The Clinical Utility of Resistance Training for Improving Cardiovascular Disease Risk in Post-Menopausal Women

The number of women living with cardiovascular disease (CVD) is greater than for men and CVD
is the leading cause of death for women. Post-menopausal women are a particularly vulnerable
population in terms of adverse cardiovascular indicators and outcomes. Specifically, they
exhibit greater visceral adipose tissue, fasting and postprandial glucose, total cholesterol
(Total-C), fasting insulin, and systolic blood pressure, and are at increased risk for
coronary heart disease compared to pre-menopausal women. There is also evidence that
cardiovascular indicators (i.e., triglycerides, low high-density lipoprotein cholesterol
(HDL-C), etc) are stronger risk predictors in women than men. Despite the staggering rates of
CVD in post-menopausal women, as noted by the American Heart Association (AHA), CVD remains
understudied in this population. Numerous studies have demonstrated the cardioprotective
effects of exercise. However, these studies have largely featured younger individuals,
primarily men, undergoing aerobic exercise training. Findings in recent years have indicated
the potential benefits of resistance training beyond improving muscular size or strength,
such as improved aerobic fitness, central adiposity, glycemic control, and cholesterol
profiles. However, large clinical gaps have been noted for women with regard to the effects
of resistance training on cardiovascular health. Thus, there is a clear need to assess the
cardioprotective effects of progressive exercise training in post-menopausal women.

SPECIFIC AIMS:

1. To test the hypothesis that realistic full-body progressive resistance training improves
markers of (a) cardiovascular health and (b) body composition and muscular health in
post-menopausal women versus a low physical-activity control.

A. The primary markers of cardiovascular health to be assessed are aerobic capacity,
fasting and postprandial metabolic and inflammatory responses, vascular function via
flow-mediated dilation (FMD) and markers of angiogenesis.

B. The primary body composition and muscle function variables to be assessed are muscle
size, isometric and dynamic muscle strength, lean body mass, percent body fat, and
abdominal adiposity.

2. To compare the effects of realistic, full-body progressive resistance training in
post-menopausal women versus moderate-intensity aerobic exercise, the standard exercise
prescription for cardiovascular health, on the cardiovascular, body composition, and
muscular health outcomes listed above in 1A. and B.

Inclusion Criteria:

- provide written and dated informed consent to participate in the study; (2) be willing
and able to comply with the protocol

- be willing and able to comply with the protocol

- be a female between the ages of 45 and 65, inclusive

- be postmenopausal for ≥ 1 year

- be in good health and free from chronic cardiovascular, pulmonary, or musculoskeletal
disease as determined by a health history questionnaire

- have a BMI between 18.5 and 40.0, inclusive; and

- answer no to all questions on the PAR-Q for people aged 15 to 69, which are as
follows:

1. Has your doctor ever said that you have a heart condition and that you should
only do physical activity recommended by a doctor?

2. Do you feel pain in your chest when you do physical activity?

3. In the past month, have you had chest pain when you were not doing physical
activity?

4. Do you lose your balance because of dizziness or do you ever lose consciousness?

5. Do you have a bone or joint problem that could be made worse by a change in
physical activity?

6. Is your doctor currently prescribing drugs for your blood pressure or heart
condition? Do you know of any other reason why you should not do physical
activity?

Exclusion Criteria:

- are currently prescribed and/or taking lipid-lowering medications

- are participating in another clinical trial within thirty days prior to enrollment