Posts Tagged ‘physical activity’

The Implications and Association of Stair Climbing with Atherosclerotic Cardiovascular Disease (ASCVD)

Reporter: Arav Gandhi, Research Assistant 2, Domain Content: Cardiovascular Diseases, Series A


Atherosclerotic Cardiovascular Disease (ASCVD) is a condition in which cholesterol builds up in the arteries to an extent that develops long-term complications for other areas of the body and in some cases emergence of symptoms such as chest pain, dizziness, and shortness of breath are presented and reported to PCPs. This can cause a strain on daily activities such as walking and especially may be noticed when climbing stairs which represents a form of exertion related to elevation. To further understand the significance of ASCVD upon daily activities, Zimin Song et al. (2023), using a sample of 458,860 participants (55.9% female) from the UK Biobank, aimed to evaluate the intensity of stair climbing and the present risk of ASCVD. All participants had a history of ASCVD, put at risk for ASCVD, or had a recorded levels of genetic risk.

Prior to the study, all participants underwent blood tests and other necessary measurements. During the study, the researchers assessed the intensity of stair climbing through a self-reported structure in which participants were asked a set of questions addressing the duration of climbing stairs and whether they continued to climb. Additional questionnaires were administered to collect sociodemographic characteristics, lifestyle factors, and health status. Following the conclusion of the study, the researchers found, with an application of statistical analysis, that over a period of 12.5 years individuals with a higher intensity of stair climbing were of younger age, female, and non-regular smokers. Moreover, those individuals exemplified a higher level of education and income along with healthier dietary habits and prolonged exercise durations. Beyond demographic characteristics, researchers found that when individuals especially those with a family history of ASCVD increased the intensity of stair climbing, the risk of ASCVD was reduced. This remained consistent across other groups of participants finding an association between the intensity of stair climbing and the risk of ASCVD.

Ultimately, given the large sample of UK adults, the findings conclude that high-intensity climbing, or climbing more than five flights of stairs daily was associated with over a 20% reduction in risk of obtaining ASCVD. Despite the variance of disease tendencies among individuals, active engagement in stair climbing can significantly reduce the risk of ASCVD in contrast to those who discontinued stair climbing leading to a higher risk of ASCVD. However, the intensity of stair climbing was limited to a threshold in which it no longer decreased the risk of ASCVD.

Simply climbing stairs can be considered a prevention strategy for ASCVD, but the application of active engagement in physical activities may be associated with reducing the risk of obtaining other diseases. For instance, the positive effects of stair climbing on reducing the risk of ASCVD may also apply to

  • atrial fibrillation,
  • diabetes, and
  • hypertension.

Other existing studies find associations with a

  • lower risk of metabolic syndrome, and even
  • mortality.

In contrast to structured sports and exercise, stair climbing proves to be an effective method with minimal equipment and low cost that allows an individual to practice cardiorespiratory fitness reducing the risks of various diseases while improving their overall standard of life. Although further studies need to be conducted on the extent to which intense stair climbing improves different areas of the body and what diseases it helps prevent, current studies prove the effects of stair climbing to be beneficial to an extent in which individuals should be encouraged in incorporate it in their daily routine yielding both short-term and long-term benefits.

To learn more about the topic, check out the article below.


Song Z, Wan L, Wang W, et al. Daily stair climbing, disease susceptibility, and risk of atherosclerotic cardiovascular disease: A prospective cohort study. Atherosclerosis. 2023:117300. doi: 10.1016/j.atherosclerosis.2023.117300


Other related articles published in this Open Access Online Scientific Journal include the following:

Archive for the ‘Atherogenic Processes & Pathology’ Category

N =178 articles

Series A: e-Books on Cardiovascular Diseases

Series A Content Consultant: Justin D Pearlman, MD, PhD, FACC



Etiologies of Cardiovascular Diseases:

Epigenetics, Genetics and Genomics





Larry H Bernstein, MD, FCAP, Senior Editor, Author and Curator


Aviva Lev-Ari, PhD, RN, Editor and Curator


2.1.3 Physical Activity and Prevention of Cardiovascular Diseases

  • Causes
  • Biomarkrs
  • Therapies  In Two-thirds of Waking Hours Older Women are Sedentary

Aviva Lev-Ari, PhD, RN Walking and Running: Similar Risk Reductions for Hypertension, Hypercholesterolemia, DM, and possibly CAD

Aviva Lev-Ari, PhD, RN Cardiac Arrhythmias: A Risk for Extreme Performance Athletes

Aviva Lev-Ari, PhD, RN Preventive Medicine Philosophy: Exercise vs. Drug, IF More of the First THEN Less of the Second

Aviva Lev-Ari, PhD, RN Heart Rate Variability (HRV) as a Tool

Larry H. Bernstein, MD, FCAP   Is it Hypertension or Physical Inactivity: Cardiovascular Risk and Mortality – New results in 3/2013

Aviva Lev-Ari, PhD, RN  2014 Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism Conference: San Francisco, Ca.   Conference Dates:  San Francisco, CA 3/18-21, 2014

Aviva Lev-Ari, PhD, RN

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How Might Sleep Apnea Lead to Serious Health Concerns like Cardiac and Cancer?

Author: Larry H Bernstein, MD, FCAP


3.3.16   How Might Sleep Apnea Lead to Serious Health Concerns like Cardiac and Cancer?, Volume 2 (Volume Two: Latest in Genomics Methodologies for Therapeutics: Gene Editing, NGS and BioInformatics, Simulations and the Genome Ontology), Part 2: CRISPR for Gene Editing and DNA Repair

UPDATED on 7/23/2019

Israel-led research team develops AI-based model to detect sleep apnea | The Times of Israel


What is the link between sleep apnea and cardiovascular disease and is the treatment of obstructive sleep apnea (OSA) by continuous positive airway pressure in patients (CPAP) with heart failure to improve left ventricular systolic function sufficient?  There are statistics incicating the benefit of CPAP and improvement of LVSF in those patients on CPAP with CHF.  But that observation does not get at why the patients benefit, or whether the OSA is sufficient.  Don’t expect a randomized clinical trial of any design to be brought to bear on the subject, considering the ethical issues involved.  We’ll return to that in a moment.
In a recent study researchers in Spain followed thousands of patients at sleep clinics and found that those with the most severe forms of sleep apnea had a 65 percent greater risk of developing cancer of any kind. The second study, of about 1,500 government workers in Wisconsin, showed that those with the most disordered sleep had five times the rate of dying from cancer as people without the sleep disorder (apnea not specified). Both research teams only looked at cancer diagnoses and outcomes in general.  If I lump the two studies, assuming that all patients with the most disordered sleep had OSA and were on CPAP, what does this tell us?  The heart and lung function together as a cardiopulmonary oxygenation unit!  A problem disrupting oxygenation, such as autonomically controlled sleep disruption or, oronasal obstruction (ASSOCIATED WITH SNORING), would be expected to have an effect on alertness during the day, predisposition to CHF from strain on the CP circulation as well as ventilatory impairment and peripheral oxygenation.  It appears that an association with ANY cancer, unspecified, is a long reach.
In both studies the researchers ruled out the possibility that the usual risk factors for cancer, like
  1. age
  2. smoking
  3. alcohol use
  4. physical activity
  5. weight
The association between cancer and disordered breathing at night remained
  • even after they adjusted for confounding variables.
This led to the conclusion that cancer might be linked to (intermittent) lack of oxygen supply interrupting aerobic cell activity over long periods of time.  The conclusion is drawn that from two associations
  • the research on positive outcome from CPAP in OSA and
  • a possible link between breathing and cardiac and cancer clearly
demonstrates the importance of regular breathing exercises (other wise known as ‘Pranayama’ in India) as part of our every day life.
This answers the first observation I posed. That is, the use of CPAP, while enormously important, is not sufficient.  Regular breathing exercises would seem to be helpful, although not a standard part of current treatment. This would be especially important if the movement of the abdominal muscles and diaphragm were synchronized with the expansion of the nthorax for maximum air flow.  This observation is familiar from working with a certified exercise physiologist.   The other part of this is an optimum time for walking and carrying out basic muscle and flexibility exercises several times a week, which has been shown repeatedly by studies on health benefits.
It is not my place to raise some questions about the way the studies were carried out.  The patients who have sleep apnea would be expected to have an increased body mass index (BMI), and while not sarcopenic, more likely to have excess body fat, abdominal distribution in males, and hip distribution in females, amd more importantly, unseen fat in the abdominal peritoneum.  This is related to type 2 diabetes with a metabolic syndrome, a separate indicator of CVD risk.   The metabolic syndrome involves TNF-alpha (once also known as cachexin), IL-1, IL-6, C-reactive protein, and in the case of fat signaling, adipokines, as well as insulin resistance and, as a result, some counter-regulatory secretion of glucocorticosteroids.  This metabolic picture would result in the following:
  1. impaired glucose utilization
  2. some excess and uncompensated gluconeogenesis
  3. the impaired lactate reentry at the end of glycolysis
  4. an effect on allosteric PFK
Features 1-4 look like what Warburg called a Pasteur Effect, not at the clellular level, but in the whole individual.   While obesity and type 2 diabetes are occuring in the young and adolescent population, the consequences might not be seen until years later.  The consequences could be in a middle aged person falling asleep at a meeting, or a series of automabile accidents related to falling asleep at the wheel.
At a time that clinical laboratory measurements are so accurate, and
  • the associations between type 2 diabetes,
  • measurement of wt/ht^2,
  • arm strength,
  • skin fold thickness,

are common measures of fitness, they don’t appear to have any place in these studies. If that is the case, then how is it possible to make sense of a relationship between SEVERITY of sleep disturbance and health outcome.

English: The Cycle of Obstructive Sleep Apnea ...

English: The Cycle of Obstructive Sleep Apnea – OSA (Photo credit: Wikipedia)

English: The graph shows the correlation betwe...

English: The graph shows the correlation between body mass index (BMI) and percent body fat (%BF) for men in NCHS’ NHANES III 1994 data. The body fat percent shown uses the method from Romero-Corral et al. to convert NHANES BIA to %BF (June 2008). “Accuracy of body mass index in diagnosing obesity in the adult general population”. International Journal of Obesity 32 (6) : 959–956. DOI:10.1038/ijo.2008.11. PMID 18283284. (Photo credit: Wikipedia)

English: Body mass index, BMI, body size, body...

English: Body mass index, BMI, body size, body weight, mortality Italiano: indice di massa corporea, IMC, altezza corporea, peso corporeo, mortalità (Photo credit: Wikipedia)

Italiano: biometria, epidemiologia, rischio, p...

Italiano: biometria, epidemiologia, rischio, peso corporeo umano, mortalità, indice di massa corporea, IMC, body mass index, BMI, prospective studies collaboration (Photo credit: Wikipedia)

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