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Blood pressure, salivary cortisol, and inflammatory cytokine outcomes in senior female cancer survivors enrolled in a tai chi chih randomized controlled trial

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Abstract

Purpose

Older cancer survivors are a vulnerable population due to an increased risk for chronic diseases (e.g., cardiovascular disease) compounded with treatment late-effects and declines in physical functioning. Therefore, interventions that reduce chronic disease risk factors (i.e., blood pressure, chronic inflammation, and cortisol) are important in this population. Tai chi chih (TCC) is a mind-body exercise associated with reductions in chronic disease risk factors, but has not been examined with older cancer survivors. In a feasibility randomized controlled trial of TCC, we examined secondary outcomes of blood pressure, salivary cortisol, and inflammatory cytokines (interleukin (IL)-6, IL-12, tumor necrosis factor-α, IL-10, IL-4) due to their implications in chronic diseases.

Methods

Sixty-three senior female cancer survivors (M age = 67 years, SD = 7.15) with physical functioning limitations (SF-12 physical functioning ≤80 or role-physical ≤72) were randomized to 12-weeks (60-min, three times a week) of TCC or Health Education control (HEC) classes. Resting blood pressure, 1-day salivary cortisol samples, and fasting plasma samples for cytokine multiplex assays were collected at baseline and 1-week post-intervention.

Results

Controlling for baseline values, the TCC group had significantly lower systolic blood pressure (SBP, p = 0.002) and cortisol area-under-curve (AUC, p = 0.02) at post-intervention than the HEC group. There was no intervention effect on inflammatory cytokines (p’s > 0.05).

Conclusions

This TCC feasibility trial was associated with significant reductions in SBP and cortisol AUC in senior female cancer survivors. Larger, definitive trials are needed to confirm these findings.

Implications for Cancer Survivors

Senior survivors’ have an increased risk for chronic diseases; however, TCC interventions may help reduce associated risk factors.

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Notes

  1. The study’s physical assessments (i.e., blood draw for cytokines, blood pressure assessed) were held during a morning session 1 week before the classes began, before participants’ randomization to study group, and during a morning session 1 week following the last study class. The sessions were held in a group format in which all the participants attended.

  2. We also conducted an ANCOVA subanalysis for SBP that excluded the five TCC participants who reported a history of a heart attack and found similar results (p = 0.004).

  3. The sample times for the cortisol AUC analysis were fixed at 7:00 am, 7:30 am, 12:00 noon, 5:00 pm, and 10:00 pm. We recognize that this is a study limitation and that these results should be viewed as preliminary.

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Acknowledgments

Preparation of this manuscript was funded by a National Institutes of Health National Center for Complementary and Alternative Medicine Research Fellowship in Complementary and Alternative Medicine (T-32 AT00378) at the University of North Carolina for the first author (R.A. Campo). The Health Education and Active Living in Surviving Seniors (HEALS) Project was funded by a grant from the National Cancer Institute (R21CA135250) awarded to Dr. Anita Kinney and by the Huntsman Cancer Foundation. Additional support was provided by the Shared Resources (P30 CA042014) for use of the Research Informatics Shared Resource and the Study Design and Biostatistics Center. Additionally, the Linda B. and Robert B. Wiggins Wellness-Survivorship Center at Huntsman Cancer Institute provided support for the study physical assessments. This content is solely the responsibility of the authors and does not necessarily represent the official views of the funding and supporting agencies. We thank the Associated Regional and University Pathologists’ Institute for Clinical and Experimental Pathology at the University of Utah and the Kirschbaum Biopsychology Laboratory at Technical University of Dresden, Germany for assays of the inflammatory cytokines and cortisol samples, respectively.

Conflict of interest

All authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Program on Integrative Medicine, Department of Physical Medicine & Rehabilitation, University of North Carolina at Chapel Hill, CB# 7200, Chapel Hill, NC, 27599-7200, USA

    Rebecca A. Campo

  2. Department of Anesthesiology, University of Utah, Salt Lake City, UT, USA

    Kathleen C. Light, Yoshio Nakamura & David Lipschitz

  3. Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA

    Kathleen O’Connor, Neeraj Agarwal & Anita Y. Kinney

  4. Department of Physical Therapy, University of Utah, Salt Lake City, UT, USA

    Paul C. LaStayo

  5. Study Design and Biostatistics Center, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA

    Lisa M. Pappas & Kenneth M. Boucher

  6. Department of Oncological Science, University of Utah, Salt Lake City, UT, USA

    Kenneth M. Boucher

  7. Psychoneuroimmunology, Semel Institute for Neuroscience, University of California, Los Angeles, CA, USA

    Michael R. Irwin

  8. ARUP Institute for Clinical and Experimental Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA

    Harry R. Hill & Thomas B Martins

  9. Department of Pathology, University of Utah, Salt Lake City, UT, USA

    Harry R. Hill & Thomas B Martins

  10. Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA

    Neeraj Agarwal & Anita Y. Kinney

  11. University of New Mexico Cancer Center, Albuquerque, NM, USA

    Anita Y. Kinney

  12. Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA

    Anita Y. Kinney

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  1. Rebecca A. Campo
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  2. Kathleen C. Light
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  3. Kathleen O’Connor
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  5. David Lipschitz
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  9. Michael R. Irwin
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  13. Anita Y. Kinney
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Correspondence to Rebecca A. Campo.

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Campo, R.A., Light, K.C., O’Connor, K. et al. Blood pressure, salivary cortisol, and inflammatory cytokine outcomes in senior female cancer survivors enrolled in a tai chi chih randomized controlled trial. J Cancer Surviv 9, 115–125 (2015). https://doi.org/10.1007/s11764-014-0395-x

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  • DOI: https://doi.org/10.1007/s11764-014-0395-x

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