title: Short-term aerobic exercise reduces nitroglycerin-induced orthostatic intolerance in older adults with type 2 diabetes.
abstract: OBJECTIVE
  Older adults are at a high risk for syncope due to orthostatic intolerance (OI), and this risk increases with comorbid type 2 diabetes and vasoactive medications. Despite many benefits, previous investigations have shown worsening OI with aerobic training. We examined whether aerobic exercise reduced OI in older adults with type 2 diabetes who were given a short-acting vasoactive agent (nitroglycerin).
  
  
  METHODS
  Forty older adults (25 males and 15 females, mean age 71.4 ± 0.7 years, ranging in age from 65 to 83 years) with type 2 diabetes were recruited. Subjects were randomized to each of 2 groups: an aerobic group (3 months of vigorous aerobic exercise) and a nonaerobic (no aerobic exercise) group. Exercise sessions were supervised by a certified exercise trainer 3 times per week. After being given 400 μg of sublingual nitroglycerin, each subject was placed in a 70° head-up tilt for 30 minutes.
  
  
  RESULTS
  When the 2 groups were compared using a Cox proportional hazards model, tilt table tolerance was significantly better in the aerobic group as compared to in the nonaerobic group (χ(2)(MC) = 7.271, P = 0.007).
  
  
  CONCLUSIONS
  Our findings indicate that a relatively short aerobic exercise intervention can improve postnitroglycerin orthostatic tolerance in older adults with type 2 diabetes.
authors.affiliation: VITALITY Research Laboratory, Division of Geriatric Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. kmmadden@interchange.ubc.ca
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Madden
authors.forename: Chris K
authors.initials: CK
authors.lastname: Lockhart
authors.forename: Tiffany F
authors.initials: TF
authors.lastname: Potter
authors.forename: Darcye J
authors.initials: DJ
authors.lastname: Cuff
authors.forename: Graydon S
authors.initials: GS
authors.lastname: Meneilly
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000628:therapy*; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D005996:Nitroglycerin; D054971:Orthostatic Intolerance / Q000139:chemically induced / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control*; D010809:Physical Fitness; D016016:Proportional Hazards Models; D016037:Single-Blind Method; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin