In Great Expectations, Charles
Dickens wrote, “Take nothing on its
looks; take everything on evidence.
There’s no better rule.” That’s why we
go to scientific sessions. He also wrote,
“There was a long hard time when I
kept far from me the remembrance of
what I had thrown away when I was
quite ignorant of its worth.” The current
value of some old approaches–and a
reminder of the basics–also were front
and center at this year’s meeting of the
European Society of Cardiology (ESC).
And, of course, there were a number
of encouraging trials, albeit tempered
with clear evidence that cutting-edge
medicine just can’t keep up with our
deteriorating lifestyles. After ESC, there
is reason for both celebration and
despair.
LONDON
ACC.org/CSWN
Move It or Lose It
Aspiring, but Failing
Whether we experience them or not, we all know
the many benefits of regular physical activity and
now we have interesting insights into why it’s
so good for us. The reason goes well beyond the
cardiovascular system and lands right at the telomeres, the caps at the end of each strand of DNA
that protect our chromosomes.
At the ESC meeting, investigators showed that
a combination of physical activity and cognitive
training reduces mild cognitive impairment (MCI)
and, when you train the brain, leukocyte telomere length (LTL) is increased. In one telomere
study presented at ESC.15, 94 individuals with
MCI were compared to 37 age- and sex-matched
controls. Fifty patients with MCI were randomly
placed in a 3-hour environmental enrichment
therapy program 3 times a week for 7 months,
participating in tailored, stepwise physical, cognitive, and social training. A no-training group of
27 patients received standard treatment. Leukocyte telomere length was evaluated by real-time
polymerase chain reaction (PCR) before and after
7-month intervention period.
Patients with MCI and controls had a similar
prevalence of traditional cardiovascular risk factors. The relative telomere length (T/S) ratio was
significantly reduced in the MCI group compared
with controls (p = 0.02). After a 7-month follow-up
period, patients in the training group showed a significantly increased LTL when compared to baseline
(0.97 ± 0.21 vs. 1.03 ± 0.23; p = 0.03). An opposite
trend was observed in the no-training group.
In a second study, investigators found an
inverse relationship between LTL and risk of
coronary artery stenosis (CAS). They studied 254
patients with a confirmed diagnosis of CAS who
were matched 1:1 on age and sex with a group
of controls without CAS. For each 1 SD shorter
LTL, patients experienced a 54% hi