PhD project participating in the National Research School in General Medicine.
Our research projects aim to identify individuals with high cardiovascular risk by measurement of vascular elasticity. We also want to examine whether physical activity improves vascular elasticity.
One of the most important goals in primary care is to identify individuals with increased risk for cardiovascular disease (CVD). Measures of arterial elasticity provide extra prognostic information regarding cardiovascular risk beyond arterial blood pressure measurements. Whether arterial elasticity affects the risk for CVD in the long term is still unclear.
Increased physical activity is included in the recommendations to prevent CVD for individuals with diabetes mellitus type 2 (T2DM). However, the real impact of increased physical activity on vascular function still needs to be thoroughly investigated. There are only a few observations on how physical activity affects changes in vascular elasticity. Studies in representative populations and long-term follow-ups are still missing.
Our main goal is to determine the association of arterial elasticity with the development of cardiovascular disease. We will thoroughly investigate the effect of physical activity on arterial elasticity.
To investigate the association between physical activity levels and arterial stiffness in a longitudinal observational study from a representative Swedish population.
To investigate whether arterial elasticity measured by pulse wave analysis predicts cardiovascular morbidity and mortality for men and women in a longitudinal observational study.
To investigate whether arterial stiffness measured by non-invasive measurement of diastolic pulse wave improves the predictive model for risk of developing CVD.
To investigate the effect of physical activity on arterial elasticity in patients with T2DM.
Study 1- 3 is based on data from the Vara-Skövde cohort in the Skaraborg project. Between 2002 and 2005, 2816 randomly selected individuals were examined (Men = 1400) at baseline.
After ten years (2012- 2014), 1327 participants were re-examined according to the same protocol as at baseline. Information on psychosocial, lifestyle matters, medical history and medication was collected. Body height, weight, pulse and blood pressure were measured. Analysis for LDL cholesterol, C- reactive protein, insulin and oral glucose tolerance test were performed. The level of physical activity was estimated using a question about Leisure Time Physical Activity (LTPA). Arterial compliance was measured over arteria radialis based on diastolic pulse contour analysis of arterial waveform. Data on acute myocardial infarction and stroke were obtained from the Swedish Cause of Death Register and the Swedish National Inpatient Register.
Study 4 will be a randomized controlled trial where we plan to include patients with DM type 2.
We have found that high LTPA was associated with higher small arterial compliance suggesting that positive effects of LTPA on arterial elasticity persist over time (published). Moreover, we hypothesize that increased physical activity will improve vascular elasticity in people with T2DM.
We have observed that arterial elasticity strongly correlates with CVD independently from other known risk factors, including blood pressure in a general population. These results might help to develop preventive strategies to decrease CVD (in manuscript).
This study will provide information on the impact of physical activity on vascular health, which will be useful in clinical work in primary health care and public health.
Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Bledar Daka, Associate professor in general medicine and general practitioner
