Cardiovascular Diseases Clinical Trial
To determine the minimal dose of physical activity necessary to improve cardiovascular (CV) health by evaluating and aerobically training 500 healthy men and women, 30-65 years of age.
BACKGROUND:
Results from the study will provide important data regarding the dose of exercise required
to improve cardiovascular health, as described both by the NIH Consensus Conference on
Physical Activity and CV Health and by the recent Report of the Surgeon General. The study
was initiated in response to a Program Announcement released in October 1994 on Physical
Activity and Cardiopulmonary Health.
DESIGN NARRATIVE:
Subjects were randomized into one of five groups in a 2x2 factorial design plus a usual care
control group (n=100 in each of 5 groups). Subjects trained at a moderate (45-55 percent) or
high (65-75 percent of maximum heart rate reserve) intensity, and at a frequency of 3-4 or
5-7 days/week (viz., Group 1, 65-75 percent at 5-7 days/week; Group 2, 65-75 percent at 3-4
days/week; Group 3, 45-55 percent at 5-7 days/weekk; Group 4, 45-55 percent at 3-4
days/week; and, Group 5, usual care control). Controls received advice from a physician to
increase their physical activity. The subjects in Groups 1-4 participated in an exercise
intervention using walking as the mode of training for a total of 24 months. A lifestyle
model of physical activity was used, in that subjects could accumulate exercise minutes
during the day in 10-minute increments or more continuously (for a total duration of 30
minutes/day), and training was conducted where it was most convenient for the subject (i.e.
at home, work or some combination thereof). Tests occurred at baseline (0), 12, and 24
months of the intervention.
The hypothesis was that Groups 1-4 would show a significant reduction in systolic and
diastolic blood pressure and an increase in HDL-cholesterol compared to the usual care
control group. A second hypothesis was that that there would be significant main effects for
both frequency and intensity, with the higher levels of each producing greater improvement
on the major outcome variables compared to the lower levels of each dose. The study also
planned to determine the minimal dose response to exercise necessary to elicit significant
improvement in cardiovascular and behavioral health factors. Finally, the project included
examination of the effects of age and level of initial test values on outcome variables to
determine if their interactions affected the results of the intervention.
The study also includes assessment of the effect of specific doses of exercise on the
reduction in systolic and diastolic blood pressure and increase in HDL-cholesterol (primary
outcomes), in addition to changes in levels of physical activity, aerobic fitness (VO2 max),
body composition (percent fat and waist-to-hip ratio), triglycerides, and LDL-cholesterol
(secondary outcomes). Psychological variables (depression, anxiety, anger, and perceived
stress) and health-related quality of life are also evaluated, and the important issue of
adherence to exercise is examined with respect to the effect of dose of exercise.
;
Primary Purpose: Prevention
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