Lifelong Training Mitigates Age-Related Vascular Stiffness Independent Of Blood Pressure

Abstract

Introduction: Carotid-femoral pulse wave velocity (cfPWV) is a well-established independent predictor of cardiovascular risk and increases progressively with advancing age. However, sustained lifelong physical activity may attenuate vascular aging and reduce associated cardiovascular risks. In this study, we tested the hypothesis that older master athletes with a history of long-term endurance training exhibit reduced arterial stiffness compared to both a reference population (population-based cohort, n=8509, age 18 to 80 years), and age-matched sedentary controls. Methods: We recruited 109 master athletes (age 58.7±13.2 years; BMI 22.8±2.4 kg/m²; 53 females) during the 25th World Masters Athletics Championships in 2024 (Gothenburg, Sweden). Individuals with significant cardiovascular conditions, such as atrial fibrillation or congestive heart failure, were excluded. We compared a sub-cohort of 30 master athletes aged over 65 years (age 73.9±6.5 years; BMI 23.8±2.8 kg/m²; 8 females) to a sedentary group of 49 participants (age 73.8±6.5 years; BMI 26.3±3.6 kg/m²; 22 females) from the Mecklenburg-Vorpommern Frailty Interventional Trial (MV-Fit). We assessed heart rate, brachial oscillometric blood pressure (MAP), and cfPWV using oscillometry (Vicorder). Results: Compared to Baier et al. (Clin Res Cardiol, 2018), cfPWV in 94.7% of the master athletes was below the 50th percentile, and 7.5% fell below the 2.5th percentile. cfPWV of master athletes was correlated with age (r=0.5315), BMI (r=0.2369), waist-to-hip ratio (r=0.4740), and weekly training volume (r=-0.2503; all p<0.05). Within the sub-cohort aged ≥65 years, master athletes did not differ significantly from sedentary controls in age (MV-Fit 73.8±6.5 years vs athletes 73.9±6.5 years, p=0.9459) or MAP (95.8±11.5 mmHg vs 94.3±10.2 mmHg; p=0.9003). However, they exhibited a significantly lower BMI (23.8±2.8 kg/m² vs 26.3±3.6 kg/m², p=0.0010). Notably, cfPWV was substantially lower among older master athletes compared to sedentary controls (9.2±1.7 m/s vs. 11.1±2.0 m/s; p<0.0001). Conclusion: Physical training is associated with a marked attenuation of age-related vascular stiffening. This finding supports the notion that sustained vigorous physical activity may result in protective effects on vascular health in older adults. These results highlight the importance of promoting regular endurance exercise as a non-pharmacological strategy to preserve vascular function and reduce cardiovascular risk with aging.