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The Effect of Exercise Training on Mental Stress-Induced Silent Ischemia

This study has been completed.

Sponsored by: Department of Veterans Affairs
Information provided by: Department of Veterans Affairs
ClinicalTrials.gov Identifier: NCT00018252
  Purpose

Coronary artery disease (CAD) remains the leading cause of death in the elderly. Silent myocardial ischemia (SI) is a manifestation of CAD in which there is a transient alteration in myocardial perfusion, function, and/or electrical activity not accompanied by chest pain. Mental and emotional stress, in particular hostility and anger are potent inducers of SI, Individuals with SI are at a 3-5 fold higher risk for the development of angina, myocardial infarction and death than subjects without SI.


Condition Intervention
Myocardial Ischemia
Behavioral: exercise

MedlinePlus related topics:   Exercise and Physical Fitness    Stress   

U.S. FDA Resources

Study Type:   Interventional
Study Design:   Randomized
Official Title:   The Effect of Exercise Training on Mental Stress-Induced Silent Ischemia

Further study details as provided by Department of Veterans Affairs:

Study Start Date:   April 1997
Estimated Study Completion Date:   March 2000

Detailed Description:

The hypothesis of this study is that older individuals with occult cad, mental stress/ emotional arousal (anger) increases sympathetic nervous system activity resulting in vasoconstriction thereby eliciting transient episodes of SI. Therefore an aerobic exercise intervention that reduces the response to anger/hostility and improves vascular compliance will decrease the ischemic burden in SI patients. The specific objectives are: To determine if non-smoking older individuals with exercise-induced SI have increased vasoreactivity (blood pressure, heart rate) responses to the laboratory presentation of mental stressors, decreased vascular compliance and brachial artery endothelial reactivity compared to matched non-ischemic controls; 2) To perform a randomized clinical trial that will examine the effects of 9 months of aerobic exercise training versus usual care on vasoreactivity, vascular compliance and ischemic burden on Holter monitor. Older individuals without a history of overt CAD will be recruited and evaluated for the presence of exercise-induced SI. Baseline cross-sectional comparisons of vasoreactivity and cardiovascular function will be performed between those with SI and non-ischemic controls. The individuals with SI will be enrolled in a randomized clinical trial of exercise vs usual care. Exercise treadmill testing with measurement of maximal aerobic capacity will be used to determine fitness. Vasoactivity will be quantified during a mental stress test with real time 2d echo imaging. Vascular function will be assessed using high frequency ultrasound measurements of flow-mediated brachial artery endothelial reactivity.

  Eligibility
Ages Eligible for Study:   60 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes

Criteria

Older individuals without a history of overt CAD.

  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00018252

Locations
United States, Maryland
VA Maryland Health Care System    
      Baltimore, Maryland, United States, 21201

Sponsors and Collaborators
  More Information


Study ID Numbers:   AGCG-003-96F
First Received:   July 3, 2001
Last Updated:   June 23, 2005
ClinicalTrials.gov Identifier:   NCT00018252
Health Authority:   United States: Federal Government

Study placed in the following topic categories:
Heart Diseases
Myocardial Ischemia
Stress, Psychological
Vascular Diseases
Stress
Ischemia
Behavioral Symptoms

Additional relevant MeSH terms:
Pathologic Processes
Cardiovascular Diseases

ClinicalTrials.gov processed this record on October 07, 2008




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