First-Time Marathoners Turn Back Clock on Vascular Aging

You'll want this reversal but your doctor will look at the healthy individuals recruited and be able to successfully say this doesn't apply to stroke survivors. That 'get out of jail free' card should be laughed at and DEMAND your doctor provide protocols to get you running again.  Since you will get no help from your doctor you are completely on your own to learn running again. I'd suggest 'Teaching Me to Run' by Tommye-K. Mayer

First-Time Marathoners Turn Back Clock on Vascular Aging

Arterial stiffening cannot be helped by available medications

• by Nicole Lou, Staff Writer, MedPage Today January 07, 2020

Healthy individuals training for their first marathon saw a reversal in age-related aortic stiffening, a known cardiovascular risk factor, researchers found in a prospective study.
After 6 months of unsupervised training for the London Marathon, 138 people demonstrated improved distensibility on cardiac MRI in two levels of the thoracic aorta: the proximal descending aorta (average 9% increase from baseline, P=0.009) and the diaphragmatic descending aorta (16% increase, P=0.002).
This correlates with 4 years regained in "aortic age" given the amount of distensibility known to be lost over time due to aging, reported Charlotte Manisty, MD, of Barts Heart Centre in London, and colleagues in the Journal of the American College of Cardiology.
"If the observed effects of exercise on LAS [large artery stiffening] can be sustained, they could have major effects on the myocardium, kidney, brain, and various other organs, with a potentially broad impact on age-related conditions," commented Julio Chirinos, MD, PhD, of the Hospital of the University of Pennsylvania in Philadelphia.
"Despite its benefits, exercise remains underutilized and challenging to implement on a large scale, both in the general public and in clinical populations. Therefore, there is a need for implementation research aimed at overcoming common barriers to exercise and physical activity," he wrote in an accompanying editorial.
Study participants had no previous marathon experience and were running less than 2 hours a week at baseline. Half of the enrolled cohort were men. Mean age was 37.
Their recommended exercise training regimen consisted of 6 to 13 miles of weekly running before the 2016 and 2017 London Marathons. They had central blood pressure and aortic stiffness evaluated roughly 176 days before and 16 days after finishing the marathon.
Greater reversals in aortic stiffening were observed in older individuals, men, slower runners, and those with higher blood pressure.
"This study emphasizes the importance of lifestyle to modify the aging process, particularly as it appears 'never too late' to gain the benefit as seen in older, slower runners," Manisty's group noted.
Not all thoracic aortic segments showed improved elasticity with marathon training, however, as no change was seen in the ascending aorta in the study.
Marathon training reduced both brachial and aortic systolic blood pressures by 4 mm Hg -- in line with the magnitude achievable on first-line antihypertensive drugs, the investigators reported.
"The improvement in aortic stiffness was both functional due to blood pressure lowering, as well as intrinsic due to structural changes in the descending aorta. This is supported by wave separation analysis, which showed that reflection magnitude was unchanged," they stated.
That the increase in distal descending aortic distensibility was at least partially independent of the change in distending pressure suggests intrinsic changes in the material properties of the aortic wall, rather than changes in loading conditions alone, Chirinos agreed.
Manisty's team acknowledged that the study of healthy marathon-finishers precludes the generalizability of their results to hypertensive individuals and those who didn't complete the marathon.
They also had no information on the intensity, frequency, and type of exercise training undertaken.
A lack of controls also limits the interpretation of the findings, Chirinos said, noting that the finding of a more pronounced reduction in aortic stiffness among certain subgroups appears to be at odds with previous data suggesting less pronounced effects of exercise training on aortic stiffness among hypertensive and older adults.
"As a consequence of its key role in health and disease, LAS imposes a large global burden of age-related morbidity and mortality, which will become increasingly important as competing causes of death (such as atherosclerosis, cancer, and transthyretin amyloidosis) are addressed with more effective prevention and treatment strategies," the editorialist said.
"LAS therefore represents a high-priority therapeutic target that is not addressed by our current pharmacological approaches," he stated.

• Primary Source

  Journal of the American College of Cardiology

  Source Reference: Bhuva AN, et al "Training for a first-time marathon reverses age-related aortic stiffening" J Am Coll Cardiol 2020; DOI: 10.1016/j.jacc.2019.10.045.

• Secondary Source

  Journal of the American College of Cardiology

  Source Reference: Chirinos JA "The run against arterial aging" J Am Coll Cardiol 2020; DOI: 10.1016/j.jacc.2019.11.007.