Lloyd, Kelly D.
(2010)
Impact of Lifestyle Factors on Vascular Aging.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
Preventing, delaying and managing morbidities is critical to sustain a strong economy and health care system as the proportion of adults over 65 years increases. Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in Americans. Signs of CVD are apparent in the vasculature before symptoms of clinical disease are present. Subclinical disease can be measured using non-invasive B-mode ultrasound to assess carotid-femoral pulse wave velocity, common carotid artery intima media thickness, adventitial diameter and lumen diameter. Vascular aging is a natural process that can be modified by lifestyle and pharmacologic interventions. The purpose of this dissertation is to evaluate the impact of lifestyle factors on vascular aging.Hormone therapy use in early postmenopausal women was associated with significantly smaller adventitial and lumen diameter than those who did not use hormone therapy after adjustment for traditional CVD risk factors. These results concur with findings from another study in which higher levels of endogenous estrogen was related to smaller adventitial diameters. Together, these results suggest endogenous and exogenous estrogen have similar effects on adventitial diameter.Sedentary, overweight and obese male young adults at low risk of sleep apnea, and non-snorers had better vascular health, reflected in smaller adventitial and lumen diameters, than those at high risk for sleep apnea and snorers in a cross-sectional study. Results were robust after adjustment for age and systolic blood pressure and add to the literature linking CVD with sleep disordered breathing. Sedentary older adults who participated in a 6-month physical activity intervention had a clinically relevant decline in arterial stiffness, but greater increases in adventitial and lumen diameters compared to control participants. These findings support that it is never too late to gain cardiovascular benefit from physical activity. Research is needed to understand the implications of arterial diameter following introduction of physical activity to sedentary older adults.Together these studies support the public health importance of lifestyle factors contribution to subclinical CVD. Each study also provides evidence that measurement of adventitial diameter is critical for a comprehensive understanding of the vascular remodeling processes that accompany these lifestyle changes across the vascular aging continuum.
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Details
| Item Type: |
University of Pittsburgh ETD
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| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
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| Date: |
28 June 2010 |
| Date Type: |
Completion |
| Defense Date: |
2 April 2010 |
| Approval Date: |
28 June 2010 |
| Submission Date: |
5 April 2010 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Epidemiology |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
hormone therapy; physical activity; sleep apnea risk; adventitial diameter; aging; carotid ultrasound; lumen diameter; pulse wave velocity; lifecourse; obesity; subclinical cardiovascular disease |
| Other ID: |
http://etd.library.pitt.edu/ETD/available/etd-04052010-145936/, etd-04052010-145936 |
| Date Deposited: |
10 Nov 2011 19:34 |
| Last Modified: |
15 Nov 2016 13:38 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/6781 |
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