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Aerobic training in older adults with type 2 diabetes and vasodepressive carotid sinus hypersensitivity

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Abstract

Background and aims

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.

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Acknowledgments

This research was supported by Canadian Institutes of Health Research, as well as the Academic Enhancement Fund (Department of Medicine, University of British Columbia).

Conflict of interest

None of the authors have relevant conflict of interests to disclose.

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Authors and Affiliations

  1. 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 M. Madden, Chris Lockhart, Darcye Cuff, Tiffany F. Potter & Graydon S. Meneilly

  2. Room 7185, Gordon and Leslie Diamond Health Care Centre, 2775 Laurel St., Vancouver, BC, V5Z 1M9, Canada

    Kenneth M. Madden

Authors
  1. Kenneth M. Madden
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  2. Chris Lockhart
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  3. Darcye Cuff
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  4. Tiffany F. Potter
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  5. Graydon S. Meneilly
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Corresponding author

Correspondence to Kenneth M. Madden.

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Madden, K.M., Lockhart, C., Cuff, D. et al. Aerobic training in older adults with type 2 diabetes and vasodepressive carotid sinus hypersensitivity. Aging Clin Exp Res 25, 651–657 (2013). https://doi.org/10.1007/s40520-013-0160-4

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  • DOI: https://doi.org/10.1007/s40520-013-0160-4

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