The effect of 1 year of Alagebrium and moderate-intensity exercise training on left ventricular function during exercise in seniors: a randomized controlled trial.
Level 2 - randomized trial
Individual randomized controlled trial with four parallel arms
PubMed 27402556 · doi:10.1152/japplphysiol.00021.2016
What was done
Sixty-two sedentary seniors (aged ≥60 years) were randomized to four 1-year intervention arms: sedentary + placebo, sedentary + Alagebrium (an advanced glycation end-product cross-link breaker), exercise + placebo, or exercise + Alagebrium. Moderate-intensity aerobic exercise was performed 3-4 sessions/week; controls did yoga/balance training. Twenty-four lifelong exercisers served as a non-randomized comparator group. Primary measures were maximum oxygen uptake (Douglas bags), stroke index (SI; acetylene rebreathing), and effective arterial elastance (Ea) at rest and during exercise.
What was found
Exercise improved maximum oxygen uptake (23 ± 5 to 25 ± 6 ml·kg⁻¹·min⁻¹), SI (35 ± 11 to 39 ± 12 ml/m²), and Ea (4.0 ± 1.1 to 3.7 ± 1.2 mmHg·ml⁻¹·m⁻²) compared to controls (exercise × time, P ≤ 0.018). Alagebrium did not affect SI or Ea (medication × time, P ≥ 0.468), and there was no synergistic interaction with exercise (interaction P ≥ 0.252). Exercise combined with Alagebrium left SI and Ea 15-24% and 9-22% below lifelong exercisers (P ≤ 0.415).
Why it matters
Moderate exercise improves exercise cardiovascular function in older adults, but adding the AGE cross-link breaker Alagebrium offers no additional benefit, and 1 year of late-life training does not match lifelong exercise adaptations.
Limits
Small sample size split across four parallel arms (~15 per group). Lifelong exerciser comparator group was non-randomized and cross-sectional. The abstract lacks direct biochemical confirmation of AGE reduction and long-term clinical outcome data.
Cited by
- contradicts In sedentary 70-year-olds, combining 1 year of exercise training with an advanced glycation end-product (AGE) cross-link breaker resulted in the equivalent of approximately a 15-year reduction in vascular age, whereas either intervention alone produced no benefit.