Moderate regular exercise increases basal production of nitric oxide in elderly women

Regular exercise delays microvascular endothelial dysfunction by regulating antioxidant capacity and cellular metabolism

Aging is the basis for several unfavorable conditions, including cardiovascular diseases (CVDs). In this sense, regular physical activity (regular PA) has been proven to delay cellular aging and prevent endothelial dysfunction related to CVDs. Despite numerous studies involving athletes, little is known about cellular and molecular mechanisms of regular PA among master athletes. The present study aimed at evaluating the effects of regular PA on local microcirculatory functions in elderly athletes as compared to age-matched sedentary controls. Moreover, molecular/epigenetic mechanisms (nitric oxide, oxidative stress, PGC-1α, SIRT1 and miR29) were also assessed. The results of the present study showed that regular PA significantly increased local blood flow in post-ischemia and post-heating conditions, as well as NO plasma concentrations, denoting a better endothelial function/microcirculatory efficiency. Moreover, athletes presented a greater plasma antioxidant and increased transcriptional levels of the metabolism regulator PGC-1α. Finally, regular PA enhanced plasma level of SIRT1 and miR29, suggested as epigenetic regulators of redox balance and cellular metabolism. In addition, stimulated local blood flow was directly related to plasma antioxidant capacity, and SIRT1 and miR29 levels. Overall, our data confirm the beneficial effects of regular PA on the cardiovascular profile in elderly athletes and shed light on molecular signals involved in the positive adaptations to exercise.

Effect of Exercise Training on Blood Pressure in Healthy Postmenopausal Females: A Systematic Review with Meta-analysis

INTRODUCTION

The prevalence of hypertension is greater in postmenopausal females compared with males of similar age. Previous meta-analyses of normotensive and hypertensive adults have shown that aerobic exercise training reduces systolic blood pressure (SBP) and/or diastolic blood pressure (DBP). However, the effect of aerobic exercise training on blood pressure specifically within healthy postmenopausal females remains unclear. This systematic review with meta-analysis quantified the effect of aerobic exercise training on resting SBP and DBP in healthy postmenopausal females.

METHODS

The systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines and was registered in PROSPERO (CRD42020198171). The literature search was done in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL Plus, and SPORTDiscus. Randomized controlled trials involving healthy postmenopausal females with normal or high normal blood pressure and undergoing ≥4 wk of aerobic exercise training were included. The total weighted mean change in SBP and DBP was compared between the exercise and the control interventions. A random-effects model was used to calculate the overall effect sizes of the weighted mean differences and the 95% confidence interval (CI).

RESULTS

Twelve studies were included in the meta-analysis (exercise interventions: n = 357, age = 60 ± 4 yr, baseline SBP/DBP = 128 ± 13/79 ± 8 mm Hg; control interventions: n = 330, age = 60 ± 4 yr, baseline SBP/DBP = 126 ± 11/77 ± 6 mm Hg). Compared with the change observed in response to the control interventions, exercise training significantly reduced SBP (-0.43 mm Hg, 95% CI = -0.78 to -0.09, P = 0.02) and DBP (-0.39 mm Hg, 95% CI = -0.73 to -0.05, P = 0.05).

CONCLUSIONS

Aerobic exercise training significantly reduces resting SBP and DBP in healthy postmenopausal females with normal or high normal blood pressure. However, this reduction is small and of uncertain clinical significance.

Effect of exercise training on nitric oxide and nitrate/nitrite (NOx) production: A systematic review and meta-analysis

Background: Exercise and physical activity can improve circulation through various mechanisms, such as the increment of nitric oxide (NO) production, by affecting vascular endothelial nitric oxide synthase, and reducing reactive oxygen species (ROS). Although, theoretically, this mechanism is well known, studies in living subjects have made controversial findings regarding the association of NO production and its metabolites [nitrate/nitrite (NOx)] with physical activity. Hence, this systematic review and meta-analysis was designed to gather all these studies and evaluate the effects of exercise training, and physical activity duration and length on the mean change of serum/plasma NO and NOx.

Method: We searched all available bibliographic electronic databases from inception through to May 2022 to include all randomized controlled trials (RCT) and quasi-experimental trials which assessed the effect of exercise and training on NO and NOx levels. Random-effects meta-analysis was used to pool the standardized mean difference (SMD) and 95% confidence interval (CI) of included RCT studies which assessed the effect of training. Stratified meta-analysis was performed according to the type of exercise (high-intensity interval training (HIIT), aerobic training (AT), the duration of exercise (≤8 and > 8 weeks), and length of exercise in each session ≥40 and 40 < minutes).

Results: Overall, 15 and 10 studies were included in the systematic review and meta-analysis, respectively. According to the random-effects meta-analysis, exercise significantly increased the mean change of NO and NOx compared to control (SMD: 1.82, 95%CI: 1.14 to 2.49. In the stratified meta-analysis, the mean change of NO and NOx in the intervention group was significantly higher than in the control group in the AT (SMD: 1.36, 95%CI: 0.55–2.18), HIIT (SMD: 2.55, 95%CI: 1.14–3.96), duration of ≤8 (SMD: 2.29, 95%CI: 1.24–3.35) and > 8 weeks (SMD: 1.19, 95%CI: 0.52–1.86), length of ≥40 (SMD: 1.61, 95%CI: 1.04–2.18), and 40 < minutes in each session (SMD: 2.07, 95%CI: 0.79–3.35).

Conclusion: The findings of this study indicate that, regardless of exercise duration, length, and type (AT or HIIT), exercise can significantly increase serum NO and NOx levels.

Effects of moderate-continuous and high-intensity interval aerobic training on cardiac function of spontaneously hypertensive rats

The aim of this study was to verify the effects of moderate-intensity continuous (MICT) and high-intensity interval (HIIT) aerobic training on cardiac morphology and function and the mechanical properties of single cardiomyocytes in spontaneously hypertensive rats (SHR) in the compensated phase of hypertension. Sixteen-week-old male SHR and normotensive Wistar (WIS) rats were allocated to six groups of six animals each: SHR CONT or WIS CONT (control); SHR MICT or WIS MICT (underwent MICT, 30 min/day, five days per week for eight weeks); and SHR HIIT or WIS HIIT (underwent HIIT, 30 min/day, five days per week for eight weeks). Total exercise time until fatigue and maximum running speed were determined using a maximal running test before and after the experimental period. Systolic (SAP), diastolic (DAP), and mean (MAP) blood pressures were measured using tail plethysmography before and after the experimental period. Echocardiographic evaluations were performed at the end of the experimental period. The rats were euthanized after in vivo assessments, and left ventricular myocytes were isolated to evaluate global intracellular Ca²⁺ transient ([Ca²⁺]_i) and contractile function. Cellular measurements were performed at basal temperature (~37°C) at 3, 5, and 7 Hz. The results showed that both training programs increased total exercise time until fatigue and, consequently, maximum running speed. In hypertensive rats, MICT decreased SAP, DAP, MAP, interventricular septal thickness during systole and diastole, and the contraction amplitude at 5 Hz. HIIT increased heart weight and left ventricular wall thickness during systole and diastole and reduced SAP, MAP, and the time to peak [Ca²⁺]_i at all pacing frequencies. In conclusion, both aerobic training protocols promoted beneficial adaptations to cardiac morphology, function, and mechanical properties of single cardiomyocytes in SHR.

Exercise Training Induces a Shift in Extracellular Redox Status with Alterations in the Pulmonary and Systemic Redox Landscape in Asthma

Redox dysregulation and oxidative stress have been implicated in asthma pathogenesis. Exercise interventions improve symptoms and reduce inflammation in asthma patients, but the underlying mechanisms remain unclear. We hypothesized that a personalised exercise intervention would improve asthma control by reducing lung inflammation through modulation of local and systemic reactive species interactions, thereby increasing antioxidant capacity. We combined deep redox metabolomic profiling with clinical assessment in an exploratory cohort of six female patients with symptomatic asthma and studied their responses to a metabolically targeted exercise intervention over 12 weeks. Plasma antioxidant capacity and circulating nitrite levels increased following the intervention (p = 0.028) and lowered the ratio of reduced to oxidised glutathione (p = 0.029); this was accompanied by improvements in physical fitness (p = 0.046), symptoms scores (p = 0.020), quality of life (p = 0.046), lung function (p = 0.028), airway hyperreactivity (p = 0.043), and eosinophilic inflammation (p = 0.007). Increased physical fitness correlated with improved plasma antioxidant capacity (p = 0.019), peak oxygen uptake and nitrite changes (p = 0.005), the latter also associated with reductions in peripheral blood eosinophil counts (p = 0.038). Thus, increases in “redox resilience” may underpin the clinical benefits of exercise in asthma. An improved understanding of exercise-induced alterations in redox regulation offers opportunities for greater treatment personalisation and identification of new treatment targets.

Physical Exercise Protects Against Endothelial Dysfunction in Cardiovascular and Metabolic Diseases

Increasing evidence shows that endothelial cells play critical roles in maintaining vascular homeostasis, regulating vascular tone, inhibiting inflammatory response, suppressing lipid leakage, and preventing thrombosis. The damage or injury of endothelial cells induced by physical, chemical, and biological risk factors is a leading contributor to the development of mortal cardiovascular and cerebrovascular diseases. However, the underlying mechanism of endothelial injury remains to be elucidated. Notably, no drugs effectively targeting and mending injured vascular endothelial cells have been approved for clinical practice. There is an urgent need to understand pathways important for repairing injured vasculature that can be targeted with novel therapies. Exercise training-induced protection to endothelial injury has been well documented in clinical trials, and the underlying mechanism has been explored in animal models. This review mainly summarizes the protective effects of exercise on vascular endothelium and the recently identified potential therapeutic targets for endothelial dysfunction.

The effect of exercise training on blood pressure in menopause and postmenopausal women: A systematic review of randomized controlled trials

The prevalence of hypertension is higher in postmenopausal than in premenopausal women. Regular exercise training has been shown to be effective in addressing hypertension. The aim of this systematic review was to synthesize the effect of exercise training on systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) in menopausal and postmenopausal women. This review was reported according to the PRISMA statement and registered in PROSPERO. The literature search was done in MEDLINE, Embase, Cochrane CENTRAL and ClinicalTrials. Randomized controlled trials involving menopausal and postmenopausal women undergoing exercise training were included. Two blinded reviewers assessed risk of bias in the included studies by using the Cochrane Risk of Bias tool. A random-effects model was used for all analyses. Significance was set at P < 0.05. Compared with the control group, exercise training resulted in clinically significant reductions on SBP (MD -3.43 mmHg; 95% CI, -5.16, -1.71; P < 0.0001), DBP (MD, -2.25 mmHg; 95% CI, -3.40, -1.11; P = 0.0001) and MAP (MD, -3.48 mmHg; 95% CI, -5.84, -1.11; P = 0.004). Aerobic training (AT) did not produce a significant reduction in SBP, DBP and MAP (P >0.05). Combined training (CT) generated larger reductions. Exercise training generated small but clinically relevant reductions in SBP, DBP and MAP in menopausal and postmenopausal women, younger or older than 65 years, with prehypertension or hypertension. AT did not lead to a clinically relevant improvement in blood pressure (BP) in this population. In addition, CT showed the largest reductions in SBP, DBP and MAP.

Influences of Recreational Tennis-Playing Exercise Time on Cardiometabolic Health Parameters in Healthy Elderly: The ExAMIN AGE Study

BACKGROUND

Aging and chronic degeneration are the primary threats to cardiometabolic health in elderly populations. Regular appropriate exercise would benefit the advanced aging population.

PURPOSE

This study investigates whether the degree of weekly tennis participation exhibits differences in primary cardiometabolic parameters, including arterial stiffness, inflammation, and metabolic biomarkers in elderly tennis players.

METHODS

One hundred thirty-five long-term participants in elder tennis (>50 years old) were initially screened. Twenty-six eligible and voluntary subjects were divided into high tennis time group (HT) (14 ± 1.3 h/week) and low tennis time group (LT) (4.5 ± 0.7 h/week) by stratification analysis based on the amount of tennis playing activity time. The brachial-ankle pulse wave velocity (baPWV), blood pressure, ankle-brachial index (ABI), blood metabolic biomarkers, and insulin resistance were measured to compare the difference between HT and LT groups.

RESULTS

The baPWV was significantly lower in the HT group than that in the LT group (1283.92 ± 37.01 vs. 1403.69 ± 53.71 cm/s, p < 0.05). We also found that the HT insulin-resistant homeostasis model assessment (HOMA-IR) was significantly lower than that of LT (1.41 ± 0.11 vs. 2.27 ± 0.48 μIU/mL, p < 0.05). However, the blood lipid biomarkers (glucose, cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride) were not statistical different between HT and LT groups (p > 0.05).

CONCLUSION

We demonstrated that under the condition of similar daily physical activity level, elderly with a higher time of tennis-playing (HT group) exhibited relatively lower arterial stiffness (lower PWV) and lower insulin resistance compared to those with lower time tennis-playing (LT).

THE EFFECTS OF BASKETBALL AND SOCCER TRAINING ON ARTERIAL STIFFNESS

ABSTRACT Objective The purpose of this study was to examine arterial stiffness in elite basketball and soccer athletes by pulse wave velocity. Methods The cohort comprised 35 healthy male volunteers aged 17 to 26 years. All the subjects were either basketball players (n=9), soccer players (n=12) or sedentary controls (n=14). Arterial stiffness was measured by the Pulse Trace System (Micro Medical Ltd., Rochester, UK) and echocardiographic images were taken using a commercially available machine (Vivid 7 GE-Vingmed, Horten, Norway) with a 2.5 MHz transducer. Results The basketball players had significantly higher heights and body weights as compared to both the soccer players and the controls. The aortic elastic properties derived from the echocardiographic measurements did not differ between the groups. The peripheral pulse wave velocity measurements showed significantly lower values both in the basketball and soccer players compared to the controls, whereas the central pulse wave velocity measurement was significantly lower only in the basketball players as compared to the controls. No significant difference was seen between the basketball and soccer players. Conclusions The results of this study show that football and basketball exercises comprised of aerobic, anaerobic, endurance balance-coordination and sport-specific training play a role in reducing arterial stiffness. Level of evidence I; type of study: prognostic study.

Combined aerobic and low-intensity resistance exercise training increases basal nitric oxide production and decreases arterial stiffness in healthy older adults

Meta-analyses have concluded that combined aerobic and high-intensity or moderate-intensity resistance exercise training has no effects on arterial stiffness. However, a recent study demonstrated that combined aerobic training and resistance training using rubber bands increases basal nitric oxide (NO) production and decreases arterial stiffness with marked reduction of body weight in obese adolescent girls. To investigate whether combined aerobic and low-intensity resistance training increases basal NO production and decreases arterial stiffness without body weight reduction in older adults, 27 healthy older individuals participated in a 6-week program as a part of the training group (mean body mass index, 21 kg/m²; walking and resistance training using one’s body weight) or the control group (22 kg/m², asked not to modify their lifestyle). The exercise intervention increased aerobic capacity, muscle strength, and plasma concentrations of nitrite/nitrate (end products of NO) and decreased pulse wave velocity (an index of arterial stiffness) without changes in body weight. In the control group, there were no differences in these measures before and after the study period. These results suggest that combined aerobic and low-intensity resistance exercise training increases basal NO production and decreases arterial stiffness in healthy older adults.

The effects of isoflavone supplementation plus combined exercise on salivary markers of oxidative stress in postmenopausal women

This study tested the effect of isoflavone supplementation in addition to combined exercise training in salivary oxidative stress markers in non-obese postmenopausal women. Thirty-two postmenopausal women without hormone therapy were randomly assigned to exercise + placebo (n = 15) or exercise + isoflavone supplementation (n = 17) groups. They performed 30 sessions of combined exercises (aerobic plus resistance) over ten weeks and consumed 100 mg of isoflavone supplementation or placebo. Saliva samples were collected after an overnight fast. Superoxide dismutase, total antioxidant capacity, thiobarbituric acid reactive substances, catalase, total protein and nitrite were determined before and after ten weeks of the intervention. The ANOVA two-way analysis of variance was applied with α of 5%. Both groups increase (p<0.05) superoxide dismutase activity and decrease catalase levels. There was interaction (time × group) in both nitrite and thiobarbituric acid reactive substances results, with increase (p<0.05) in placebo group and decrease (p<0.05) in isoflavone group. No difference was found for total antioxidant capacity or total protein. The combination of isoflavone supplementation and exercise training can promote an antioxidant effect through reduction of lipid peroxidation and concentrations of salivary nitrite.

Nitric Oxide and Decreases in Resistance Exercise Blood Pressure With Aerobic Exercise Training in Older Individuals

An exaggerated blood pressure response to resistance exercise is a marker of masked hypertension and a risk factor for future essential hypertension. Habitual aerobic exercise decreases systolic blood pressure (SBP) during resistance exercise in older individuals, but the underlying mechanisms have not been explored. This study tested the hypothesis that nitric oxide (NO) mediates a reduction of resistance exercise SBP with aerobic training in older individuals. Normotensive older adults participated in a 6-week program as a part of the aerobic training group (n = 23, exercised for an average of 4.4 d/wk and 59 min/d) or the control group (n = 26, asked not to modify their lifestyle during the experimental period). The aerobic exercise intervention increased plasma concentrations of nitrite/nitrate (NOx, end products of NO) and decreased SBP during a one-hand arm curl exercise at 20% and 40% of one-repetition maximum and brachial-ankle pulse wave velocity (an index of arterial stiffness). In the control group, there were no differences in these measures before and after the experimental period. Changes in plasma NOx concentrations during the study period were correlated with changes in resistance exercise SBP. Stepwise regression revealed that changes in plasma NOx concentrations during the experimental period are a significant factor of changes in resistance exercise SBP, independent of age, sex, and changes in serum lipid profile, maximal oxygen uptake, resting SBP, and other variables. These results suggest that NO is associated with decreases in resistance exercise SBP with aerobic training in older individuals and help us better understand why habitual aerobic exercise prevents cardiovascular disease.

The effect of exercise training on blood pressure in African and Asian populations: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Exercise is key in the primary prevention and management of hypertension. Yet, current exercise recommendations are predominantly based on meta-analyses involving populations of European descent. Since blood pressure (BP) responses to pharmaceutical interventions are known to differ among ethnic groups, we aimed to investigate the BP responses to exercise training in non-European descendants.

PURPOSE

The aim of this study was to systematically summarize the available literature on the efficacy of exercise on BP in healthy adults (age ≥18 years) of African or Asian origin.

METHODS

We searched the MEDLINE database for randomized controlled trials that evaluated the effect of exercise training on BP in healthy African and Asian adults with optimal BP, elevated BP or hypertension and published in a peer-reviewed journal up to May 2019. Random effect models were fitted to estimate the effect sizes.

RESULTS

We identified 22 trials involving individuals of Asian origin (n = 931; mean age: 44 years; 41% male) and four trials involving individuals of African origin (n = 510; mean age: 56.7 years; 80% male). Aerobic exercise training significantly (p < 0.001) reduced systolic and diastolic BP in each ethnic group. Resistance training did not affect the BP of Asian participants with optimal BP. The effect of resistance training in Asians with elevated BP or hypertension and Africans could not be determined due to lack of data. Sub-analyses suggested somewhat larger reductions in systolic BP following aerobic training in hypertensive Africans compared with hypertensive Asians.

CONCLUSIONS

We found favorable effects of aerobic exercise training on BP in the African and the Asian populations. However, the overall low number of studies and especially the lack of data on resistance training and combined training in African and Asian populations warrant more research to improve the quality of evidence.

Effects of Aerobic Exercise Alone on Lipids in Healthy East Asians: A Systematic Review and Meta-Analysis

AIM

The purpose of the current work was to review the effects of regular aerobic exercise on serum lipid and lipoprotein levels in East Asians using meta-analysis.

METHODS

The randomized controlled trials analyzed involved healthy adults who were East Asians with a mean age ≥40 years, an exercise group that only performed regular aerobic exercise, and a control group that did not carry out exercise-related intervention; the trials indicated mean high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), or triglyceride (TG). The mean difference (MD) was defined as the difference (mean value at post-intervention in the exercise group－mean value at baseline in the exercise group)－(mean value at post-intervention in the control group－mean value at baseline in the control group) in HDL-C, LDL-C, TC, and TG and was calculated for each trial. The weighted MD was calculated with a random-effects model.

RESULTS

The meta-analysis examined 994 subjects in 25 studies. The weighted MD in HDL-C, TC, and TG improved significantly (HDL-C, 2.2 mg/dL; TC, －5.8 mg/dL; TG, －13.7 mg/dL). The weighted MD in HDL-C and TC contained significant heterogeneity (HDL-C, I²＝45.1%; TC, I²＝56.2%). When trials were limited to those involving moderate-intensity exercise (55%-69% of the maximum heart rate) or an exercise volume ≥150 min/week, the weighted MD in HDL-C, LDL-C, TC, and TG improved significantly and did not contain significant heterogeneity.

CONCLUSIONS

The findings suggest that the ideal form of exercise to improve lipid and lipoprotein levels in East Asians is exercise of moderate-intensity and in a volume ≥150 min/week.

High-intensity interval training lowers blood pressure and improves apelin and NOx plasma levels in older treated hypertensive individuals

Hypertension is the major risk factor for cardiovascular diseases and is one of the primary causes of morbidity and mortality worldwide. Apelin levels and NO bioavailability are impaired in older hypertensive patients. Exercise is an effective intervention for treating hypertension. Our purpose was to evaluate the effect of high-intensity interval training on blood pressure, apelin, and NOx plasma levels in older treated hypertensive individuals. Thirty treated hypertensive subjects (61.70 ± 5.78 years, 17 males, 13 females) were randomly divided into 6 weeks of high-intensity interval training (n = 15) and control (n = 15). The exercise training was conducted for three 35-min sessions a week (1.5-min interval at 85-90% of heart rate reserve [HRR] and 2 min active phase at 50-55% of HRR). Assessment of plasma apelin, nitrite/nitrate (NOx), and endothelin-1 (ET-1) was performed before and after the intervention. At the end of the study, apelin, and NOx plasma levels increased significantly in the high-intensity interval training (HIIT) group (P = 0.021, P = 0.003, respectively). Conversely, ET-1 plasma levels significantly decreased in the training group after the intervention (P = 0.015). Moreover, there was a positive correlation between the change of plasma apelin and change of plasma NOx (r = 0. 771, P = 0.0008). In addition, there was a negative correlation between the change of plasma ET-1, change of plasma apelin (r = - 0.595, P = 0.019), and variation of NOx (r = - 0.572, P = 0.025). This study indicates that, by increasing of apelin and NOx plasma levels, HIIT may be effective in reducing blood pressure.

The Effect of Being Aerobically Active vs. Inactive on Cutaneous Vascular Conductance during Local Heat Stress in an Older Population

Objective: To test the hypothesis that long- term aerobically trained elderly individuals have a greater amount of bioavailable nitric oxide (NO) and have a larger cutaneous vasodilation during local heat stress compared to their inactive elderly counterparts.

Methods: Eight aerobically trained and 8 inactive older men (>60 years old) participated in this study. NO bioavailability in blood and intradermal dialysate were measured with an ozone based chemiluminescence NO analyzer. Cutaneous vasodilator response to local heating was obtained using laser Doppler velocimetry.

Results: Whole blood NO were similar in older- trained and inactive subjects (0.75 ± 0.56 and 0.38 ± 0.32 μM, respectively; Mann–Whitney, p = 0.153), as was intradermal dialysate NO before (7.82 ± 6.32 and 4.18 ± 1.89 μM, respectively) and after local heating (7.16 ± 6.27 and 5.88 ± 3.97 μM, respectively, p = 0.354). The cutaneous vasodilator response of the older- inactive group was smaller than the older- trained group [Group-Time interaction, F_{(24, 264)} = 12.0, p < 0.0001]. When compared to a young group the peak vasodilator response of the older- trained subjects was similar. However, the time to initial dilation was 3.1 and 2.2 times longer (p < 0.05) in older- inactive and older- trained subjects, respectively, compared to young subjects.

Conclusions: Our data support the hypothesis that the age-related reductions in cutaneous vasodilation can possibly be restored by maintaining an aerobic training regimen (at least 3 years). However, some residual effects of aging remain, specifically a delayed cutaneous vasodilator response to local heating is still present in active older adults. We found no evidence for an increase in systemic or local NO-bioavailability with an extended commitment to aerobic fitness.

Regular aerobic exercise and blood pressure in East Asians: A meta-analysis of randomized controlled trials

The aim of this meta-analysis was to evaluate the effects of regular aerobic exercise on blood pressure in East Asians. The inclusion criteria of the randomized controlled trials were healthy East Asian adults, exercise group performing regular aerobic exercise and control group not exercising, and a description of the mean systolic blood pressure or diastolic blood pressure at rest. This study included 31 study groups and 1994 subjects. Pooled changes in blood pressure showed significant reductions (systolic blood pressure: -4.7 mmHg; diastolic blood pressure: -3.2 mmHg). In subgroup analyses, the change in systolic blood pressure for randomized controlled trials meeting the America Heart Association and American College of Sports Medicine guidelines for physical activity to maintain health was significantly larger than in randomized controlled trials not meeting the guidelines. In addition, meta-regression indicated that the change in systolic blood pressure was significantly related to "exercise time × exercise frequency." The ideal volume of exercise is that for a long time at a high frequency, such as the volume recommended in the America Heart Association and American College of Sports Medicine guidelines: moderate intensity and >150 min per week. List of abbreviations: BP: blood pressure; BMI: body mass index; SBP: systolic blood pressure; DBP: diastolic blood pressure; RCT: randomized controlled trial; AHA: America Heart Association; ACSM: America College of Sports Medicine; SD: standard deviation; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; TC: total cholesterol; TG: triglycerides; PEDro: Physiotherapy Evidence Database; CI: confidence intervals; %HR_max: percentage of maximal heart rate.

Impact of Age and Aerobic Exercise Training on Conduit Artery Wall Thickness: Role of the Shear Pattern

Hemodynamic shear stress is the frictional force of blood on the arterial wall. The shear pattern in the conduit artery affects the endothelium and may participate in the development and progression of atherosclerosis. We investigated the role of the shear pattern in age- and aerobic exercise-induced changes in conduit artery wall thickness via cross-sectional and interventional studies. In a cross-sectional study, we found that brachial shear rate patterns and brachial artery intima-media thickness (IMT) correlated with age. Additionally, brachial artery shear rate patterns were associated with brachial artery IMT in 102 middle-aged and older individuals. In an interventional study, 39 middle-aged and older subjects were divided into 2 groups: control and exercise. The exercise group completed 12 weeks of aerobic exercise training. Aerobic exercise training significantly increased the antegrade shear rate and decreased the retrograde shear rate and brachial artery IMT. Moreover, changes in the brachial artery antegrade shear rate and the retrograde shear rate correlated with the change in brachial artery IMT. The results of the present study indicate that changes in brachial artery shear rate patterns may contribute to age- and aerobic exercise training-induced changes in brachial artery wall thickness.

Regular physical exercise improves cardiac autonomic and muscle vasodilatory responses to isometric exercise in healthy elderly

The objective of this study was to evaluate cardiac autonomic control and muscle vasodilation response during isometric exercise in sedentary and physically active older adults. Twenty healthy participants, 10 sedentary and 10 physically active older adults, were evaluated and paired by gender, age, and body mass index. Sympathetic and parasympathetic cardiac activity (spectral and symbolic heart rate analysis) and muscle blood flow (venous occlusion plethysmography) were measured for 10 minutes at rest (baseline) and during 3 minutes of isometric handgrip exercise at 30% of the maximum voluntary contraction (sympathetic excitatory maneuver). Variables were analyzed at baseline and during 3 minutes of isometric exercise. Cardiac autonomic parameters were analyzed by Wilcoxon and Mann–Whitney tests. Muscle vasodilatory response was analyzed by repeated-measures analysis of variance followed by Tukey’s post hoc test. Sedentary older adults had higher cardiac sympathetic activity compared to physically active older adult subjects at baseline (63.13±3.31 vs 50.45±3.55 nu, P=0.02). The variance (heart rate variability index) was increased in active older adults (1,438.64±448.90 vs 1,402.92±385.14 ms, P=0.02), and cardiac sympathetic activity (symbolic analysis) was increased in sedentary older adults (5,660.91±1,626.72 vs 4,381.35±1,852.87, P=0.03) during isometric handgrip exercise. Sedentary older adults showed higher cardiac sympathetic activity (spectral analysis) (71.29±4.40 vs 58.30±3.50 nu, P=0.03) and lower parasympathetic modulation (28.79±4.37 vs 41.77±3.47 nu, P=0.03) compared to physically active older adult subjects during isometric handgrip exercise. Regarding muscle vasodilation response, there was an increase in the skeletal muscle blood flow in the second (4.1±0.5 vs 3.7±0.4 mL/min per 100 mL, P=0.01) and third minute (4.4±0.4 vs 3.9±0.3 mL/min per 100 mL, P=0.03) of handgrip exercise in active older adults. The results indicate that regular physical activity improves neurovascular control of muscle blood flow and cardiac autonomic response during isometric handgrip exercise in healthy older adult subjects.

Effects of voluntary exercise on structure and function of cortical microvasculature

Aerobic activity has been shown highly beneficial to brain health, yet much uncertainty still surrounds the effects of exercise on the functioning of cerebral microvasculature. This study used two-photon fluorescence microscopy to examine cerebral hemodynamic alterations as well as accompanying geometric changes in the cortical microvascular network following five weeks of voluntary exercise in transgenic mice endogenously expressing tdTomato in vascular endothelial cells to allow visualization of microvessels irrespective of their perfusion levels. We found a diminished microvascular response to a hypercapnic challenge (10% FiCO₂) in running mice when compared to that in nonrunning controls despite commensurate increases in transcutaneous CO₂ tension. The flow increase to hypercapnia in runners was 70% lower than that in nonrunners (p = 0.0070) and the runners' arteriolar red blood cell speed changed by only half the amount seen in nonrunners (p = 0.0085). No changes were seen in resting hemodynamics or in the systemic physiological parameters measured. Although a few unperfused new vessels were observed on visual inspection, running did not produce significant morphological differences in the microvascular morphometric parameters, quantified following semiautomated tracking of the microvascular networks. We propose that voluntary running led to increased cortical microvascular efficiency and desensitization to CO₂ elevation.

Relationship between exercise capacity and urinary liver-type fatty acid-binding protein in middle-aged and older individuals

BACKGROUND

The underlying mechanism linking the decline in exercise capacity with renal dysfunction remains unclear. Urinary liver-type fatty acid-binding protein (L-FABP) levels reflect the degree of peritubular capillary blood flow, an important factor for renal dysfunction with aging. The aim of this study was to examine the relationship between exercise capacity and urinary L-FABP levels.

METHODS

This was a cross-sectional study of 187 middle-aged and older individuals (aged 50-83 years) without chronic kidney disease (CKD). We assessed urinary L-FABP levels, peak oxygen consumption ([Formula: see text]), and grip strength.

RESULTS

Urinary L-FABP levels inversely correlated with both [Formula: see text] (r _s  = -0.349) and grip strength (r _s  = -0.485). When the participants were divided into four groups according to the median values of aerobic fitness and muscular strength ([Formula: see text] and grip strength), urinary L-FABP levels were the highest in participants with lower levels of aerobic fitness and muscular strength (2.95 ± 1.43 μg/g creatinine) and the lowest in the participants with higher levels of aerobic fitness and muscular strength (1.33 ± 0.76 μg/g creatinine). The difference between the two groups was significant (P < 0.001).

CONCLUSION

Our results demonstrate that both [Formula: see text] and grip strength were inversely associated with urinary L-FABP levels in middle-aged and older individuals without CKD. This suggests that a decline in exercise capacity is associated with a reduction in peritubular capillary blood flow, providing a novel insight into the underlying mechanism linking the decline in exercise capacity to the development of renal dysfunction.

Exercise Training and Epigenetic Regulation: Multilevel Modification and Regulation of Gene Expression

Exercise training elicits acute and adaptive long term changes in human physiology that mediate the improvement of performance and health state. The responses are integrative and orchestrated by several mechanisms, as gene expression. Gene expression is essential to construct the adaptation of the biological system to exercise training, since there are molecular processes mediating oxidative and non-oxidative metabolism, angiogenesis, cardiac and skeletal myofiber hypertrophy, and other processes that leads to a greater physiological status. Epigenetic is the field that studies about gene expression changes heritable by meiosis and mitosis, by changes in chromatin and DNA conformation, but not in DNA sequence, that studies the regulation on gene expression that is independent of genotype. The field approaches mechanisms of DNA and chromatin conformational changes that inhibit or increase gene expression and determine tissue specific pattern. The three major studied epigenetic mechanisms are DNA methylation, Histone modification, and regulation of noncoding RNA-associated genes. This review elucidates these mechanisms, focusing on the relationship between them and their relationship with exercise training, physical performance and the enhancement of health status. On this chapter, we clarified the relationship of epigenetic modulations and their intimal relationship with acute and chronic effect of exercise training, concentrating our effort on skeletal muscle, heart and vascular responses, that are the most responsive systems against to exercise training and play crucial role on physical performance and improvement of health state.

Role of Physical Therapists in Health Care of the Elderly

Japan is one of the leading countries worldwide in terms of longevity. However, with the increase in the elderly population, the number of individuals requiring some type of daily living assistance has currently exceeded 6 million. Cerebrovascular disease is the main reason for the requirement of care among the elderly. However, individuals in the late old age (≥75 years)-the number of which is rapidly increasing-also experience problems related to the functional decline of their musculoskeletal system, owing to age-related frailty and falls/fractures. Increasing the amount of physical activity not only helps prevent the onset of lifestyle-related diseases, but can also prevent the age-related decline in motor function. Hence, elderly individuals should perform exercises for health promotion and preventative care. However, as the physical functions and chronic diseases differ among individuals, it appears that the exercise programs offered as part of primary and secondary prevention programs may not be effective. Hence, physical therapists should play a large role in establishing appropriate and individualized exercise programs, as they have considerable experience in providing exercise therapy in the context of medical care for elderly people with varying conditions and risks.

Effects of Buddhist walking meditation on glycemic control and vascular function in patients with type 2 diabetes

OBJECTIVE

To investigate and compare the effects of Buddhist walking meditation and traditional walking on glycemic control and vascular function in patients with type 2 diabetes mellitus.

METHODS

Twenty three patients with type 2 diabetes (50-75 years) were randomly allocated into traditional walking exercise (WE; n=11) or Buddhism-based walking meditation exercise (WM; n=12). Both groups performed a 12-week exercise program that consisted of walking on the treadmill at exercise intensity of 50-70% maximum heart rate for 30min/session, 3 times/week. In the WM training program, the participants performed walking on the treadmill while concentrated on foot stepping by voiced "Budd" and "Dha" with each foot step that contacted the floor to practice mindfulness while walking.

RESULTS

After 12 weeks, maximal oxygen consumption increased and fasting blood glucose level decreased significantly in both groups (p<0.05). Significant decrease in HbA1c and both systolic and diastolic blood pressure were observed only in the WM group. Flow-mediated dilatation increased significantly (p<0.05) in both exercise groups but arterial stiffness was improved only in the WM group. Blood cortisol level was reduced (p<0.05) only in the WM group.

CONCLUSION

Buddhist walking meditation exercise produced a multitude of favorable effects, often superior to traditional walking program, in patients with type 2 diabetes.

Combined whole-body vibration training and l-citrulline supplementation improves pressure wave reflection in obese postmenopausal women

Postmenopausal women have increased wave reflection (augmentation pressure (AP) and index (AIx)) and reduced muscle function that predispose them to cardiac diseases and disability. Our aim was to examine the combined and independent effects of whole-body vibration training (WBVT) and l-citrulline supplementation on aortic hemodynamics and plasma nitric oxide metabolites (NOx) in postmenopausal women. Forty-one obese postmenopausal women were randomized to 3 groups: l-citrulline, WBVT+l-citrulline and WBVT+Placebo for 8 weeks. Brachial and aortic systolic blood pressure, diastolic blood pressure, AP, AIx, AIx adjusted to 75 beats/min (AIx@75), and NOx were measured before and after 8 weeks. All groups similarly decreased (P < 0.05) brachial and aortic pressures as well as AP, and similarly increased (P < 0.05) NOx levels. AIx and AIx@75 decreased (P < 0.01) in the WBVT+l-citrulline and WBVT+Placebo groups, but not in the l-citrulline group. The improvement in AIx@75 (−10.5% ± 8.8%, P < 0.05) in the WBVT+l-citrulline group was significant compared with the l-citrulline group. l-Citrulline supplementation and WBVT alone and combined decreased blood pressures. The combined intervention reduced AIx@75. This study supports the effectiveness of WBVT+l-citrulline as a potential intervention for prevention of hypertension-related cardiac diseases in obese postmenopausal women.

Physical exercise and epigenetic adaptations of the cardiovascular system

During the last decade, epigenetics became one of the fastest growing research fields in numerous clinical and basic science disciplines. Evidence suggests that chromatin modifications (e.g., histone modifications and DNA methylation) as well as the expression of micro-RNA molecules play a crucial role in the pathogenesis of several cardiovascular diseases. On the one hand, they are involved in the development of general risk factors like chronic inflammation, but on the other hand, epigenetic modifications are conducive to smooth muscle cell, cardiomyocyte, and endothelial progenitor cell proliferation/differentiation as well as to extracellular matrix processing and endothelial function (e.g., endothelial nitric oxide synthase regulation). Therefore, epigenetic medical drugs have gained increased attention and provided the first promising results in the context of cardiovascular malignancies. Beside other lifestyle factors, physical activity and sports essentially contribute to cardiovascular health and regeneration. In this review we focus on recent research proposing physical activity as a potent epigenetic regulator that has the potential to counteract pathophysiological alterations in almost all the aforementioned cardiovascular cells and tissues. As with epigenetic medical drugs, more knowledge about the molecular mechanisms and dose-response relationships of exercise is needed to optimize the outcome of preventive and rehabilitative exercise programs and recommendations.

Aerobic exercise training-induced changes in serum adropin level are associated with reduced arterial stiffness in middle-aged and older adults

Aging-induced arterial stiffening is reduced by aerobic exercise training, and elevated production of nitric oxide (NO) participates in this effect. Adropin is a regulator of endothelial NO synthase and NO release, and circulating adropin level decreases with age. However, the effect of habitual aerobic exercise on circulating adropin levels in healthy middle-aged and older adults remains unclear. We sought to determine whether serum adropin level is associated with exercise training-induced changes in arterial stiffness. First, in a cross-sectional study, we investigated the association between serum adropin level and both arterial stiffness and cardiorespiratory fitness in 80 healthy middle-aged and older subjects (65.6 ± 0.9 yr). Second, in an intervention study, we examined the effects of 8-wk aerobic exercise training on serum adropin level and arterial stiffness in 40 healthy middle-aged and older subjects (67.3 ± 1.0 yr) divided into two groups: aerobic exercise training and sedentary controls. In the cross-sectional study, serum adropin level was negatively correlated with carotid β-stiffness (r = -0.437, P < 0.001) and positively correlated with plasma NOx level (r = 0.493, P < 0.001) and cardiorespiratory fitness (r = 0.457, P < 0.001). Serum adropin levels were elevated after the 8-wk aerobic exercise training intervention, and training-induced changes in serum adropin level were correlated with training-induced changes in carotid β-stiffness (r = -0.399, P < 0.05) and plasma NOx level (r = 0.623, P < 0.001). Thus the increase in adropin may participate in the exercise-induced reduction of arterial stiffness.

Nonpreventive Role of Aerobic Exercise Against Cisplatin-induced Nephrotoxicity in Female Rats

Background:

Cisplatin (CP) is a chemotherapy drug and nephrotoxicity is a major concern for CP therapy. CP-induced nephrotoxicity is gender-dependent, and the effect of aerobic exercise in females has not been reported yet while it has a beneficial effect in males. Hence, this study was designed to determine the protective role of aerobic exercise against CP-induced nephrotoxicity in female rats.

Methods:

Twenty-eight adult female rats were divided into four groups. Groups I and II had aerobic exercise on a treadmill for 8 weeks. Then, the exercise protocol was continued for another week in group I and stopped in group II. All animals in these groups received CP (2.5 mg/kg/day; i.p.) for 1-week. Groups III and IV were treated with CP and vehicle, respectively, without exercise. Finally, the animals were sacrificed for biochemical measurements and tissue histopathology investigations.

Results:

CP alone without exercise increased serum levels of blood urea nitrogen (BUN) and creatinine (Cr), kidney weight, and kidney tissue damage score (KTDS); while exercise could not attenuate these parameters in female rats. Exercise in females increased the serum levels of BUN and Cr and KTDS and weight loss (P < 0.05). Kidney nitrite levels reduce significantly in group I in compared to positive and negative control groups. Exercise also did not have beneficial effects on malondialdehyde levels in plasma and kidney.

Conclusions:

Aerobic exercise cannot reduce CP-induced nephrotoxicity in female rats. Increasing the damage in female rats may be related to female sex hormone estrogen or gender differences in renal hemodynamic and renin-angiotensin system activity in the presence of exercise. In general, it is recommended that the females under CP chemotherapy avoid exercising during treatment.

Response of oxidative stress and inflammatory biomarkers to a 12-week aerobic exercise training in women with metabolic syndrome

BACKGROUND

Evidences have been highlighted the relationship among metabolic syndrome, chronic low-grade inflammation, oxidative stress and several diseases. In this sense, the aim of this study was to investigate the effects of aerobic exercise training on oxidative stress and inflammatory parameters on women with metabolic syndrome (MS).

METHODS

Twenty-three untrained women (51.86 ± 6.58 years old, BMI 30.8 ± 4.3 kg/m2) completed a 12-week treadmill exercise training, without modifications on dietary pattern. Advanced oxidation protein products (AOPP), thiobarbituric acid-reactive substances (TBARS), total thiol content (T-SH) and nitrite and nitrate (NOx) levels were assessed in plasma while the levels of interleukin-1 beta (IL-1β), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor alpha (TNF-α) and interferon-gamma (IFN-γ) were evaluated in the serum. The RNA expression (mRNA) of IL-1β, IL-10, TNF-α, IFN-γ, insulin receptor substrate 2 (IRS-2) and matrix metalloproteinase-9 (MMP-9) were performed inperipheral blood mononuclear cells (PBMC) of a subset with eight women with MS using real real-time polymerase chain reaction (qPCR).

RESULTS

The intervention resulted in decreased serum levels of IL-1β, IL-6, TNF-α, IFN-γ, AOPP and TBARS, besides increased levels of IL-10 and T-SH (P < 0.001). NOx concentrations were unchanged, similarly to mRNA expressions quantified in PBMC.

CONCLUSIONS

Twelve weeks of AT improved systemic oxidative stress and inflammatory biomarkers in women with MS, although PBMC mRNA expression for inflammatory pathways appeared to be unchanged. This may indicate that AT induced beneficial effects not only in physical fitness but also on health promotion through decreased oxidative damage and proinflammatory status.

Exercise interventions and peripheral arterial function: implications for cardio-metabolic disease

Physical inactivity is a major risk factor for the development of obesity and other cardiovascular (CV) disease (CVD). Vascular endothelial dysfunction is a key event in the development of CVD and is associated with a sedentary lifestyle in otherwise healthy adults. In addition, vascular endothelial dysfunction may be exacerbated in sedentary individuals who are obese and insulin resistant, since excess body fat is associated with elevated levels of pro-atherogenic inflammatory adipokines and cytokines that reduce the nitric oxide (NO) and other upstream paracrine signaling substances which reduces vascular health. Since blood flow-related shear stress is a major stimulus to NO release from the endothelium, disturbed flow or low shear stress is the likely mechanism by which vascular endothelial function is altered with inactivity. Evidence shows that regular physical exercise has beneficial effects on CVD and the risk factors that promote peripheral arterial function and health. Both aerobic and resistance exercise training are generally believed to improve endothelial function and are commonly recommended for CV health, including the management of obesity, hypertension, and insulin resistance. However, many factors including age, disease status, and race appear to influence these outcomes. Although evidence supporting the health benefits of exercise is compelling, the optimum prescription (volume and intensity) and the exact mechanism underlying the effects of exercise training on arterial function and cardiometabolic risk has yet to be identified. The focus of this review will be on the evidence supporting exercise interventions for peripheral arterial function.

The effects of different exercise modes for preventing endothelial dysfunction of arteries and bone loss in ovariectomized rats

[Purpose]

Several epidemiological studies have demonstrated that there are positive correlations between vascular disorders and bone loss in postmenopausal women. The aim of the present study was to examine the effect of different types of exercise (e.g., climbing and swimming) for preventing endothelial dysfunction of arteries and bone loss in ovariectomized rats.

[Methods]

Twenty Sprague-Dawley female rats were randomly divided into three groups: ovariectomy (OVX) plus treatment with vitamin D₃ and nicotine (VDN) (control rats [Con], n = 7), which is an animal model for endothelial dysfunction and bone loss; voluntary climbing resistance exercise with OVX plus VDN (climbing rats [Clim], n = 6), and swimming exercise with OVX plus VDN (swimming rats [Swim], n = 7). The period of exercise training was 8 weeks.

[Results]

The endothelin-1 (ET-1) protein levels were significantly lower in the Clim and Swim groups than in the Con. The endothelial nitric oxide synthase protein levels were significantly higher in the Swim group than in the Con, but they did not differ between the Clim and Con groups. The cortical bone mineral density in the tibia and breaking energy of the femur were significantly higher in the Clim group than in the Con, but this positive effect was not seen in the Swim group.

[Conclusion]

Voluntary climbing exercise decreased arterial ET-1 protein levels and prevented bone loss in a postmenopause-model rat combining OVX and VDN. Conversely, swimming suppressed endothelial dysfunction of the arteries but did not prevent bone loss. Thus, the type of exercise should be cautiously chosen for enhancing vascular function and bone status, especially in females after menopause.

Nitric oxide concentrations in gas emanating from the tails of obese rats

This study was undertaken to investigate the effects of oral L-arginine administration and exercising training on the NO concentration emanating from rat tail and NOx in plasma. Obese (fa/fa) Zucker rats (n = 22) were divided into four groups: (1) oral L-arginine administration (A) (n = 6), (2) exercise training (E), (3) exercise training + L-arginine administration (E + A) (n = 5), and (4) non-exercise training + non-L-arginine administration (N) (n = 6). The control (+/+) Zucker rats (n = 22) were also divided into the same four groups. The body weight of the E + A and the A groups was significantly lower than that of the N group. The NO concentration emitted from the tail was higher in the L-arginine (E + A and A) groups than in the non-L-arginine (E and N) groups in both obese and control rats. Exercise training did not affect the skin gas NO concentration in either obese or control rats. Plasma NOx concentrations in four obese rats were significantly higher than those observed in control rats. Exercise training did not influence the level of plasma NOx in obese or control rats. In conclusion, this study confirmed that L-arginine administration increases the skin gas NO concentration and obesity increases the plasma NOx level. The plasma NOx concentrations were not affected by L-arginine administration or exercise training in obese or control rats.

The presence of the NOS3 gene polymorphism for intron 4 mitigates the beneficial effects of exercise training on ambulatory blood pressure monitoring in adults

The number of studies that have evaluated exercise training (ET) and nitric oxide synthase (NOS)3 gene polymorphisms is scarce. The present study was designed to evaluate the relationship between exercise training and NOS3 polymorphisms at -786T>C, 894G>T, and intron 4b/a on blood pressure (BP) using 24-h ambulatory BP monitoring (ABPM), nitrate/nitrite levels (NOx), and redox state. Eighty-six volunteers (51 ± 0.6 yr old) were genotyped into nonpolymorphic and polymorphic groups for each of the three positions of NOS3 polymorphisms. Auscultatory BP, ABPM, SOD activity, catalase activity, NOx levels, and malondialdehyde levels were measured. DNA was extracted from leukocytes, and PCR followed by sequencing was applied for genotype analysis. Aerobic ET consisted of 24 sessions for 3 days/wk for 40 min at moderate intensity. This study was performed in a double-blind and crossover format. ET was effective in lowering office BP (systolic BP: 3.2% and diastolic BP: 3%) as well as ABPM (systolic BP: 2% and diastolic BP: 1.3%). Increased SOD and catalase activity (42.6% and 15.1%, respectively) were also observed. The NOS3 polymorphism for intron 4 mitigated the beneficial effect of ET for systolic BP (nonpolymorphic group: -3.0% and polymorphic group: -0.6%) and diastolic BP (nonpolymorphic group: -3.2% and polymorphic group: -0.5%), but it was not associated with NOx level and redox state. Paradoxical responses were found for positions T786-C and G894T for the NOS3 gene. Consistently, the presence of the polymorphism for intron 4 blunted the beneficial effects of ET in middle-aged adults. Possibly, this effect might be as consequence of intron 4 acting as a short intronic repeat RNA controlling endothelial NOS activity epigenetically.

Reduction of arterial stiffness by exercise training is associated with increasing plasma apelin level in middle-aged and older adults

Aging-induced deterioration of arterial stiffness is decreased by regular exercise, and increased nitric oxide (NO) production participates in this effect. Apelin regulates endothelial NO synthase in endothelial cells, promoting NO production. However, the effect of aerobic exercise training on circulating apelin levels in healthy middle-aged and older adults remains unknown. Accordingly, this study aimed to clarify the effects of regular aerobic exercise on apelin concentrations in middle-aged and older adults. Thirty-four healthy middle-aged and older subjects (67.0 ± 1.3 years) were randomly divided into two groups: exercise intervention and sedentary controls. Subjects in the training group completed 8-week of aerobic exercise training (60–70% peak oxygen uptake [VO_2peak] for 45 min, 3 days/week). Before and after the intervention, we evaluated plasma apelin and nitrite/nitrate (NOx) concentrations, VO_2peak, and arterial stiffness index. In the training group, VO_2peak was significantly increased, and carotid β-stiffness was significantly decreased, after the intervention (P<0.05). Moreover, plasma apelin and NOx levels were significantly increased in the training group after the intervention (P<0.05). Additionally, there was a correlation between the training effects of plasma apelin levels and carotidβ-stiffness (r = −0.508, P = 0.032) and plasma NOx levels (r = 0.494, P = 0.037). By contrast, none of these parameters changed significantly in the control group. These results suggest that the increased in plasma apelin levels may be associated with exercise training-induced alternation of arterial stiffness in middle-aged and older adults.

Aerobic exercise training decreases plasma asymmetric dimethylarginine concentrations with increase in arterial compliance in postmenopausal women

BACKGROUND

Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, increase with advancing age and menopausal status. ADMA plays a role in endothelial dysfunction and increasing arterial stiffness. Regular aerobic exercise has a positive effect on arterial function (i.e., arterial compliance). This study investigated the effects of aerobic exercise training on plasma ADMA concentrations and arterial compliance in postmenopausal women.

METHODS

Thirty postmenopausal women were divided into 2 groups: an exercise group (n = 20) and a control group (n = 10). Subjects in the exercise group completed 12 weeks of aerobic exercise training (65%-80% of maximal heart rate, 40-60 min/day, 3-6 days/week). Before and after each intervention, plasma ADMA concentrations and carotid arterial compliance were measured in all participants.

RESULTS

The baseline plasma ADMA concentrations, carotid arterial compliance, and most other key dependent variables did not differ between the 2 groups. In the exercise group, carotid arterial compliance significantly increased after exercise intervention (P < 0.01), and plasma ADMA concentrations significantly decreased (P < 0.05). In addition, changes in carotid arterial compliance after the exercise intervention were inversely correlated with changes in plasma ADMA concentrations (r = -0.367; P < 0.05).

CONCLUSIONS

We demonstrated that aerobic exercise training significantly decreased plasma ADMA concentrations with increase in carotid arterial compliance in postmenopausal women. These results suggest that reduction in ADMA may play an important role in the aerobic exercise training-induced increase in arterial compliance.

Potential benefits of exercise on blood pressure and vascular function

Physical activity seems to enhance cardiovascular fitness during the course of the lifecycle, improve blood pressure, and is associated with decreased prevalence of hypertension and coronary heart disease. It may also delay or prevent age-related increases in arterial stiffness. It is unclear if specific exercise types (aerobic, resistance, or combination) have a better effect on blood pressure and vascular function. This review was written based on previous original articles, systematic reviews, and meta-analyses indexed on PubMed from years 1975 to 2012 to identify studies on different types of exercise and the associations or effects on blood pressure and vascular function. In summary, aerobic exercise (30 to 40 minutes of training at 60% to 85% of predicted maximal heart rate, most days of the week) appears to significantly improve blood pressure and reduce augmentation index. Resistance training (three to four sets of eight to 12 repetitions at 10 repetition maximum, 3 days a week) appears to significantly improve blood pressure, whereas combination exercise training (15 minutes of aerobic and 15 minutes of resistance, 5 days a week) is beneficial to vascular function, but at a lower scale. Aerobic exercise seems to better benefit blood pressure and vascular function.

Relationships between maximal oxygen uptake and endothelial function in healthy male adults: a preliminary study

Aerobic capacity, as indicated by maximal oxygen uptake (VO2 max) has an important role in contrasting the traditional cardiovascular risk factors and preventing cardiovascular morbidity and mortality. It is known that endothelial function, measured as flow-mediated dilation (FMD) of the brachial artery, is strictly linked to atherogenesis and cardiovascular risk. However, the relationship between VO2 max and FMD has not been fully investigated especially in healthy non-obese subjects. This preliminary study cross-sectionally investigated the relationship between VO2 max and FMD in 22 non-obese, healthy sedentary male subjects. Dividing the cohort in two subgroups of 11 subjects each according to the median value of VO2 max, the FMD was significantly lower in the subgroup with lower VO2 max (mean ± sem: 7.1 ± 0.7 vs. 9.5 ± 0.8 %; P = 0.035). Absolute VO2 max (mL min(-1)) was significantly and independently correlated with body fat mass (r = -0.50; P = 0.018) and with FMD (r = 0.44; P = 0.039). This preliminary study suggests that maximal oxygen uptake is independently correlated with endothelial function in healthy non-obese adults. These results are also in agreement with the possibility that improving maximal oxygen uptake may have a favorable effect on endothelial function and vice versa.

Prepubertal children with suitable fitness and physical activity present reduced risk of oxidative stress

To assess the impact of fitness status and physical activity on oxidative stress in prepubertal children, we measured selected biomarkers such as protein carbonyls (PC), lipid peroxidation products, and total nitrites, as well as the antioxidant system: total glutathione (TG), oxidized glutathione (GSSG), reduced glutathione (GSH), superoxide dismutase activity, and glutathione peroxidase. A total of 132 healthy children ages 7-12, at prepubertal stage, were classified into two groups according to their fitness level: low fitness (LF) and high fitness (HF). They were observed while engaged in an after-school exercise program, and a questionnaire was created to obtain information on their physical activity or sedentary habits. Plasma and red blood cells were obtained to analyze biomarkers. Regarding oxidative stress markers, the LF group and the sedentary group showed higher levels of TG and GSSG and a lower GSH/GSSG ratio than the HF group and the children engaged in physical activity. A negative association was found between PC and GSSG and TG and between TG and the GSH/GSSG ratio. Moreover, a negative correlation was found between GSSG and fitness, with a positive correlation with the GSH/GSSG ratio. TG, GSSG, and the GSH/GSSG ratio seem to be reliable markers of oxidative stress in healthy prepubertal children with low fitness or sedentary habits. This research contributes to the recognition that an adequate level of fitness and recreational physical activity in childhood leads to better health and oxidative status.

The relationships between endothelial nitric oxide synthase polymorphisms and the formation of intracranial aneurysms in the Korean population

OBJECT

Some genetic factors are known to be associated with the formation of cerebral aneurysms in the Caucasian population. One of these factors is endothelial nitric oxide synthase (eNOS) gene polymorphisms. Endothelial nitric oxide synthase genes encode eNOS, which synthesizes NO from l-arginine. There continues to be controversy about the relationships between eNOS gene polymorphisms and the formation of intracranial aneurysms. In this study, the authors evaluated these relationships in the Korean population.

METHODS

Three eNOS polymorphisms (eNOS 27VNTR, T786C, and G894T) were genotyped in 96 patients with ruptured aneurysms, 53 patients with unruptured aneurysms, and in 121 volunteers via polymerase chain reaction-restriction fragment length polymorphism analysis.

RESULTS

The mean ages of the patients and healthy volunteers were 52.9 ± 12.3 years and 55.2 ± 9.1 years, respectively. The patient group was composed of 56 men and 93 women, and the healthy volunteer group was composed of 46 men and 75 women. Only the incidence of smoking history was significantly higher in the patient group than in the control group (p = 0.001). The genotypic frequencies for the 3 eNOS gene polymorphisms were in agreement with those predicted by Hardy-Weinberg equilibrium. There were no significant associations between the eNOS recessive models and the formation of an aneurysm. The authors found no genotypic differences between similar races among patients with aneurysms.

CONCLUSIONS

The present study shows that eNOS 27VNTR, T786C, and G894T polymorphisms cannot be used as indicators of the formation of intracranial aneurysms in Korean patients. To confirm these findings an additional analyses might need to be performed using a larger sample size. There were no differences in the genotypic distributions and allelic frequencies between similar races among patients with aneurysms, which were the same in previously reported normal populations.

Effects of bench step exercise on arterial stiffness in post-menopausal women: contribution of IGF-1 bioactivity and nitric oxide production

OBJECTIVE

To examine the effect of bench step exercise on arterial pulse wave velocity (PWV) and the associated contribution of insulin-like growth factor (IGF)-1 bioactivity and nitric oxide (NO).

DESIGN

Twenty-six elderly (post-menopausal) women were randomly allocated to a bench step exercise group or a control group. The participants in the bench step exercise group practiced a 12-week home-based bench step exercise for 10-20min, 3 times daily (i.e., for a total of 140min/week at the intensity level of lactate threshold (LT)). In addition to conventional risk factors of atherosclerosis, PWV, IGF-1/IGF binding protein (IGFBP)-3 molar ratio (an index for IGF-1 bioactivity), and urinary nitrite/nitrate (NO(x)) excretion were measured before and after the intervention.

RESULTS

BMI, systolic blood pressure, fasting plasma glucose, low-density lipoprotein cholesterol, LT, and PWV were significantly improved in the bench step exercise group. A significant positive correlation between changes in PWV and IGF-1/IGFBP-3 molar ratio, and a significant negative correlation between changes in IGF-1/IGFBP-3 molar ratio and urinary NO(x) excretion were found in the bench step exercise group.

CONCLUSION

The bench step exercise leads to improvements in not only the classical risk factors of atherosclerosis but also the arterial stiffness in elderly women, partly through NO production via IGF-1 bioactivity.

Habitual rowing exercise is associated with high physical fitness without affecting arterial stiffness in older men

The present study elucidated the effects of habitual rowing exercise on arterial stiffness and plasma levels of the vasoconstrictor endothelin-1 and the vasodilator nitric oxide (NO) in older men. Eleven rowers (68.0 ± 1.6 years) and 11 sedentary control older men (64.9 ± 1.1 years) were studied. Peak oxygen uptake (36.0 ± 1.7 vs. 27.7 ±1.9 ml · kg(-1) · min(-1)), leg press power (1346 ± 99 vs. 1077 ± 68 W), and HDL-cholesterol (75 ± 5 vs. 58 ±3 mg · ml(-1)) were higher and triglyceride (78 ± 9 vs. 120 ± 14 mg · ml(-1)) was lower in rowers than in control participants (all P < 0.05). Arterial stiffness indices (carotid β-stiffness and cardio-ankle vascular index) and plasma endothelin-1 and NOx (nitrite + nitrate) levels did not differ between the two groups. These results suggest that habitual rowing exercise in older men is associated with high muscle power and aerobic capacity, and favourable blood lipid profile without affecting arterial stiffness or plasma levels of endotheline-1 and NO.