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Effects of high‐intensity aerobic interval training on cardiovascular disease risk in testicular cancer survivors: A phase 2 randomized controlled trial
Author(s) -
Adams Scott C.,
DeLorey Darren S.,
Davenport Margie H.,
Stickland Michael K.,
Fairey Adrian S.,
North Scott,
Szczotka Alexander,
Courneya Kerry S.
Publication year - 2017
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.30859
Subject(s) - medicine , cardiorespiratory fitness , high intensity interval training , aerobic exercise , interval training , framingham risk score , cardiology , physical therapy , population , randomized controlled trial , arterial stiffness , disease , blood pressure , environmental health
BACKGROUND Testicular cancer survivors (TCS) have an increased risk of treatment‐related cardiovascular disease (CVD), which may limit their overall survival. We evaluated the effects of high‐intensity aerobic interval training (HIIT) on traditional and novel CVD risk factors and surrogate markers of mortality in a population‐based sample of TCS. METHODS This phase 2 trial ( ClinicalTrials.gov identifier NCT02459132) randomly assigned 63 TCS to usual care (UC) or 12 weeks of supervised HIIT (ie, alternating periods of vigorous‐intensity and light‐intensity aerobic exercise). The primary outcome was peak aerobic fitness (VO 2peak ) assessed via a treadmill‐based maximal cardiorespiratory exercise test. Secondary endpoints included CVD risk (eg, Framingham Risk Score), arterial health, parasympathetic nervous system function, and blood‐based biomarkers. RESULTS Postintervention VO 2peak data were obtained for 61 participants (97%). HIIT participants attended 99% of the exercise sessions and achieved 98% of the target exercise intensity. Analysis of covariance demonstrated that HIIT was superior to UC for improving VO 2peak (adjusted between‐group mean difference, 3.7 mL O 2 /kg/min; 95% confidence interval, 2.4‐5.1 [ P <.001]) and multiple secondary outcomes including CVD risk ( P = .011), arterial thickness ( P <.001), arterial stiffness ( P <.001), postexercise parasympathetic reactivation ( P = .001), inflammation ( P = .045), and low‐density lipoprotein ( P = .014). Overall, HIIT reduced the prevalence of modifiable CVD risk factors by 20% compared with UC. CONCLUSIONS This randomized trial provides the first evidence that HIIT improves cardiorespiratory fitness, multiple pathways of CVD risk, and surrogate markers of mortality in TCS. These findings have important implications for the management of TCS. Further research concerning the long‐term effects of HIIT on CVD morbidity and mortality in TCS is warranted. Cancer 2017;123:4057‐65. © 2017 American Cancer Society .