of Work: The purpose of this intra-agency agreement (Y02-AG-5-0282) was to support the measurement of aortic pulse wave velocity (APWV) as a measure of arterial stiffness in the NHLBI Activity Counseling Trial (ACT). This portion of the trial was designed to test the hypothesis that increases in physical activity resulting from educational interventions will reduce arterial stiffness. The setting is appropriate for this hypothesis testing because of the prospective nature of the study and the range of interventions which have been adopted. The measurements were taken at three points in time when other physiologic measures were taken. This allows assessment of intra-individual variability as well as the possibility of examining change over time in these measures in relation to the level of compliance with the physical activity intervention. The study has taken place in three geographic locations to assure adequate sample size for subgroup analysis: Memphis, TN, Dallas, TX and Palo Alto, CA. Pulse wave velocity was measured by two Doppler flow velocity probes simultaneously measuring the carotid and femoral arteries. A computer algorithm calculated average flow velocity tracings on a beat-to-beat basis. The time needed for the pressure wave to travel from the proximal to distal sampling site was calculated from the foot of the pressure wave. All examinations have been completed, and both cross-sectional and longitudinal data files have been prepared and used for analysis. While the numbers of individual participants with readings at all three time periods is relatively small, there are sufficient numbers of persons with a baseline and at least one follow-up reading to permit longitudinal analysis to assess the effect of the intervention on the measures of stiffness. Participants in the study were randomized to one of three levels of intervention. The first, called standard care, consisted of in-clinic physician's advice and health educator advice concerning the value of exercise in maintaining health. The second level, called staff assistance, added to standard care in-clinic counseling by the health educator and a program of interactive mailings between the health educator and the participant. The third level of intervention, called staff counseling, added to staff assistance a program of telephone counseling and invitations to the participants to attend classes at the clinic on the benefits of exercise. Baseline results have been published. Activity in this project for FY 2002 has dealt with analysis of longitudinal pulse wave velocity data from the study. Preliminary analyses to date have shown no significant effect of the study intervention on changes in pulse wave velocity over time. However, a number of measured independent variables, including participant self-reports of walking, have shown significant effects on pulse wave velocity. These analyses are continuing and a manuscript is in preparation.
| Havlik, R J; Brock, D; Lohman, K et al. (2001) High-density lipoprotein cholesterol and vascular stiffness at baseline in the activity counseling trial. Am J Cardiol 87:104-7, A9 |
