Aerobic exercise (AE) has well documented health benefits to prevent cardiovascular diseases (CVD) such as heart diseases or stroke. However, there is very little evidence whether resistance exercise (RE) prevents CVD or modifies the development of CVD risk factors, independent of and combined with AE. In fact, the Federal Physical Activity Guidelines primarily focus on AE for health. There remains an important unanswered question: ?What type or combination of exercise is most effective for CVD prevention?? To answer this question, the goal of this study, ?Comparison of the Cardiovascular Benefits of Resistance, Aerobic, and Combined Exercise (Cardio-RACE)? is to test the hypothesis that RE and AE have independent CVD benefits, thus the combined RE plus AE have greater additive benefits than either RE or AE alone. To achieve this goal, the project includes two specific aims:
AIM 1 : To explore the comparative effectiveness of RE, AE, and combined exercise on incident CVD risk factors (hypertension, type 2 diabetes, hypercholesterolemia, and obesity) and CVD morbidity and mortality, by analyzing a large cohort data.
AIM 2 : To evaluate the independent and additive (combined) effects of RE and AE training on traditional and emerging CVD risk factors/markers (central hemodynamics, inflammatory biomarkers, glucose metabolism, blood lipids, adiposity, sarcopenic indices, and fitness), by conducting a randomized controlled trial of exercise.
In Aim 1, the Aerobics Center Longitudinal Study data in >34,000 adults will be used. This is the largest cohort followed over 35 years with RE and objectively measured muscular strength.
In Aim 2, 400 adults at high risk of developing CVD will be recruited and randomized to one of four 1-year intervention groups: 1) RE training only, 2) AE training only, 3) a combined RE plus AE training, or 4) no training control. The proposed project will investigate mechanisms of how RE and AE training modify traditional and emerging CVD risk factors/markers (Aim 2), and further prevent CVD morbidity and mortality in the general population (Aim 1). This study could fill an important gap in our knowledge of the benefits of RE to further prevent CVD, beyond the well-documented benefits of AE. This project potentially contributes to developing more effective clinical and public health strategies to prevent CVD and advancing more comprehensive future physical activity guidelines to support the mission of the National Institutes of Health.

Public Health Relevance

Aerobic (cardio) exercise has well-documented health benefits. Resistance exercise such as weight lifting was traditionally associated with improving sports performance in athletes, yet little evidence exists regarding health benefits of resistance exercise in the general population, especially for cardiovascular disease (CVD) prevention such as heart attack or stroke. To answer one of the most commonly asked questions about exercise and health: ?What type or combination of exercise is most effective to prevent CVD?? we have 2 comprehensive research strategies: we will 1) analyze a large cohort database in over 34,000 adults, followed for 35 years, on incident CVD risk factors and CVD morbidity and mortality and 2) investigate mechanisms of how resistance exercise modify traditional and emerging CVD risk factors, by conducting a 1-year exercise intervention in 400 adults at high risk of developing CVD with 4 groups: resistance training only, aerobic training only, a combined resistance plus aerobic training, or no training control, following our developed pilot study protocol. This project will contribute to developing more effective clinical and public health strategies to further prevent CVD, and advancing more comprehensive future physical activity guidelines.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL133069-03
Application #
9477770
Study Section
Clinical and Integrative Cardiovascular Sciences Study Section (CICS)
Program Officer
Nicastro, Holly L
Project Start
2016-07-01
Project End
2021-04-30
Budget Start
2018-05-01
Budget End
2019-04-30
Support Year
3
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Iowa State University
Department
Other Health Professions
Type
Sch of Home Econ/Human Ecology
DUNS #
005309844
City
Ames
State
IA
Country
United States
Zip Code
50011
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Bakker, Esmée A; Lee, Duck-Chul; Sui, Xuemei et al. (2018) Association of Resistance Exercise With the Incidence of Hypercholesterolemia in Men. Mayo Clin Proc 93:419-428
Bakker, Esmée A; Lee, Duck-Chul; Sui, Xuemei et al. (2017) Association of Resistance Exercise, Independent of and Combined With Aerobic Exercise, With the Incidence of Metabolic Syndrome. Mayo Clin Proc 92:1214-1222