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Physical exercise, fitness and dietary pattern and their relationship with circadian blood pressure pattern, augmentation index and endothelial dysfunction biological markers: EVIDENT study protocol

Luis García-Ortiz1*, José I Recio-Rodríguez1, Carlos Martín-Cantera2, Alfredo Cabrejas-Sánchez3, Amparo Gómez-Arranz4, Natividad González-Viejo5, Eguskiñe Iturregui-San Nicolás6, Maria C Patino-Alonso1, Manuel A Gómez-Marcos1 and the EVIDENT Group7

Author Affiliations

1 La Alamedilla Health Centre, Castilla y León Health Service-SACYL, Salamanca, Spain

2 Passeig de Sant Joan Health Centre. Catalan Health Service-CS. Barcelona. Spain

3 Cuenca III Health Centre, Castilla La Mancha Health Service-SESCAM, Cuenca, Spain

4 Casa de Barco Health Centre, Castilla y León Health Service-SACYL, Valladolid, Spain

5 Torre Ramona Health Centre, Aragón Health Service - Salud, Zaragoza, Spain

6 Primary Care Research Unit of Bizkaia, Basque Health Service-Osakidetza, Bilbao, Spain

7 EVIDENT Group. redIAPP: Red de Investigación en Actividades Preventivas y Promoción de la Salud, Spain

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BMC Public Health 2010, 10:233  doi:10.1186/1471-2458-10-233

Published: 6 May 2010



Healthy lifestyles may help to delay arterial aging. The purpose of this study is to analyze the relationship of physical activity and dietary pattern to the circadian pattern of blood pressure, central and peripheral blood pressure, pulse wave velocity, carotid intima-media thickness and biological markers of endothelial dysfunction in active and sedentary individuals without arteriosclerotic disease.


Design: A cross-sectional multicenter study with six research groups.

Subjects: From subjects of the PEPAF project cohort, in which 1,163 who were sedentary became active, 1,942 were sedentary and 2,346 were active. By stratified random sampling, 1,500 subjects will be included, 250 in each group.

Primary measurements: We will evaluate height, weight, abdominal circumference, clinical and ambulatory blood pressure with the Radial Pulse Wave Acquisition Device (BPro), central blood pressure and augmentation index with Pulse Wave Application Software (A-Pulse) and SphymgoCor System Px (Pulse Wave Analysis), pulse wave velocity (PWV) with SphymgoCor System Px (Pulse Wave Velocity), nutritional pattern with a food intake frequency questionnaire, physical activity with the 7-day PAR questionnaire and accelerometer (Actigraph GT3X), physical fitness with the cycle ergometer (PWC-170), carotid intima-media thickness by ultrasound (Micromax), and endothelial dysfunction biological markers (endoglin and osteoprotegerin).


Determining that sustained physical activity and the change from sedentary to active as well as a healthy diet improve circadian pattern, arterial elasticity and carotid intima-media thickness may help to propose lifestyle intervention programs. These interventions could improve the cardiovascular risk profile in some parameters not routinely assessed with traditional risk scales. From the results of this study, interventional approaches could be obtained to delay vascular aging that combine physical exercise and diet.

Trial Registration

Clinical Identifier: NCT01083082