AJH 2006; 19:701–707
Sedentary Lifestyle and Antecedents
of Cardiovascular Disease in Young Adults
Jonathan M. McGavock, Todd J. Anderson, and Richard Z. Lewanczuk
Background: The aim of this study was to determine
whether sedentary young individuals are characterized by
reductions in determinants of vascular health and insulin
sensitivity relative to their physically active, age-matched
peers.
Methods: A total of 135 otherwise healthy young men
(n ⫽ 68) and women (n ⫽ 67) ⬍40 years of age (28 ⫾ 5
years) were studied in this investigation and stratified into
three groups based on physical activity status: 1) sedentary
(n ⫽ 73); 2) physically active (n ⫽ 24); and 3) endurance-
trained (n ⫽ 38). Arterial compliance and flow-mediated
dilation were determined by diastolic pulse contour wave
analysis and echocardiographic imaging of the brachial
artery respectively. Insulin sensitivity was estimated from
the homeostasis model for insulin resistance and the 13C-
glucose breath test.
Results: Both conduit (16.4 ⫾ 0.5 v 19.5 ⫾ 0.7 mL/
mmHg 䡠 10; P ⬍ .01) and resistant (8.5 ⫾ 0.3 v 10.7 ⫾ 0.5
S
edentary lifestyle and physical inactivity predis-
pose individuals to as many as 25 different chronic
diseases,1 including cardiovascular disease (CVD)
and type 2 diabetes mellitus (DM-2).2,3 Moreover, low
cardiorespiratory fitness exacerbates the risk for all-cause
mortality in individuals with and without underlying chronic
disease.4 Conversely, studies in older adults reveal that
life-long daily aerobic exercise effectively attenuates the
risk for CVD and DM-2 in men and women, secondary to
favorable changes in conventional and novel risk factor
profiles.5– 8 In fact, the differences in certain determinants
of cardiovascular risk (ie, left ventricular and arterial com-
pliance) between exercising and sedentary older adults are
so profound that some speculate that excessive morbidity
and mortality associated with aging may be more related
to sedentary lifestyle than senescence.5,8
Received August 12, 2005. First decision January 9, 2006. Accepted
January 14, 2006.
From the Division of Endocrinology (JMMcG, RZL), Faculty of
Medicine, University of Alberta, Edmonton, Alberta, Canada; Depart-
ment of Cardiovascular Sciences and the Libin Cardiovascular Institute
(TJA), University of Calgary, Calgary, Alberta, Canada; and Division of
Hypertension (JMMcG), University of Texas Southwestern Medical
Centre at Dallas, Dallas, Texas.
© 2006 by the American Journal of Hypertension, Ltd.
Published by Elsevier Inc.
mL/mmHg 䡠 100; P ⬍ .01) artery compliance were sig-
nificantly lower in sedentary subjects than in physically
active or endurance-trained subjects, whereas flow-medi-
ated dilation was not different between the groups. The
HOMAIR was 2.5-fold higher in the sedentary group than
in the endurance-trained group (P ⬍ .05).
Conclusions: Sedentary individuals are character-
ized by reductions in both arterial compliance and in-
sulin sensitivity relative to their endurance-trained peers,
independent of changes in conventional risk factors for
cardiovascular disease. These findings lend further support
for the need for regular physical activity in the prevention
of cardiovascular disease in individuals of all ages. Am J
Hypertens 2006;19:701–707 © 2006 American Journal of
Hypertension, Ltd.
Key Words: Arterial compliance, cardiorespiratory fit-
ness, insulin resistance.
The underlying mechanisms through which physical
inactivity accelerates disease progression are not com-
pletely understood, but appear to be related in part to
arterial stiffening6,7 and insulin resistance.8 Although the
vascular and metabolic maladaptations associated with a
sedentary lifestyle in aged individiuals are fairly well
described, the natural history of this “sedentary death
syndrome9” is currently unresolved. Specifically it is un-
clear whether the negative influence of sedentary lifestyle
on determinants of cardiovascular risk emerge only in later
life or whether they are present in younger persons. In that
regard, the primary aim of this investigation was to deter-
mine whether sedentary, young, otherwise healthy men
and women display differences in antecedents of CVD (ie,
arterial stiffness, endothelium-dependent dilation, and in-
sulin sensitivity) relative to their physically active peers.
Support for this project was obtained from the Canadian Institutes for
Health Research; the Alberta Heritage Foundation for Medical Research;
and Pfizer Canada. Support was also provded by a Strategic Training
Fellowship from the Canadian Institutes of Health Research (to J.M.M).
Address correspondence and reprint requests to Dr. Jonathan McGav-
ock, Manitoba Institute for Child Health, 715 McDermott Avenue, Win-
nipeg, MB R3E3P4, Canada. e-mail: jon.mcgavock@utsouthwestern.
edu
0895-7061/06/$32.00
doi:10.1016/j.amjhyper.2006.01.013
702 SEDENTARY LIFESTYLE AND DISEASE RISK AJH–July 2006 –VOL. 19, NO. 7

Table 1. Characteristics of study subjects

Variable Sedentary Physically active Endurance trained

Men/women 37/37 12/14 19/16
Age (y) 28 ⫾ 5 27 ⫾ 2 26 ⫾ 6
Weight (kg) 73 ⫾ 17 71 ⫾ 8 67 ⫾ 8*
BMI (kg/m2) 24.6 ⫾ 4.8 23.8 ⫾ 2.4 22.1 ⫾ 2.1*
VO2max (mL/kg/min) 35 ⫾ 6 45 ⫾ 6* 59 ⫾ 10*
% Predicted 95 ⫾ 12 127 ⫾ 9* 156 ⫾ 14*
Metabolic variables
Cholesterol 4.7 ⫾ 1.0 4.4 ⫾ 0.8 4.1 ⫾ 0.7
LDL (mmol/L) 2.8 ⫾ 0.9 2.4 ⫾ 0.5 2.2 ⫾ 0.5
HDL (mmol/L) 1.1 ⫾ 0.2 1.2 ⫾ 0.1 1.2 ⫾ 0.2
TG (mmol/L) 1.4 ⫾ 1.0 1.0 ⫾ 0.4 1.0 ⫾ 0.6*
Insulin (␮U/L) 8.8 ⫾ 9 5.9 ⫾ 2.2 4.6 ⫾ 2.0*
Glucose (mmol/L) 5.1 ⫾ 1.4 4.8 ⫾ 0.4 4.8 ⫾ 0.3
HOMA 2.2 ⫾ 3.9 1.1 ⫾ 0.5 1.0 ⫾ 0.4*
Hemodynamic variables
SBP (mmHg) 119 ⫾ 13 122 ⫾ 9 117 ⫾ 9
DBP (mmHg) 69 ⫾ 9 67 ⫾ 7 65 ⫾ 7
HR (bpm) 68 ⫾ 12 63 ⫾ 6 55 ⫾ 6*
SVR (dynes 䡠 sec 䡠 cm⫺5) 1164 ⫾ 28 1169 ⫾ 47 1374 ⫾ 40
FMD (%) 3.6 ⫾ 1.0 2.0 ⫾ 1.2 2.9 ⫾ 1.2

% Predicted ⫽ cardiorespiratory fitness expressed as a percentage of age and gender predicted values obtained from previously published
regression equations (refs. 10, 11); BMI ⫽ body mass index; DBP ⫽ diastolic blood pressure; FMD ⫽ flow-mediated dilation; HOMA ⫽
homeostasis mode assessment; HR ⫽ heart Rate; SBP ⫽ Systolic blood pressure; SVR ⫽ systemic vascular resistance.
All data presented as mean ⫾ SE.
* P ⬍ 0.01 v sedentary group.

We hypothesized that sedentary individuals would be
characterized by lower levels of insulin sensitivity, in-
creased arterial stiffness, and reduced flow-mediated dila-
tion relative to their physically active peers.
Methods
Study Population and Design
A total of 135 otherwise healthy young men (n ⫽ 68, age
20 to 40 years) and women (n ⫽ 67, age 20 to 40 years)
were studied. Individuals were excluded from the investi-
gation if they presented with or were currently taking
medication for type 2 diabetes or cardiovascular disease
(such as statins or antihypertensive medications) (Table 1).
Subjects were stratified into one of three groups based on
self-reported physical activity status: 1) sedentary (⬍30
min/day of aerobic exercise, ⬍3 days/week); 2) physically
active (30 to 45 min/day of moderate aerobic exercise, 3 to
5 days/week); and 3) endurance-trained (⬎45 min/day of
moderate-to-intense aerobic exercise ⱖ5 days/week). Verifi-
cation of self-report was done by comparing cardiorespira-
tory fitness 䡠 (O2max, mL 䡠 kg⫺1 䡠 min⫺1) of each individual
with age-predicted values obtained from previously pub-
lished regression formulas.10,11
Participants were studied on 3 separate days for deter-
mination of the following: 1) arterial compliance, endo-
thelium-dependent dilation and phlebotomy; 2) insulin
sensitivity; and 3) maximal exercise capacity. Informed
consent was obtained from all subjects before the investi-
gation, and the Research Ethics Review Board within the
Faculty of Medicine at the University of Alberta approved
the study protocol.
Arterial Compliance
and Resting Hemodynamics
Resting measurements of vascular function were per-
formed in the morning after a 10-h fast, lying supine in a
dimly lit room, with participants having refrained from
vigorous exercise for a period of 48 h before testing.
Arterial compliance was calculated from diastolic pulse
contour wave analysis obtained from the radial artery as
previously described.12 This technique involves 30-sec
recordings of signal-averaged arterial pulse waves by ap-
planation tonometry using a surface residing pressure
transducer (HDI CR-2000, Hypertension Diagnostics, Ea-
gan, MN).
Brachial Artery
Ultrasonography for Assessment
of Flow-Mediated Vasodilation
Brachial artery flow-mediated dilation was performed in
male subjects only according to the methods initially de-
scribed by Celermajer, which have recently been described
in detail elsewhere.13 Briefly, a 7.5-MHz linear phased
array ultrasound transducer attached to an ultrasound ma-
chine (Sonos 5500, Hewlett-Packard, Avondale, PA) was
used to image the brachial artery longitudinally just above
the antecubital fossa. Brachial artery dilation in response
AJH–July 2006 –VOL. 19, NO. 7 SEDENTARY LIFESTYLE AND DISEASE RISK 703

to 5 min of forearm ischemia and after sublinguinal nitro-
glycerin (⬃0.4 mg) were used to assess endothelium-
dependent and independent dilation respectively. A period
of 5 min separated the two experiments and M-mode
images were recorded over a period of 2 to 3 min after
each experiment. Images were analyzed by two techni-
cians with extensive experience in ultrasound analysis
using computer-assisted edge detection brachial artery
analysis software (DEA, Montreal, PQ, Canada) to calcu-
late brachial artery diameters. Using this software, the
intra- and inter-observer variability is essentially zero.
Insulin Sensitivity
Insulin sensitivity was assessed using [13C]glucose breath
test method (Diatest, Isodiagnostika, Edmonton AB, Can-
ada) as previously described.14 The [13C] glucose breath
test is a noninvasive estimate of insulin sensitivity that
determines the rate of absorption and metabolism of [13C]-
labeled glucose by measuring exhaled 13CO2 in a fasted
state and 90 minutes after ingestion of 25 mg of [13C]glu-
cose mixed with 15 g dextrose. Differences in baseline and
90-min breath samples reflect insulin-mediated glucose
disposal and incorporation into CO2. The 13CO2 was mea-
sured in breath samples using an AP2003 isotope ratio mass
spectrometer (Analytical Precision Limited, Cheshire, En-
gland) by a technician blinded to the status of the study
subject. This method has been validated in our laboratory and
correlates well with glucose disposal rate during a hyperin-
sulinemic-euglycemic clamp (r ⫽ 0.69, P ⬍ .001).14
Blood Collection and Analysis
Blood was drawn in the fasted state after ultrasonographic
imaging. Fasting hematologic measurements included glu-
cose, insulin, HbA1c, total cholesterol, HDL, triglycerides,
and LDL and the homeostasis model of insulin resistance
(HOMAIR) as previously described.12
Graded Maximal Exercise Test
Expired gas analysis (TrueOne, ParvoMedics, Salt Lake
City, UT) was performed at rest and during graded exer-

Conduit Artery Compliance Resistant Artery Compliance

12
A * B *
20
(mL/mmHg*100)

10
(mL/mmHg*10)

8
15

10 4
0 0
E.T. P.A. Sedentary E.T. P.A. Sedentary
12 Insulin 14 Expired 13CO2
C D
10 12

8 10
( U/L)

(δ ‰)

8
6 *
6
4
4
2
2
0 0
E.T. P.A. Sedentary E.T. P.A. Sedentary
FIG. 1. Physical activity status, arterial compliance and insulin sensitivity in young men and women. Cross-sectional comparisons of conduit
(A) and resistance (B) artery compliance as well as (C) fasting insulin and (D) expired 13CO2 (a marker of insulin sensitivity) between
sedentary (S.E.D.), physically active (PA) and endurance-trained (ET) young adults. *P ⬍ .01 v sedentary group. Differences remained
significant after adjustment for age, body mass index, and serum triglycerides.
704 SEDENTARY LIFESTYLE AND DISEASE RISK AJH–July 2006 –VOL. 19, NO. 7

30
50
Conduit Artery Compliance

A C
25 40
(ml/mmHg*10)

Insulin ( /L)
20 30
r = -0.31, p < 0.01
20
15
10
10
r = 0.27, p < 0.01 0

5
10 20 30 40 50 60 70 80 10 20 30 40 50 60 70 80
VO2peak (mL/kg/min) VO2peak (mL/kg/min)
Resistant Artery Compliance

18
16
B
(mL/mmHg*100)

14
12
10
8
6
r = 0.25, p < 0.01
4
2
10 20 30 40 50 60 70 80
VO2peak (mL/kg/min)
FIG. 2. Inter-relationships with cardiorespiratory fitness. Differences remained significant after adjusting for age and body mass index.

cise to exhaustion on a cycle ergometer as previously Results

described.12
Statistical Analyses
Data are presented as means ⫾ SE unless otherwise stated.
Differences in insulin sensitivity and hemodynamic vari-
ables across cardiorespiratory fitness stratifications were
assessed using linear regression analysis and analysis of
covariance (ANCOVA) where appropriate. Between-group
comparisons were adjusted for age and body mass index
(BMI) as covariates. Data were evenly distributed within
the sample. Associations between insulin sensitivity, BMI,
fitness, and systolic blood pressure (BP) were examined
using stepwise linear regression analyses and bivariate
correlations. To evaluate the association between insulin
sensitivity and arterial compliance, all subjects were strat-
ified into three groups based on their HOMAIR. Differences
between the groups were determined using ANCOVA with
age and BMI included as covariates. All data was analyzed
using SPSS for windows, version 12.0 (SPSS Inc., Chi-
cago, IL). The ␣ level for all analysis was set a priori at
0.05.
Demographic Characteristics
Subject characteristics are presented in Table 1. No dif-
ferences in age or BMI were observed between the seden-
tary and physical active women; however sedentary men
were slightly heavier than the physically active and endur-
ance-trained groups (27 ⫾ 5 v 23 ⫾ 2 kg/m2; P ⬍ .05).
According to the study design, 䡠 O2max, expressed as
oxygen uptake relative to body mass and as a percentage
of age-predicted normal, was significantly higher in both
the physically active and endurance-trained groups relative
to the sedentary group (P ⬍ .01) (Table 1). Furthermore the
endurance-trained group had significantly higher VO2max
values than the physically active group (P ⬍ .05). Women
displayed significantly lower 䡠 O2max values within each
category, relative to their male peers (P ⬍ .05).
Arterial Compliance
Conduit and resistant artery compliance were both signif-
icantly higher in the endurance-trained group, relative to
the physically active and sedentary groups (P ⬍ .01) (Figs.
1A, 1B). These differences remained significant after ad-
AJH–July 2006 –VOL. 19, NO. 7 SEDENTARY LIFESTYLE AND DISEASE RISK 705

justing for differences in age, BMI, and serum triglycer- Table 2. Determinants of insulin sensitivity in
ides between the groups. The differences in arterial healthy young men and women
compliance were observed despite their being no differ-
13
ences in BP or endothelium-dependent (flow-mediated) or Expired CO2 HOMA
-independent (nitroglycerine-mediated) dilation between Cumulative Cumulative
the groups. As expected, heart rate was significantly lower Variable r2 ␤ r2 ␤
in the physically active and endurance-trained men and BMI 0.32 ⫺0.56 0.33 0.57
women (P ⬍ .01). However no differences were observed Age 0.37 ⫺0.63 0.33 0.59
between the sedentary and PA groups. VO2max 0.44 ⫺0.66 0.34 0.57
Sex 0.50 ⫺0.49 0.35 0.55
Metabolic Variables Abbreviations as in Table 1.
Fasting insulin was nearly twofold higher in sedentary
subjects relative to their endurance-trained peers (P ⬍ .01,
Fig. 1C.). Similarly the HOMAIR was significantly higher systolic BP (r ⫽ 0.36) but was unrelated to large or small
in the sedentary group relative to the endurance-trained artery compliance. Sex, BMI, age, and 䡠O2max explained
group (2.1 ⫾ 0.4 v 1.0 ⫾ 0.5, P ⬍ .05). No differences in 44% of the variability in insulin sensitivity within the
expired 13CO2 were observed between men and women or cohort studied (P ⬍ .01) (Table 2). These same variables
among the physical activity groups (Fig. 1D). The trend explained 11% and 20% of variation in conduit and resis-
toward reduced insulin sensitivity in the sedentary group tant artery compliance respectively (Table 3).
was driven primarily by significant differences in the men,
as the differences in women were modest. Finally, serum
triglyceride was ⬃40% greater (P ⬍ .05) in sedentary Discussion
individuals, relative to their endurance-trained peers. The primary novel findings of this investigation are that,
When individuals were stratified into groups based on first, large and small artery compliance are lower in sed-
their HOMAIR, conduit artery compliance was signifi- entary individuals when compared with those of their
cantly lower in individuals with HOMAIR ⬎2.5 than in- endurance-trained peers, independent of conventional risk
dividuals with HOMAIR ⬍1.0 (Fig. 3). Resistant artery factors for cardiovascular disease, including BP. Second,
compliance was not different between the groups. sedentary individuals are also characterized by elevated
fasting insulin and HOMAIR relative to their endurance-
Relationships Between Vascular trained peers. Finally, arterial compliance and insulin sen-
Function, Insulin Sensitivity, and 䡠O2max sitivity, were indistinguishable between physically active
䡠O2max was positively associated with conduit and resis- individuals and their sedentary peers despite a large dif-
tant artery compliance (Figs. 2A, 2B) and was negatively ference in fitness.
associated with fasting insulin (Fig. 2C). These relation- Under the general concept of Neel’s Thrifty Genotype
ships remained significant after adjustment for age and Hypothesis, Lees and Booth suggest that successful human
BMI. The BMI was significantly (P ⬍ .01) associated with evolution has depended upon “a sub-group of genes [that
expired 13CO2(r ⫽ ⫺0.56), HOMAIR (r ⫽ 0.51), and function] to support physical activity for survival through
most of humankind’s existence, [and] require daily exer-
cise to maintain long-term health and vitality.”9 Within
20
this paradigm, Lees and Booth suggest that in cross-
Compliance (mL/mmHg)

* HOMA >2.5
sectional studies, physically active individuals must be
considered as reflecting the control condition, whereas
HOMA 1-2.5
-2.5
sedentary individuals represent the experimental condi-
HOMA < 1.0
15

Table 3. Determinants of arterial compliance in

young men and women
10
Conduit Resistant
Cumulative Cumulative
Variable r2 ␤ r2 ␤
0
Conduit Resistant Age 0.05 ⫺0.21 0.02 ⫺0.09
BMI 0.05 0.07 0.12 0.34
Arterial Compliance VO2max 0.10 0.23 0.18 0.20
FIG. 3. Arterial compliance in young adults stratified by HOMAIR Sex 0.11 0.22 0.20 0.35
index. *P ⬍ .01 v sedentary group. Differences remained significant
after adjusting for age, body mass index, and serum triglycerides. Abbreviations as in Table 1.
706 SEDENTARY LIFESTYLE AND DISEASE RISK
tion.9 The current study was designed in this manner to
determine the influence of sedentary lifestyle on cardio-
vascular and metabolic determinants of health in young
men and women.
Several authors have reported that age-related decre-
ments in arterial compliance15 and endothelium-dependent
dilation16 are attenuated with vigorous life-long endurance
exercise.6,7 To our knowledge no studies have assessed the
influence of sedentary lifestyle on conduit and resistance
artery compliance in younger adults. We support and
extend the findings of previous studies6,7 in elderly indi-
viduals by demonstrating that sedentary young men and
women are characterized by reductions in both conduit
and resistant artery compliance, relative to their endur-
ance-trained peers. Interestingly, in contrast to studies in
younger17 and older men,7 we did not observe differences
in endothelium-dependent dilation between sedentary and
endurance-trained young men. This discrepancy is likely
related to the different methods used (ie, venous occlusion
plethysmography versus ultrasound imaging) or to the
possibility that the methods used were not adequately
sensitive to detect subtle differences between these groups
of young, otherwise healthy men and women.
In addition to CVD prevention, chronic daily aerobic
exercise is a cornerstone in the prevention of DM-218,19
Conversely, prolonged20 and severe inactivity21,22 (ie, bed
rest) cause resistance to insulin-mediated glucose disposal,
which at least partly explains the increased risk for DM-2
in physically inactive older individuals.23,24 Similar to
previous studies in aged individuals11 and women with
DM-2,15 we demonstrate that sedentary lifestyle/inactivity
is associated with elevated fasting insulin and a concom-
itant increase in the HOMAIR in young men and women.
The negative influence of sedentary lifestyle on insulin
and HOMAIR were observed in a stepwise fashion to be
reduced marginally with moderate physical activity and
significantly with chronic endurance training (Fig. 1B).
Furthermore, similar to our previous studies in women
with DM-2, a negative association was observed between
䡠O2peak and HOMAIR in this population of young healthy
men and women (Fig. 2A), supporting the close link
between activity level and insulin sensitivity in human
beings.
In general, the similarities between the cardiovascular
and metabolic responses to chronic aerobic exercise and
prolonged deconditioning are quite remarkable. Ample
evidence is available to demonstrate the close relationship
between metabolic dysregulation and cardiovascular dis-
ease and dysfunction.25 We believe that one of the mech-
anisms through which sedentary lifestyle leads to cardiac
and vascular dysfunction is through a progressive decline
in insulin sensitivity.12 To evaluate the relationship be-
tween insulin resistance on vascular compliance, we strat-
ified the group into tertiles based on their HOMAIR (Fig. 3).
Interestingly, large artery compliance was reduced in those
with the highest HOMAIR, independent of age and BMI.
Although these data are merely cross-sectional in nature,
AJH–July 2006 –VOL. 19, NO. 7
we believe that, similar to previous studies,26,27 the data
suggest an interaction between insulin sensitivity and vas-
cular health in young adults.
The most interesting clinical aspect of this study is that
dramatic reductions in novel biomarkers for cardiovascu-
lar and metabolic disease are evident in sedentary, young,
otherwise healthy men and women despite a normal con-
ventional cardiovascular risk profile. These data support
the overwhelming amount of evidence demonstrating neg-
ative cardiovascular-related health outcomes in sedentary
individuals and underscore the need for clinical recogni-
tion of the positive health outcomes associated with daily
aerobic exercise, even in young, otherwise healthy indi-
viduals. In the face of obesity and sedentary lifestyles occur-
ring at epidemic proportions among adults and children,
early recognition of high-risk behavious and appropriate
intervention strategies are paramount in the prevention of
chronic disease. Finally, these data demonstrate that neg-
ative cardiovascular and metabolic outcomes associated
with physical inactivity are only marginally improved in
individuals who perform aerobic exercise ⬍45 min at
moderate intensity, 3 to 4 days per week. These findings
support previous studies that have demonstrated more
favorable metabolic outcomes associated with vigorous
physical activity.28
A common concern with this investigation and similar
studies relates to the inability to determine whether the
differences in cardiovascular and metabolic parameters
between the groups are related to physical inactivity per se
or whether they are a function of differences in body
composition. Because BMI was a significant determinant
of insulin sensitivity within this group, it is possible that
differences in fasting insulin/HOMAIR are a function of
greater adiposity in sedentary individuals. Although we
have addressed this limitation by using BMI as a covariate
in all group-wise comparisons, lean-ness is also a key
adaptation to vigorous exercise, and the two should not be
considered mutually exclusive.
A second possible concern, regarding the interpretation
of the data, relates to the methods used for determining
vascular health. We are aware that several methods are
currently available to estimate vascular health noninva-
sively in human beings and that the two methods used in
this study have their own limitations and inherent weak-
nesses.29 –31 Although flow-mediated dilation is a crude
estimate of endothelium-mediated dilation, it does not
reflect the other properties of the endothelium, nor does it
reflect the entire vasculature. Similarly, the use of diastolic
pulse contour wave analysis has been criticized for its
theoretical nature within a Windkessel model of the vas-
culature.29 We are confident that using both methods si-
multaneously adequately addresses these concerns.30
In conclusion, a sedentary lifestyle was found to be
characterized by a decrease in conduit and resistant arterial
compliance as well as by lower insulin sensitivity in young
men and women. These data suggest that the negative
influence of sedentary lifestyle on vascular and metabolic
AJH–July 2006 –VOL. 19, NO. 7
health begins early in life and may contribute to the increased
risk for type 2 diabetes and cardiovascular disease in those
who are physically inactive. The findings also underscore
the need for more regular and prolonged physical activity
in the primary prevention of chronic disease beginning
early in life.
Acknowledgments
The authors acknowledge the expert technical support pro-
vided by Cameron McKnight and Ashlee McGuire. The
authors also thank Dave Buchaski and the Hewlett Pack-
ard Corporation for providing the ultrasonographic equip-
ment used for this investigation. T.J.A. is a Senior Scholar
of the Alberta Heritage Foundation for Medical Research.
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