title: Aerobic training in older adults with type 2 diabetes and vasodepressive carotid sinus hypersensitivity.
abstract: OBJECTIVE
  Vasodepressive carotid sinus hypersensitivity (V-CSH) is a common but incurable etiology for fainting in older adults with diabetes (OADM), and is diagnosed by carotid sinus massage (CSM). Aerobic exercise has been shown to be an effective therapy for other neuroautonomic etiologies of syncope (such as orthostatic hypotension), but the effectiveness of aerobic training in V-CSH remains unknown. We examined whether aerobic training could attenuate the vasodepressive response to CSM in OADM (older adults with type 2 diabetes) subjects complicated by V-CSH.
  
  
  METHODS
  Forty OADM subjects (mean age 72.2 ± 0.7) complicated by V-CSH were recruited. Subjects were randomized to each of two groups: an aerobic group (AT, n = 20, 3 months vigorous aerobic exercise), and a nonaerobic (NA, n = 20, no aerobic exercise) group. Exercise sessions were supervised by a certified exercise trainer three times per week. The vasodepressive response [defined as the decrease in systolic blood pressure (SBP) during CSM] was measured before and after the training intervention using a Finometer.
  
  
  RESULTS
  The intervention had no impact on the number of subjects that met the criteria for V-CSM in either the AT or NA groups, regardless of the criteria used (-10, -20, -30, -40 and -50 mmHg). There was no training effect on the vasodepressive response in either the AT or NA group (P = 0.214, 2-way analysis of variance, -30 mmHg definition for V-CSH).
  
  
  CONCLUSIONS
  Aerobic training has no effect on the SBP response to CSM in OADM subjects with V-CSH. Unlike in other neuroautonomic etiologies for fainting, aerobic exercise is not effective as a treatment for V-CSH, at least in the OADM population.
authors.affiliation: VITALiTY (Vancouver Initiative to Add Life to Years) Research Laboratory, Division of Geriatric Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada, Kenneth.Madden@ubc.ca.
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Madden
authors.forename: Chris
authors.initials: C
authors.lastname: Lockhart
authors.forename: Darcye
authors.initials: D
authors.lastname: Cuff
authors.forename: Tiffany F
authors.initials: TF
authors.lastname: Potter
authors.forename: Graydon S
authors.initials: GS
authors.lastname: Meneilly
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D002346:Carotid Sinus / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000503:physiopathology / Q000628:therapy; D008297:Male; D019462:Syncope, Vasovagal / Q000503:physiopathology* / Q000628:therapy*; D013663:Teaching