduce multifactorial arterial stiffness (type 2 diabetes, aging, hypertension, and hypercholesterolemia).

Aerobic training restores arterial baroreflex sensitivity in older adults with type 2 diabetes, hypertension, and hypercholesterolemia.

Objective: Lowered baroreflex sensitivity (BRS) predicts mortality and occurs with increasing age and diabetes. We examined whether aerobic exercise could restore arterial BRS in adults at high cardiovascular risk (diabetes, geriatric age group, hypercholesterolemia, and hypertension). Design: Randomized, controlled, single-blind study. Setting: VITALiTY (Vancouver Initiative to Add Life to Years) Research Laboratory. Participants: Thirty-nine older adults (mean age, 71.5 ± 0.7 years) with diet-controlled or oral hypoglycemic-controlled type 2 diabetes, hypertension, and hypercholesterolemia. Interventions: Subjects were recruited to each of 2 groups: an aerobic group (3 months of vigorous aerobic exercise as defined by 80% to 85% of maximal heart rate), and a nonaerobic (no aerobic exercise) group. Exercise sessions were supervised by a certified exercise trainer 3 times per week. Main Outcome Measures: Baroreflex function was assessed using the spontaneous baroreflex method. Main outcome measures included BRS, BRSup, BRSdown, and &OV0312;o2max. Results: The aerobic group demonstrated an increase in BRS that was not demonstrated in the nonaerobic group (+60.9 ± 23.5 vs +2.2 ± 7.9%; P = 0.010). Conclusions: Our findings indicate that a relatively short aerobic exercise intervention can reverse functional impairments of the arterial baroreflex function in older adults at high cardiovascular risk.

Aerobic training-induced improvements in arterial stiffness are not sustained in older adults with multiple cardiovascular risk factors

There is a well-established relationship between increased arterial stiffness and cardiovascular mortality. We examined whether a long-term aerobic exercise intervention (6 months) would increase arterial compliance in older adults with hypertension complicated by Type 2 diabetes (T2DM) and hyperlipidemia. A total of 52 older adults (mean age 69.3±0.6 years, 30 males and 22 females) with diet/oral hypoglycemic-controlled T2DM, hypertension and hypercholesterolemia were recruited. Subjects were randomly assigned to one of two groups: an aerobic group (6 months vigorous aerobic exercise, AT group) and a non-aerobic group (6 months of no aerobic exercise, NA group). Arterial stiffness was measured as pulse-wave velocity (PWV) using the Complior device. Aerobic training decreased arterial stiffness as measured by both radial (P=0.001, 2-way analysis of variance with repeated measures) and femoral (P=0.002) PWV. This was due to a decrease in arterial stiffness in the AT group after 3 months of training, which was not maintained after 6-month training for either radial (P=0.707) or femoral (P=0.680) PWV. Our findings indicate that in older adults with multiple cardiovascular risk factors, short-term improvements in arterial stiffness became attenuated over the long term.

Short-term aerobic exercise reduces nitroglycerin-induced orthostatic intolerance in older adults with type 2 diabetes.

Aims/Hypothesis: Older adults are at a high risk for syncope due to orthostatic intolerance (OI), and this risk increases with comorbid type 2 diabetes and vasoactive medications. Despite many benefits, previous investigations have shown worsening OI with aerobic training. We examined whether aerobic exercise reduced OI in older adults with type 2 diabetes who were given a short-acting vasoactive agent (nitroglycerin). Methods: Forty older adults (25 males and 15 females, mean age 71.4 ± 0.7 years, ranging in age from 65 to 83 years) with type 2 diabetes were recruited. Subjects were randomized to each of 2 groups: an aerobic group (3 months of vigorous aerobic exercise) and a nonaerobic (no aerobic exercise) group. Exercise sessions were supervised by a certified exercise trainer 3 times per week. After being given 400 μg of sublingual nitroglycerin, each subject was placed in a 70° head-up tilt for 30 minutes. Results: When the 2 groups were compared using a Cox proportional hazards model, tilt table tolerance was significantly better in the aerobic group as compared to in the nonaerobic group (χ2MC = 7.271, P = 0.007). Conclusions: Our findings indicate that a relatively short aerobic exercise intervention can improve postnitroglycerin orthostatic tolerance in older adults with type 2 diabetes.

Circular Taxonomies: Regulating European and American Women through Representations of North American Indian Women

In eighteenth-century accounts of Indigenous North American cultures, the socially mediated European female body was imported as a prescriptive model for the construction of the public identity of the Native American woman. Not surprisingly, presumed prediscursive notions of feminineweakness (physical, intellectual, sexual, and spiritual) informEuropean accounts of and policy toward the physical bodies, social roles, and cultural organizations of Indigenous North American women as their racialized female identity was articulated as a negative space. What is perhaps more surprising are the ways in which this negative space was then used to further define and regulate European femininity.1 The created idea of the Indigenous woman became ameans to coerce European women into accepting acquiescent and subordinating models of identity and behavior, given that even supposed savages were reported to recognize them as natural. This circular taxonomyof femininity is an important dialogue between the old and new worlds, where a scale of relative liminality undermines by comparison women in either culture who act outside of their prescribed identities and roles. As JoanWallach Scott has argued, ‘‘Gender is a constitutive element of social relationships based upon perceived differences between the sexes, and gender is a primary way of signifying relationships of power’’ (42). In eighteenth-century Europe, the formalized domestic relationship of marriage functioned as the physical and social embodiment of those hierarchical gendered relationships. As might be expected, colonial accounts of North American Indian life take a particular interest in the domestic arrangements of the people they describe. The discursive implications of the accounts of these arrangements are the focus of this essay, which assesses

A Certain Sign That He Is One of Us: Clarissa's Other Libertines

The typology that links Robert Lovelace with the Restoration rake— derived from the Restoration stage and the life of Rochester1—depicts Lovelace as the greatest, most rakish, most demonic embodiment of the libertine model. With the exception of Tom Keymers excellent analysis of Lovelaces relationship to the intellectual libertinism of his day, little has been done to position Lovelace and his fellow libertines, Jack Belford and Colonel Morden, within the cultural discourses of the era of their creation, some seventy years after the death of Rochester.2 Though libertinism is often assumed to have declined after the reign of Charles p, or at least with