title: Physical exercise, fitness and dietary pattern and their relationship with circadian blood pressure pattern, augmentation index and endothelial dysfunction biological markers: EVIDENT study protocol.
abstract: BACKGROUND
  Healthy lifestyles may help to delay arterial aging. The purpose of this study is to analyze the relationship of physical activity and dietary pattern to the circadian pattern of blood pressure, central and peripheral blood pressure, pulse wave velocity, carotid intima-media thickness and biological markers of endothelial dysfunction in active and sedentary individuals without arteriosclerotic disease.
  
  
  METHODS
  
  
  
  METHODS
  A cross-sectional multicenter study with six research groups.
  
  
  METHODS
  From subjects of the PEPAF project cohort, in which 1,163 who were sedentary became active, 1,942 were sedentary and 2,346 were active. By stratified random sampling, 1,500 subjects will be included, 250 in each group.
  
  
  METHODS
  We will evaluate height, weight, abdominal circumference, clinical and ambulatory blood pressure with the Radial Pulse Wave Acquisition Device (BPro), central blood pressure and augmentation index with Pulse Wave Application Software (A-Pulse) and SphymgoCor System Px (Pulse Wave Analysis), pulse wave velocity (PWV) with SphymgoCor System Px (Pulse Wave Velocity), nutritional pattern with a food intake frequency questionnaire, physical activity with the 7-day PAR questionnaire and accelerometer (Actigraph GT3X), physical fitness with the cycle ergometer (PWC-170), carotid intima-media thickness by ultrasound (Micromax), and endothelial dysfunction biological markers (endoglin and osteoprotegerin).
  
  
  CONCLUSIONS
  Determining that sustained physical activity and the change from sedentary to active as well as a healthy diet improve circadian pattern, arterial elasticity and carotid intima-media thickness may help to propose lifestyle intervention programs. These interventions could improve the cardiovascular risk profile in some parameters not routinely assessed with traditional risk scales. From the results of this study, interventional approaches could be obtained to delay vascular aging that combine physical exercise and diet.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT01083082.
authors.affiliation: La Alamedilla Health Centre, Castilla y León Health Service-SACYL, Salamanca, Spain. Lgarciao@usal.es
authors.forename: Luis
authors.initials: L
authors.lastname: García-Ortiz
authors.forename: José I
authors.initials: JI
authors.lastname: Recio-Rodríguez
authors.forename: Carlos
authors.initials: C
authors.lastname: Martín-Cantera
authors.forename: Alfredo
authors.initials: A
authors.lastname: Cabrejas-Sánchez
authors.forename: Amparo
authors.initials: A
authors.lastname: Gómez-Arranz
authors.forename: Natividad
authors.initials: N
authors.lastname: González-Viejo
authors.forename: Eguskiñe
authors.initials: E
authors.lastname: Iturregui-San Nicolás
authors.forename: Maria C
authors.initials: MC
authors.lastname: Patino-Alonso
authors.forename: Manuel A
authors.initials: MA
authors.lastname: Gómez-Marcos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D015415:Biomarkers / Q000097:blood*; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D059168:Carotid Intima-Media Thickness; D002940:Circadian Rhythm / Q000502:physiology; D003430:Cross-Sectional Studies; D004032:Diet; D004730:Endothelium, Vascular / Q000503:physiopathology*; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness
chemical_list: D015415:Biomarkers
references.citation: Public Health Nutr. 2006 Dec;9(8A):1073-6
references.pmid: 17378943
references.citation: Circulation. 2006 Mar 7;113(9):1213-25
references.pmid: 16476843
references.citation: Hypertension. 2005 Feb;45(2):240-5
references.pmid: 15596571
references.citation: Hypertension. 2001 Aug;38(2):222-6
references.pmid: 11509480
references.citation: Atherosclerosis. 2007 Mar;191(1):128-34
references.pmid: 16620835
references.citation: Circulation. 2000 Sep 12;102(11):1270-5
references.pmid: 10982542
references.citation: Hypertension. 2005 Jul;46(1):156-61
references.pmid: 15939805
references.citation: Hypertension. 2007 Aug;50(2):325-32
references.pmid: 17562971
references.citation: Ann Intern Med. 2001 Jan 2;134(1):12-20
references.pmid: 11187415
references.citation: Circulation. 1993 Oct;88(4 Pt 1):1456-62
references.pmid: 8403292
references.citation: Med Sci Sports Exerc. 2007 Aug;39(8):1423-34
references.pmid: 17762377
references.citation: JAMA. 1995 Apr 12;273(14):1093-8
references.pmid: 7707596
references.citation: Vasc Med. 2005 May;10(2):97-102
references.pmid: 16013193
references.citation: Hypertension. 2007 Jul;50(1):197-203
references.pmid: 17485598
references.citation: Br J Nutr. 2008 Jul;100(1):159-65
references.pmid: 18275619
references.citation: Eur J Endocrinol. 2003 Jul;149(1):39-42
references.pmid: 12824864
references.citation: Atherosclerosis. 2009 Jun;204(2):608-11
references.pmid: 19062016
references.citation: Ann Intern Med. 2006 Jul 4;145(1):1-11
references.pmid: 16818923
references.citation: Med Sci Sports Exerc. 1995 Jun;27(6):934-40
references.pmid: 7658958
references.citation: Circulation. 2006 Mar 21;113(11):e463-654
references.pmid: 16549646
references.citation: Circulation. 2006 Feb 7;113(5):657-63
references.pmid: 16461838
references.citation: J Appl Physiol (1985). 2008 Oct;105(4):1323-32
references.pmid: 18583377
references.citation: Blood Press Monit. 2009 Aug;14(4):145-51
references.pmid: 19581802
references.citation: Dev Biol. 2000 Jan 1;217(1):42-53
references.pmid: 10625534
references.citation: Angiology. 2009 Jun-Jul;60(3):351-7
references.pmid: 19022788
references.citation: Exp Physiol. 2005 Jul;90(4):645-51
references.pmid: 15849230
references.citation: J Hypertens. 2007 Jun;25(6):1105-87
references.pmid: 17563527
references.citation: J Hum Hypertens. 2005 Aug;19(8):597-605
references.pmid: 15959537
references.citation: Atherosclerosis. 2008 Feb;196(2):742-8
references.pmid: 17276438
references.citation: Hypertension. 2003 Jan;41(1):130-5
references.pmid: 12511542
references.citation: J Hypertens. 2005 Apr;23(4):697-701
references.pmid: 15775768
references.citation: N Engl J Med. 1997 Apr 17;336(16):1117-24
references.pmid: 9099655
references.citation: Circulation. 2005 Apr 12;111(14):1777-83
references.pmid: 15809377
references.citation: Eur J Endocrinol. 2005 Dec;153(6):879-85
references.pmid: 16322394
references.citation: J Hypertens. 2004 Oct;22(10):1937-44
references.pmid: 15361765
references.citation: Cerebrovasc Dis. 2007;23(1):75-80
references.pmid: 17108679
references.citation: Biomed Pharmacother. 2006 Sep;60(8):443-7
references.pmid: 16904861
references.citation: J Hum Hypertens. 2005 Oct;19(10):801-7
references.pmid: 15959536
references.citation: J Hypertens. 2006 Sep;24(9):1753-9
references.pmid: 16915024
references.citation: Med Clin (Barc). 2003 Nov 15;121(17):665-72
references.pmid: 14642230
references.citation: Int J Epidemiol. 1993 Jun;22(3):512-9
references.pmid: 8359969
references.citation: Aten Primaria. 2003 Nov 15;32(8):475-80
references.pmid: 14636505
references.citation: Med Sci Sports Exerc. 1998 May;30(5):777-81
references.pmid: 9588623
references.citation: Arterioscler Thromb Vasc Biol. 1998 Jan;18(1):127-32
references.pmid: 9445266
references.citation: J Hum Hypertens. 2008 Mar;22(3):220-2
references.pmid: 17992251
references.citation: Lancet. 2003 Apr 5;361(9364):1149-58
references.pmid: 12686036
references.citation: Circulation. 1998 Dec 15;98(24):2709-15
references.pmid: 9851957
references.citation: Circulation. 2006 Feb 7;113(5):664-70
references.pmid: 16461839
references.citation: Circulation. 2003 Sep 30;108(13):1554-9
references.pmid: 12975254
references.citation: Biol Res. 2004;37(2):225-30
references.pmid: 15455651
references.citation: BMC Public Health. 2008 May 22;8:172
references.pmid: 18498623
references.citation: Eur Heart J. 2006 Nov;27(21):2588-605
references.pmid: 17000623