The effect of participation in an exercise training program on cardiovascular reactivity in sedentary middle-aged males

Does a 20-week aerobic exercise training programme increase our capabilities to buffer real-life stressors? A randomized, controlled trial using ambulatory assessment

PURPOSE

The cross-stressor adaptation hypothesis suggests that regular exercise leads to adaptations in the stress response systems that induce decreased physiological responses to psychological stressors. Even though an exercise intervention to buffer the detrimental effects of psychological stressors on health might be of utmost importance, empirical evidence is mixed. This may be explained by the use of cross-sectional designs and non-personally relevant stressors. Using a randomized controlled trial, we hypothesized that a 20-week aerobic exercise training does reduce physiological stress responses to psychological real-life stressors in sedentary students.

METHODS

Sixty-one students were randomized to either a control group or an exercise training group. The academic examination period (end of the semester) served as a real-life stressor. We used ambulatory assessment methods to assess physiological stress reactivity of the autonomic nervous system (heart rate variability: LF/HF, RMSSD), physical activity and perceived stress during 2 days of everyday life and multilevel models for data analyses. Aerobic capacity (VO2max) was assessed pre- and post-intervention via cardiopulmonary exercise testing to analyze the effectiveness of the intervention.

RESULTS

During real-life stressors, the exercise training group showed significantly reduced LF/HF (β = -0.15, t = -2.59, p = .01) and increased RMSSD (β = 0.15, t = 2.34, p = .02) compared to the control group.

CONCLUSIONS

Using a randomized controlled trial and a real-life stressor, we could show that exercise appears to be a useful preventive strategy to buffer the effects of stress on the autonomic nervous system, which might result into detrimental health outcomes.

Effects of a 12-week endurance training program on the physiological response to psychosocial stress in men: a randomized controlled trial

The present study experimentally tested the cross-stressor adaptation hypothesis by examining whether endurance exercise training leads to reductions in the physiological stress response to a psychosocial stressor. We randomly assigned 149 healthy men to a 12-week exercise training, relaxation training, or a wait list control group. Before and after intervention we assessed the groups' physical fitness (lactate testing) and compared their physiological stress responses to the Trier Social Stress Test for Groups in terms of salivary free cortisol, heart rate (HR) and heart rate variability (HRV); the final sample consisted of 96 subjects. As hypothesized, the exercise training significantly improved fitness and reduced stress reactivity in all three parameters; however, it only improved stress recovery in terms of HR. The relaxation program reduced only cortisol, but not HR or HRV reactivity; no changes emerged for the control group. The findings suggest that the cross-stressor adaptation hypothesis is valid for cardiovascular as well as endocrine stress reactivity.

Effects of Exercise Training on Cardiorespiratory Fitness and Biomarkers of Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Guidelines recommend exercise for cardiovascular health, although evidence from trials linking exercise to cardiovascular health through intermediate biomarkers remains inconsistent. We performed a meta-analysis of randomized controlled trials to quantify the impact of exercise on cardiorespiratory fitness and a variety of conventional and novel cardiometabolic biomarkers in adults without cardiovascular disease.

METHODS AND RESULTS

Two researchers selected 160 randomized controlled trials (7487 participants) based on literature searches of Medline, Embase, and Cochrane Central (January 1965 to March 2014). Data were extracted using a standardized protocol. A random-effects meta-analysis and systematic review was conducted to evaluate the effects of exercise interventions on cardiorespiratory fitness and circulating biomarkers. Exercise significantly raised absolute and relative cardiorespiratory fitness. Lipid profiles were improved in exercise groups, with lower levels of triglycerides and higher levels of high-density lipoprotein cholesterol and apolipoprotein A1. Lower levels of fasting insulin, homeostatic model assessment-insulin resistance, and glycosylated hemoglobin A1c were found in exercise groups. Compared with controls, exercise groups had higher levels of interleukin-18 and lower levels of leptin, fibrinogen, and angiotensin II. In addition, we found that the exercise effects were modified by age, sex, and health status such that people aged <50 years, men, and people with type 2 diabetes, hypertension, dyslipidemia, or metabolic syndrome appeared to benefit more.

CONCLUSIONS

This meta-analysis showed that exercise significantly improved cardiorespiratory fitness and some cardiometabolic biomarkers. The effects of exercise were modified by age, sex, and health status. Findings from this study have significant implications for future design of targeted lifestyle interventions.

The psychological benefits of recreational running: a field study

Running yields positive changes in affect, but the external validity of controlled studies has received little attention in the literature. In this inquiry, 50 recreational runners completed the Exercise-Induced Feeling Inventory (Gauvin & Rejeskí, 1993) before and after a bout of self-planned running on an urban running path. Positive changes were seen in all four measures of affect (p < .001). Multivariate regressions were performed to examine the contribution of four exercise characteristics (i.e., duration of the current run, weekly running time, weekly running distance, and running experience) to the observed changes in affect. The results have revealed that exercise characteristics accounted for only 14-30% of the variance in the recreational runners' affect, in both directions. It is concluded that psychological benefits of recreational running may be linked to placebo (conditioning and/or expectancy) effects.

Effect of a skiing intervention on the psycho-physiological reactivity and recovery in the elderly

This study determined the effects of a skiing intervention lasting 12 weeks on the psycho-physiological reactivity to and recovery from mental stressors in individuals who are 60+ years of age. In accordance with the cross-stressor hypothesis, it was assumed that a skiing intervention optimizes psycho-physiological pre-conditions for coping with stress. A cognitive task was used to investigate stress-induced changes (reactivity) in the high-frequency (HF) component of the heart rate variability (HRV) and in the skin conductance level (SCL) as well as recovery from this stressor. The intervention group demonstrated a significant increase in maximal oxygen consumption that was not accompanied by alterations in HRV at rest. In comparison with the control group, there was no difference in the alteration of the reactivity and recovery in the HF component and in the SCL after completing the training. The findings indicate that neither the psycho-physiological reactivity nor the recovery was influenced by the skiing intervention. It may be speculated that the intensity of the skiing intervention was too low to induce such adaptations. Therefore, further studies are encouraged to enhance the duration and intensity of the exercises to achieve adaptations of the autonomous nervous system of elderly individuals.

A walking program's attenuation of cardiovascular reactivity in older adults with silent myocardial ischemia

Silent myocardial ischemia (SI) has been linked to increased risk of future coronary events. Enhanced systolic and diastolic blood pressure (SBP and DBP, respectively) and heart-rate (HR) reactions to stress (cardiovascular reactivity [CVR]) have been associated with greater severity of SI and are related prospectively to coronary-artery-disease endpoints. The authors examined the potential attenuating effects of 6 months of walking (aerobic exercise) versus control on CVR to three laboratory stressors in 25 older adults with exercise-induced SI. Maximal aerobic capacity was significantly improved by 12% for the exercise group and decreased by 8% for controls (p < .001). Groups had similar biomedical profiles pre- and postintervention. Walkers had significantly reduced DBP reactivity (pre, 12 +/- 2; post, 4 +/- 2 mm Hg) compared with controls (pre, 10 +/- 2; post, 11 +/- 2 mm Hg; p = .05), but no differences between groups were found for SBP or HR reactivity. These findings are the first to suggest that increased physical activity (via walking) can attenuate BP reactivity to emotional stressors in apparently healthy older adults with SI.

Cardiorespiratory fitness and laboratory stress: a meta-regression analysis

We performed a meta-regression analysis of 73 studies that examined whether cardiorespiratory fitness mitigates cardiovascular responses during and after acute laboratory stress in humans. The cumulative evidence indicates that fitness is related to slightly greater reactivity, but better recovery. However, effects varied according to several study features and were smallest in the better controlled studies. Fitness did not mitigate integrated stress responses such as heart rate and blood pressure, which were the focus of most of the studies we reviewed. Nonetheless, potentially important areas, particularly hemodynamic and vascular responses, have been understudied. Women, racial/ethnic groups, and cardiovascular patients were underrepresented. Randomized controlled trials, including naturalistic studies of real-life responses, are needed to clarify whether a change in fitness alters putative stress mechanisms linked with cardiovascular health.

Aerobic exercise training and cardiovascular reactivity to psychological stress in sedentary young normotensive men and women

Forty-five (22 women) sedentary young (18-30 years old) nonsmoking normotensive volunteers engaged in either 6 weeks of aerobic training (AT), weight training (WT), or a no-treatment (NT) condition to determine whether AT lowers systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR), and rate-pressure product (RPP) during rest, psychological stress, and recovery periods. Estimated VO(2)max increased for the AT (32.1+/-1.1 to 38.4+/-1.0 ml.kg(-1).min(-1)). A smaller increase for the WT (30.5+/-1.1 to 33.8+/-1.0) was likely due to increased leg strength, and VO(2)max did not change for the NT (32.5+/-1.1 to 32.9+/-1.0). Heart rate and RPP levels were lower during psychological stress and recovery after training for AT relative to the WT and NT. Overall SBP was also lower in the AT relative to the NT but not the WT. In conclusion, aerobic training lowered cardiovascular activity levels during psychological stress and recovery in healthy young adults, implying a protective role against age-related increases in coronary heart disease for individuals who adopt aerobic exercise early in life and maintain the behavior across the life span.

Effects of Physical Training on Endocrine and Autonomic Response to Acute Stress

Abstract The effects of physical training on autonomic response to acute stress are controversial. In this study, heart rate (HR) and skin conductance level (SCL) were continuously recorded in response to a mental stressor in a sample of elite athletes before and after a period of training and competition. The free testosterone to cortisol ratio (FTCR) and the Profile of Mood States (POMS) were used as markers of training impact. After the training, the men and women showed a significant FTCR decrement, although mood and the autonomic response to the acute stressor were not strongly altered. Although men showed significantly lower HR values after training, the results suggest that subjects suffered a transitory state of hormonal overstrain rather than a serious problem of adaptation to training.

Regular physical activity and changes in risk factors for coronary heart disease: a nine months prospective study

This study reports the non-acute effects of a long-term training programme of increasing intensity on some cardiovascular risk factors and the interrelation between these risk factors. Twenty sedentary men and 14 sedentary women were trained 3 to 4 times a week for nine months. After 36 weeks all individuals ran a half marathon run. The Wmax, weight, body mass index, systolic and diastolic blood pressure were recorded. The concentrations of fibrinogen, tissue plasminogen activator, plasminogen activator inhibitor, triacylglycerols, total cholesterol, LDL cholesterol, HDL cholesterol and lipoprotein(a) were measured. The training programme induced a median increase in Wmax of 12% in the male group (from 226 to 251.5 Watt) and of 18% in the female group (from 160 to 188.5 Watt). These increases inn Wmax did not correlate with any other property under investigation in this study. Blood pressure was not altered, but body weight and body mass index were significantly decreased in the male group (from 74.6 to 72.2 kg and from 23.1 to 22.0 kg/m2, respectively) at the end of the training programme and decreased non-significantly in the female group (from 63.0 to 60.7 kg and from 21.6 to 21.5 kg/m2, respectively). In the male group total cholesterol, low density lipoprotein cholesterol and triacylglycerols decreased significantly under the influence of the training sessions. Furthermore, in both groups, a great decrease in plasma plasminogen activator inhibitor concentrations was noticed: in men from 22.5.10(3) AU/l to 4.5.10(3) AU/l and in women from 18.7 x 10(3) AU/l to 5.1 x 10(3) AU/l. However, the changes in the lipid and fibrinolytic quantities were not correlated with each other. Initial total cholesterol, LDL cholesterol and triacylglycerol levels correlated significantly with systolic blood pressure, while diastolic pressure was correlated to tissue plasminogen activator. Since tissue plasminogen activator also was significantly related to triacylglycerols, a trias existed between primary risk factors like blood pressure, lipid levels and fibrinolysis. In contrast, the changes in these properties under the influence of physical training were not interrelated. Median serum lipoprotein(a) concentrations were significantly increased in both men and women five days before the half marathon run: from 32 mg/l to 39 mg/l in men, and from 65 mg/l to 125.5 mg/l in women. Concomitantly, median fibrinogen concentrations were significantly elevated in men (from 2.32 g/l to 3.10 g/l) and non-significantly in women (from 2.62 g/l to 2.93 g/l), although no correlation existed between the changes in these properties. In conclusion, the nine months exercise programme increased the aerobic fitness in both men and women as indicated by the Wmax increase. This improvement coincided but was not correlated with beneficial changes in several anthropometric, lipid and fibrinolytic properties. Improvement in the risk factors under investigation was more pronounced in men than in women. The changes in lipid and haemostasis properties did not correlate with each other. The increases in lipoprotein(a) and fibrinogen concentrations, both atherogenic indices, could actually present a normal physiological response to the physical strain of exercise training of increasing workload.

Heart rate response to psychological stressors of individuals possessing resting bradycardia

The authors examined the relation between trained and inherent bradycardia and heart rate (HR) and T-wave amplitude response to psychological stressors. They compared cardiac responses to two psychological stressors of 10 trained male runners (MVo2max = 75 mL/kg-1 min-1) possessing low resting heart rate (M = 58 bpm), 10 untrained men (MVo2max = 58 mL/kg-1 min-1) with inherently low resting heart rate (M = 58 bpm), and 10 unconditioned men (MVo2max = 51 mL/kg-1 min-1) with normal resting heart rate (M = 69 bpm). All participants completed a maximal oxygen consumption treadmill test, an easy and a hard mental arithmetic task, and the Stroop Color and Word Test. Their analysis of the data revealed no significant differences in relative heart rate response or T-wave amplitude between groups during or after any stressor. In contrast, absolute heart rates during and after mental arithmetic and during the Stroop test were significantly lower for both the trained and inherently low groups compared with the control group. These findings suggest that the lower absolute HR response during and after stressors was influenced by both aerobic training and genetic inheritance.