Overview
My training, expertise and research interests range from human integrative physiology and genetics to animal exercise models to cell culture models of skeletal muscle adaptation to mechanical stretch. I am trained clinically as an internist and preventive cardiologist, with particular expertise in preventive cardiology and cardiac rehabilitation. My research training spans molecular biology and cell culture, molecular genetics, and integrative human exercise physiology and metabolism. I practice as a preventive cardiologist with a focus on cardiometabolic risk and exercise physiology for older athletes. My research space has both a basic wet laboratory component and a human integrative physiology one.
One focus of our work is an integrative physiologic examination of exercise effects in human subjects in clinical studies of exercise training in normal individuals, in individuals at risk of disease (such as pre-diabetes and metabolic syndrome; STRRIDE), and in individuals with disease (such as coronary heart disease, congestive heart failure and cancer).
A second focus of my research group is exploration of genetic determinates of disease risk in human subjects. We conduct studies of early onset cardiovascular disease (GENECARD; CATHGEN), congestive heart failure (HF-ACTION), peripheral arterial disease (AMNESTI), and metabolic syndrome. We are exploring analytic models of predicting disease risk using established and innovative statistical methodology.
A third focus of my group’s work is to understand the cellular signaling mechanisms underlying the normal adaptive responses of skeletal muscle to physiologic stimuli, such as occur in exercise conditioning, and to understand the abnormal maladaptive responses that occur in response to pathophysiologic stimuli, such as occur in congestive heart failure, aging and prolonged exposure to microgravity.
Recently we have begun to investigate interactions of genes and lifestyle interventions on cardiometabolic outcomes. We have experience with clinical lifestyle intervention studies, particularly the contributions of genetic variants to interventions responses. We call this Lifestyle Medicopharmacogenetics.
KEY WORDS:
exercise, skeletal muscle, energy metabolism, cell signaling, gene expression, cell stretch, heart failure, aging, spaceflight, human genetics, early onset cardiovascular disease, lifestyle medicine
One focus of our work is an integrative physiologic examination of exercise effects in human subjects in clinical studies of exercise training in normal individuals, in individuals at risk of disease (such as pre-diabetes and metabolic syndrome; STRRIDE), and in individuals with disease (such as coronary heart disease, congestive heart failure and cancer).
A second focus of my research group is exploration of genetic determinates of disease risk in human subjects. We conduct studies of early onset cardiovascular disease (GENECARD; CATHGEN), congestive heart failure (HF-ACTION), peripheral arterial disease (AMNESTI), and metabolic syndrome. We are exploring analytic models of predicting disease risk using established and innovative statistical methodology.
A third focus of my group’s work is to understand the cellular signaling mechanisms underlying the normal adaptive responses of skeletal muscle to physiologic stimuli, such as occur in exercise conditioning, and to understand the abnormal maladaptive responses that occur in response to pathophysiologic stimuli, such as occur in congestive heart failure, aging and prolonged exposure to microgravity.
Recently we have begun to investigate interactions of genes and lifestyle interventions on cardiometabolic outcomes. We have experience with clinical lifestyle intervention studies, particularly the contributions of genetic variants to interventions responses. We call this Lifestyle Medicopharmacogenetics.
KEY WORDS:
exercise, skeletal muscle, energy metabolism, cell signaling, gene expression, cell stretch, heart failure, aging, spaceflight, human genetics, early onset cardiovascular disease, lifestyle medicine
Current Appointments & Affiliations
Richard and Pat Johnson University Distinguished Professor
·
2017 - Present
Medicine, Cardiology,
Medicine
Professor of Medicine
·
2006 - Present
Medicine, Cardiology,
Medicine
Professor in the School of Nursing
·
2007 - Present
School of Nursing
Member of Duke Molecular Physiology Institute
·
2013 - Present
Duke Molecular Physiology Institute,
Institutes and Centers
In the News
View All News
Recent Publications
Quadriceps mitochondrial DNA quantity, quality, and gene expression after 2 years of calorie restriction: exploratory results from the CALERIE trial.
Journal Article Geroscience · March 26, 2026 The Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE)™ trial was a randomized, 2-year controlled trial of caloric restriction (CR) versus an ad libitum (AL) control condition in nonobese humans. We performed exploratory a ... Full text Link to item CiteThe Feasibility of Using Best Practice Alerts in Pediatric Primary Care for Obesity Research.
Journal Article Acad Pediatr · March 26, 2026 BACKGROUND: Recruiting participants in pediatric obesity research is challenging due to logistical and systemic barriers. This study evaluated the use of a best practice alert (BPA) within the electronic health record (EHR) to aid in recruitment for a rand ... Full text Link to item CiteUnbiased Discovery of Genetic Determinants of Resilience to CAD: Insights From PROMISE and CATHGEN.
Journal Article JACC Adv · March 18, 2026 BACKGROUND: Genetic determinants of resilience remain poorly defined beyond family studies. OBJECTIVES: The purpose of this study was to perform an unbiased study of individuals with discordance between clinical/genetic risk and atherosclerotic burden to d ... Full text Link to item CiteRecent Grants
Sex Differences in Barriers and Predictors of Physical Activity Participation During and Following Cardiac Rehabilitation
ResearchMentor · Awarded by National Institutes of Health · 2025 - 2030Investigating Senolytic Properties in Pulmonary Rehabilitation and Metformin in COPD Exacerbations (INSPIRE-COPD-E).
ResearchCo-Mentor · Awarded by National Institutes of Health · 2025 - 2030Endocrinology and Metabolism Training Program
Inst. Training Prgm or CMEMentor · Awarded by National Institute of Diabetes and Digestive and Kidney Diseases · 2024 - 2029View All Grants
Education
Duke University ·
1982
M.D.