The beneficial effects of Tai Chi exercise on endothelial function and arterial stiffness in elderly women with rheumatoid arthritis

Abstract

BackgroundRheumatoid arthritis (RA) has been known to be associated with increased risk of cardiovascular disease (CVD). The aim of this study was to investigate the effects of Tai Chi exercise on CVD risk in elderly women with RA.MethodIn total, 56 female patients with RA were assigned to either a Tai Chi exercise group (29 patients) receiving a 3-month exercise intervention once a week or a control group (27 patients) receiving general information about the benefits of exercise. All participants were assessed at baseline and at 3 months for RA disease activity (Disease Activity Score 28 and Routine Assessment of Patient Index Data 3), functional disability (Health Assessment Questionnaire), CVD risk factors (blood pressure, lipids profile, body composition, and smoking), and three atherosclerotic measurements: carotid intima-media thickness, flow-mediated dilatation (FMD), and brachial-ankle pulse wave velocity (baPWV).ResultsFMD, representative of endothelial function, significantly increased in the Tai Chi exercise group (initial 5.85 ± 2.05 versus 3 months 7.75 ± 2.53 %) compared with the control group (initial 6.31 ± 2.12 versus 3 months 5.78 ± 2.13 %) (P = 1.76 × 10−3). Moreover, baPWV, representative of arterial stiffness, significantly decreased in the Tai Chi exercise group (initial 1693.7 ± 348.3 versus 3 months 1600.1 ± 291.0 cm/s) compared with the control group (initial 1740.3 ± 185.3 versus 3 months 1792.8 ± 326.1 cm/s) (P = 1.57 × 10−2). In addition, total cholesterol decreased significantly in the Tai Chi exercise group compared with the control group (−7.8 ± 15.5 versus 2.9 ± 12.2 mg/dl, P = 2.72 × 10−2); other changes in RA-related characteristics were not significantly different between the two groups. Tai Chi exercise remained significantly associated with improved endothelial function (FMD; P = 4.32 × 10−3) and arterial stiffness (baPWV; P = 2.22 × 10−2) after adjustment for improvement in total cholesterol level.ConclusionTai Chi exercise improved endothelial dysfunction and arterial stiffness in elderly women with RA, suggesting that it can be a useful behavioral strategy for CVD prevention in patients with RA.Electronic supplementary materialThe online version of this article (doi:10.1186/s13075-015-0893-x) contains supplementary material, which is available to authorized users.

The Effects of Tai Chi on Markers of Atherosclerosis, Lower-limb Physical Function, and Cognitive Ability in Adults Aged Over 60: A Randomized Controlled Trial

“…In addition, all groups showed significant lower values in PWV on both ankles at Week 12 than that at Week 6, indicating that all subjects had significant improvements in vascular elasticity after receiving training in phase two. Taken together, all three TC styles have the potential to effectively improve indices of atherosclerosis and arterial stiffness, which is supported by a previous study investigating the beneficial effects of 3-months of TC training on arterial stiffness in older women with rheumatoid arthritis [ 34 ]. One possible explanation is that TC can effectively modulate heart rate variability and baroreflex sensitivity, which are highly related to arterial stiffness observed in aging population [ 23 , 51 , 52 ].…”

“…TC training has been shown to be an effective therapy to maintain or elevate arterial compliance for older adults [ 33 ]. Shin et al [ 34 ] found that a 10-week (3 sessions x 60 min weekly) program of TC increased arterial compliance among female seniors. Mechanistically, these results suggest that TC can prevent cardiovascular diseases through improving endothelial function and arterial stiffness [ 34 ].…”

“…Shin et al [ 34 ] found that a 10-week (3 sessions x 60 min weekly) program of TC increased arterial compliance among female seniors. Mechanistically, these results suggest that TC can prevent cardiovascular diseases through improving endothelial function and arterial stiffness [ 34 ]. Beyond physical function and chronic illness, it is notable that early works have shown that TC has a positive effect on preventing cognitive decline.…”

Sex differences in mechanisms of arterial stiffness

“…Additional investigations have identified a positive correlation between elevations in circulating leptin and arterial stiffness in women with SLE, suggesting the potential for leptin to play a role in the development of arterial stiffness in this population (Vadacca et al, ). Additional autoimmune disorders that more frequently occur in women and are associated with elevated arterial stiffness include rheumatoid arthritis (Ambrosino et al, ; Shin et al, ), multiple sclerosis (Irzyk et al, ), and Graves' disease (Bodlaj et al, ; Inaba et al, ). Much of the work examining the presence and severity of arterial stiffness in women with autoimmune disorders has been performed at the clinical level only.…”

Efeitos do treinamento físico na função endotelial e nas propriedades estruturais de grandes artérias de pacientes com miopatias autoimunes sistêmicas

“…No que se refere às doenças autoimunes sistêmicas, vários são os estudos que mostraram a presença de rigidez arterial e disfunção endotelial nesses pacientes, bem como, observou-se em alguns estudos uma forte correlação com os parâmetros clínicos envolvidos nessas doenças, sugerindo que a doença compoe um fator idependente para doenças cardiovasculares (Soltész et al, 2009;De Groot et al, 2015). Achados mostrados em doenças como artrite reumatoide, lúpus eritematoso sistêmico, arterite de Takayasu, artrite psoriásica, síndrome de Sjögren, síndrome antifosfolipide, entre outras (Salmon e Roman, 2001;Gerli et al, 2004;Soltész et al, 2009;De Groot et al, 2015;Caraba et al, 2017 força, e a função muscular De Salles Painelli et al, 2009;Oliveira et al, 2018), observa-se melhoras sobre a função endotelial e rigidez arterial de pacientes com doenças autoimunes sistêmicas (Dos Metsios et al, 2014;Shin et al, 2015). Embora os resultados sejam motivadores, até o momento atual não há evidências sobre os potenciais efeitos de um programa de treinamento físico sobre as propriedades estruturais e funcionais de grandes vasos arteriais de pacientes com MAS.…”