Progressive resistance training might improve vascular function in older women but not in older men

Sex-based differences in the association of resistance training levels with the risk of hypertension

Introduction

Hypertension is a primary risk factor for cardiovascular disease and all-cause mortality. This study investigated sex-based differences in the association between the risk of hypertension and resistance training (RT) levels, including training frequency and period.

Methods

We enrolled 162,102 participants from nationwide Korean cohorts. The training period (months) and frequency (per week) of RT were used to investigate the presence of an inverse dose-response relationship between RT levels and the risk of hypertension. Multiple logistic regression models were used to evaluate the risk of hypertension in relation to RT levels.

Results

The prevalence of hypertension in the study population was 36.28% in men and 26.94% in women. Performing RT was associated with an 8% reduction in the risk of hypertension in women but not in men. In women, performing RT for 3-4 days/week, compared with not performing RT, reduced the risk of hypertension by 11%, even after adjusting for covariates, including RT time per week and period. However, in men, no significant association was observed between training frequency and the risk of hypertension. We also evaluated the risk of hypertension by simultaneously considering both the RT frequency and period. Performing RT for 3-4 days/week and ≥5 days/week were markedly related to 14 and 11% hypertension risk reduction, respectively, in women who had been performing RT for at least 6 months.

Conclusion

Given that no inverse dose-response association was observed between RT frequency and hypertension risk, engaging in RT for 3-4 days/week for at least 6 months is recommended for women. Further longitudinal studies are needed to verify sex-based differences in the antihypertensive effects of regular RT.

The effect of exercise training level on arterial stiffness after clinically significant weight loss

Arterial stiffness is improved by weight loss. However, no data exist on the impact of aerobic exercise levels on arterial stiffness during weight maintenance. Adults who were  overweight or with obesity (N = 39) participated in a 10-week weight loss program. Participants who achieved ≥7% weight loss were randomized to aerobic training at the minimum physical activity guidelines (PA-REC, 550 MET min/week) or weight maintenance guidelines (WM-REC, 970 MET min/week) for 18 additional weeks. Arterial stiffness (carotid-to-femoral pulse wave velocity [cfPWV], augmentation index normalized for 75 beats/min [AIX75]) and blood pressure [aortic and brachial]) were assessed at baseline, the end of the weight loss phase (week 10), and follow-up (week 28). There was a reduction in cfPWV in participants who met the weight loss goal (-0.34 m/s, p = .02) and approached significance for the entire sample (p = .051). Similarly, there were reductions in AIX75, brachial blood pressure, and aortic blood pressure (p < .05) in the full sample. In the weight maintenance phase, no differences were observed between the PA-REC and the WM-REC groups for change in arterial stiffness or blood pressure (p > .05). However, changes in cfPWV were independently associated with changes in LDL (r2 : 0.45, p = .004) and exercise intensity (r2 : 0.17, p = .033). Aerobic exercise level at the minimum physical activity guidelines or weight maintenance guidelines does not affect the change in PWV or the change in cfPWV after clinically significant weight loss. However, interventions which limit increases in LDL cholesterol and promote high-intensity aerobic exercise may prevent increases in stiffness during weight maintenance.

Vascular function in hypertension: does gender dimension matter?

Blood pressure and vascular ageing trajectories differ between men and women. These differences develop due to sex-related factors, attributable to sex chromosomes or sex hormones, and due to gender-related factors, mainly related to different sociocultural behaviors. The present review summarizes the relevant facts regarding gender-related differences in vascular function in hypertension. Among sex-related factors, endogenous 17ß-estradiol plays a key role in protecting pre-menopausal women from vascular ageing. However, as vascular ageing (preceding and inducing hypertension) has a steeper increase in women than in men starting already from the third decade, it is likely that gender-related factors play a prominent role, especially in the young. Among gender-related factors, psychological stress (including that one related to gender-based violence and discrimination), depression, some psychological traits, but also low socioeconomic status, are more common in women than men, and their impact on vascular ageing is likely to be greater in women. Men, on the contrary, are more exposed to the vascular adverse consequences of alcohol consumption, as well as of social deprivation, while "toxic masculinity" traits may result in lower adherence to lifestyle and preventive strategies. Unhealthy diet habits are more prevalent in men and smoking is equally prevalent in the two sexes, but have a disproportional negative effect on women's vascular health. In conclusion, given the major and complex role of gender-related factors in driving vascular alterations and blood pressure patterns, gender dimension should be systematically integrated into future research on vascular function and hypertension and to tailor cardiovascular prevention strategies.

Association of leisure-time physical activity and resistance training with risk of incident hypertension: The Ansan and Ansung study of the Korean Genome and Epidemiology Study (KoGES)

Hypertension is the most common preventable risk factor for the onset of cardiovascular disease and mortality. We aimed to investigate the association between incident hypertension and 4-year leisure-time physical activity (PA) levels and resistance training (RT). In this community-based Korean cohort, 5,075 participants without hypertension were included. To evaluate cumulative PA, the average PA time (the total time of moderate-intensity leisure-time PA) at baseline, 2-year follow-up, and 4-year follow-up were calculated. Based on participation in RT and compliance to PA guidelines (≥150 min/week of PA time), the participants were divided into the following four groups: Low-PA, Low-PA+RT, High-PA, and High-PA+RT. A multivariate Cox proportional hazards regression model was used to evaluate the 12-year incidence of hypertension in relation to leisure-time PA levels and RT regularity. During a mean 7.86 ± 4.20-year follow-up, 2,544 participants (1,366 women) were diagnosed with hypertension. Compared with Low-PA, High-PA, and High-PA+RT decreased the risk for hypertension by 30 and 39%, respectively. Participation in RT without compliance to PA guidelines did not affect the incidence of hypertension. The additive effect of RT on hypertension in the High-PA group was further examined. Although sex-based comparisons indicated that men had a significantly longer training period for RT than women, an additional reduction in the risk for hypertension in relation to the addition of RT was observed only in women (35%). PA may confer protective effects against hypertension, whereas the addition of RT to high levels of PA can further reduce the risk for hypertension in women.

Effect of Exercise on Arterial Stiffness in Healthy Young, Middle-Aged and Older Women: A Systematic Review

Arterial stiffness, an age-dependent phenomenon, is improved with exercise, which in turn may prevent cardiovascular diseases in women. However, there is a lack of consolidated information on the impact of exercise on arterial stiffness among healthy women. The aim of this review was to (i) analyse the effect of exercise on arterial stiffness in healthy young, middle-aged, and older women, and (ii) recommend types, intensity, and frequency for each age group. Database searches on PubMed, ScienceDirect, Web of Science, and Scopus were conducted using PRISMA guidelines until September 2022. The keywords were: exercise, women/female, and arterial stiffness. The inclusion criteria were: healthy women, supervised exercise, and arterial stiffness measures. Study quality and bias were assessed using the PEDro scale. Fifty-one papers were classified into young (n = 15), middle-aged (n = 14), and older (n = 22) women. Improvements in arterial stiffness were observed among: young women (Pulse Wave Velocity, PWV: 4.9-6.6 m/s), following an 8-week high-intensity aerobic (3 days/week) or hypoxic high-intensity interval training; middle-aged women (PWV: 5.1-7.9 m/s), aerobic exercise with moderate intensity or stretching exercise at "moderate to heavy" (Borg Scale), 20-30 s per site, 10 s of rest interval for 30 min; and for older women (PWV: 7.9-15.6 m/s), resistance training at light intensity, aerobic exercise at any intensity, or a combination of the two exercises. This review shows that arterial stiffness increases with age in healthy women and has an inverse relationship with exercise intensity. Therefore, when prescribing exercise to improve arterial stiffness, age and arterial stiffness measures should be accounted for.

Impact of Exercise on Vascular Function in Middle-Aged and Older Adults: A Scoping Review

There is a substantial literature gap related to the vascular response to different types of exercise training in middle-aged and older populations. Thus, this scoping review aimed to examine the outcomes of controlled trials testing the long-term effects of exercise interventions on vascular function-related outcomes in middle-aged and older populations. The literature search was conducted following PRISMA guidelines. Data sources: five databases were used (EBSCO, MEDLINE, Web of Science, Science Direct, and Google Scholar). Eligibility criteria: controlled trials, published in the last 10 years, in English, containing well-described exercise interventions, reporting vascular quantitative effects of exercise in middle-aged and older people. A total of 62 publications were included. The studies included distinct types and intensities of exercise and were heterogeneous in volume and frequency. The assessed vascular outcomes also presented considerable variability. Overall, most studies reported positive effects of exercise on vascular function outcomes, regardless of exercise characteristics. Different exercise interventions can be applied to improve vascular function in middle-aged and older adults. Studies on combined and stretching exercises reported encouraging results in improving vascular function. Stretching exercises rise as an effective alternative in promoting vascular function among older adults, while combined exercise delivered promising vascular benefits in both populations.

The impact of the 24-h movement spectrum on vascular remodeling in older men and women: a review

Aging is associated with increased risk of cardiovascular and cerebrovascular events, which are preceded by early, negative remodeling of the vasculature. Low physical activity is a well-established risk factor associated with the incidence and development of disease. However, recent physical activity literature indicates the importance of considering the 24-h movement spectrum. Therefore, the purpose of this review was to examine the impact of the 24-h movement spectrum, specifically physical activity (aerobic and resistance training), sedentary behavior, and sleep, on cardiovascular and cerebrovascular outcomes in older adults, with a focus on recent evidence (<10 yr) and sex-based considerations. The review identifies that both aerobic training and being physically active (compared with sedentary) are associated with improvements in endothelial function, arterial stiffness, and cerebrovascular function. Additionally, there is evidence of sex-based differences in endothelial function: a blunted improvement in aerobic training in postmenopausal women compared with men. While minimal research has been conducted in older adults, resistance training does not appear to influence arterial stiffness. Poor sleep quantity or quality are associated with both impaired endothelial function and increased arterial stiffness. Finally, the review highlights mechanistic pathways involved in the regulation of vascular and cerebrovascular function, specifically the balance between pro- and antiatherogenic factors, which mediate the relationship between the 24-h movement spectrum and vascular outcomes. Finally, this review proposes future research directions: examining the role of duration and intensity of training, combining aerobic and resistance training, and exploration of sex-based differences in cardiovascular and cerebrovascular outcomes.

Isoflavone Supplementation Does Not Potentiate the Effect of Combined Exercise Training on Resting and Ambulatory Blood Pressure in Non-Obese Postmenopausal Women: A Randomized Double-Blind Controlled Trial-A Pilot Study

Physical exercise and isoflavone supplementation are potential strategies to prevent and treat cardiovascular diseases in postmenopausal women. The aim of this study was to investigate whether there are additive effects of isoflavone supplementation when associated with combined aerobic and resistance exercise on resting and ambulatory blood pressure monitoring (ABPM) and in blood pressure variability (BPV). Thirty-one non-obese postmenopausal women were randomly allocated into two groups: placebo and exercise (Placebo n = 19); and isoflavone supplementation (100 mg/day) and exercise (isoflavone n = 19). ABPM and BPV were evaluated before and after 10 weeks of moderate combined (aerobic and resistance) exercise training. Generalized Estimating Equation (GEE) with Bonferroni correction and intention-to-treat analysis was used to compare the effects of interventions on resting BP, ABPM and BPV. Combined exercise training decreased resting systolic (SBP) and diastolic blood pressure (DBP) and reduced 24 h and awake ambulatory SBP, DBP and mean blood pressure over time, with no additional effects of isoflavone supplementation. No changes were observed in sleep period, or in BPV indexes (Standard Deviation of 24 h (SD), daytime and nighttime interval (SDdn) and average real variability (ARV) in both groups. We conclude that isoflavone supplementation does not potentiate the effects of combined training on resting and ambulatorial systolic and diastolic blood pressure in non-obese postmenopausal women.

Chronic effects and optimal dosage of strength training on SBP and DBP: a systematic review with meta-analysis

BACKGROUND AND OBJECTIVES

Hypertension is a disease affecting a large part of the world's population that causes millions of deaths annually. Physical exercise is proposed as an alternative to pharmacologic therapies used to reduce blood pressure. The main objective was to compare the effect of different types of strength training in blood pressure, as well as to analyse several variables that can modify the effect of strength training not combined with medication in SBP and DBP (SBP-DBP).

METHODS

The search was carried out in two scientific databases: PubMed and Web of Science. Articles were included following three criteria: analysing the chronic effect of strength training in blood pressure; the studies were conducted at least during 4 weeks; and the articles were published in English.

RESULTS

The analysis showed a significant decrease of blood pressure for all types of training. The effect on SBP was greater when training without medication was carried out with isometric exercises than when training was performed with dynamic exercises. Moreover, the effects were no longer significant when the duration of the training programme exceeded 20 weeks as well as when training frequency was lower than three times per week were found.

CONCLUSION

Strength training is effective in reducing both blood pressures (SBP-DBP). Training programmes, consisting of dynamic strength training without medication at a moderate intensity and with a frequency of three times per week, seem to be optimal in order to reduce blood pressure.Prospective register of Systematic Reviews: CRD42019122421.

Effect of Resistance Training Intensity on Blood Pressure in Older Women

This study aimed to compare the effects of resistance training performed with low versus moderate loads on systemic resting blood pressure (BP) in older women. A total of 29 women (72.6 ± 5.1 years) were randomized into two groups: low load (LOW, n = 15) and moderate load (MOD, n = 14). An 8-week whole-body resistance training program was carried out 3 days/week (eight exercises, three sets, 10 or 15 repetition maximum). The LOW and MOD groups trained with a relative load of 15 and 10 repetition maximum, respectively. Outcome measures included resting systolic and diastolic BP. After 8 weeks, both groups presented significant changes (p < .05) in systolic BP (LOW = -3.0%; MOD = -4.6%) and mean BP (LOW = -1.9%; MOD = -3.1%). There was no change for diastolic BP in the posttest in both groups. The results suggest that low and moderate loads are equally effective for promoting decreases in resting BP in older women.

Evidence for improved systemic and local vascular function after long-term passive static stretching training of the musculoskeletal system

KEY POINTS

Vascular function and arterial stiffness are important markers of cardiovascular health and cardiovascular co-morbidity. Transitional phases of hypoemia and hypermia, with consequent fluctuations in shear rate, occuring during repetitive passive stretching adminstration (passive stretching training) may constitute an effective stimulus to induce an amelioration in vascular function, arterial stiffness and vascular remodelling by improving central and local blood flow control mechanisms. Vascular function, arterial stiffness and vascular remodelling were evaluated before and after 12 weeks of passive stretching training and after 6 weeks from training cessation, in the femoral, popliteal (treated with stretching), and brachial arteries (untreated) of both sides. After passive stretching training, vascular function and arterial remodelling improved, and arterial stiffness decreased in all the arteries, suggesting modifications of both central and local blood flow control mechanisms. Passive stretching-induced improvements related to central mechanisms seemed to have a short duration, as they returned to pre-training baseline within 6 weeks from training cessation, whereas those more related to a local mechanism persisted in the follow-up.

ABSTRACT

Acute passive stretching (PS) effects on blood flow ( Q ̇ ), shear rate ( Y ̇ ), and vascular function in the feeding arteries of the stretched muscle have been extensively investigated; however, few data are available on vascular adjustments induced by long-term PS training. We investigated the effects of PS training on vascular function and stiffness of the involved (femoral and popliteal) and uninvolved (brachial) arteries. Our hypothesis was that PS-induced changes in Q ̇ and Y ̇ would improve central and local mechanisms of Q ̇ control. Thirty-nine participants were randomly assigned to bilateral PS (n = 14), monolateral PS (n = 13) or no PS training (n = 12). Vascular function was measured before and after 12 weeks of knee extensor and plantar flexor muscles' PS training by single passive limb movement and flow-mediated dilatation (FMD). Central (carotid-femoral artery PWV, PWV_CF ) and peripheral (carotid-radial artery PWV, PWV_CR ) arterial stiffness was measured by pulse-wave velocity (PWV), together with systolic (SBP) and diastolic (DBP) blood pressure. After PS training, increases of 30%, 25% and 8% (P < 0.05) in femoral Δ Q ̇ , popliteal and brachial artery FMD%, respectively, occurred in both PS training groups. A decrease in PWV_CF , PWV_CR , SBP and DBP (-25%, -17%, -4% and -8%, respectively; P < 0.05) was noted. No changes occurred in controls. Vascular function improved and arterial stiffness reduced in the arteries involved and uninvolved with PS training, suggesting modifications in both central and local Q ̇ control mechanisms. PS-induced improvements had a short duration in some of vascular function parameters, as they returned to baseline within 6 weeks of PS training cessation.

Sex differences in mechanisms of arterial stiffness

Arterial stiffness progressively increases with aging and is an independent predictor of cardiovascular disease (CVD) risk. Evidence supports that there are sex differences in the time course of aging-related arterial stiffness and the associated CVD risk, which increases disproportionately in postmenopausal women. The association between arterial stiffness and mortality is almost twofold higher in women versus men. The differential clinical characteristics of the development of arterial stiffness between men and women indicate the involvement of sex-specific mechanisms. This review summarizes the current literature on sex differences in vascular stiffness induced by aging, obesity, hypertension, and sex-specific risk factors as well as the impact of hormonal status, diet, and exercise on vascular stiffness in males and females. An understanding of the mechanisms driving sex differences in vascular stiffness has the potential to identify novel sex-specific therapies to lessen CVD risk, the leading cause of death in males and females. LINKED ARTICLES: This article is part of a themed section on The Importance of Sex Differences in Pharmacology Research. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.21/issuetoc.

Independent and Combined Effects of Antioxidant Supplementation and Circuit Resistance Training on Selected Adipokines in Postmenopausal Women

We examined the effects of the independent and combined effects of Zataria Multiflora supplementation and circuit resistance training (CRT) on selected adipokines among postmenopausal women. Forty-eight postmenopausal women were divided into four groups: Exercise (EG, n = 12), Zataria Multiflora (ZMG, n = 12), exercise and Zataria Multiflora (ZMEG, n = 12), and control (CG, n = 12). Participants in experimental groups either performed CRT (3 sessions per week with intensity at 55% of one-repetition maximum) or supplemented with Zataria Multiflora (500 mg every day after breakfast with 100 ml of water), or their combination, for 8 weeks. Blood samples were collected at pre- and post-intervention for measuring selected adipokines, including visfatin, omentin-1, vaspin, FGF-21, adiponectin, leptin, and ghrelin. Our findings demonstrated that visfatin, vaspin, and leptin levels significantly decreased over the intervention period (all p < 0.05), with these values were lower in EG and ZMEG in comparison to CG at post-intervention (all p < 0.05). Visfatin and vaspin levels were also lower in ZMEG in comparison to EG at post-intervention (both p < 0.05). In contrast, omentin-1, ghrelin, adiponectin, and FGF21 significantly increased in EG and EMG (all p < 0.05) after CRT. These findings suggest that Zataria Multiflora supplementation by itself has little effect on measured adipokines; however, its combination with CRT produced noticeable effects on circulating levels of these adipokines, even more than CRT alone. Consequently, a combination of CRT and Zataria Multiflora supplementation may represent a potentially beneficial non-pharmacologic intervention on some selected adipokines in postmenopausal women.

Effects of short-term resistance training on endothelial function and inflammation markers in elderly patients with type 2 diabetes: A randomized controlled trial

PURPOSE

To evaluate the effects of 12-weeks of strength training on endothelial function and inflammatory markers in elderly individuals with T2DM.

METHODS

Forty-four elderly patients with T2DM were screened for participation. After completion of the baseline assessment, participants were randomly assigned to either the resistance training group (RT) or an active control group (AC). Inflammatory (TNF-α, IL-6, IL-1β, IL-10 and CRP) and blood lipid profiles, glycated hemoglobin, basal artery diameter and flow mediated dilation were evaluated before and after the intervention. Comparisons between groups were obtained from the generalized estimation equation and all tests were two-tailed and the alpha level for significance set at 0.05.

RESULTS

TNF-α and IL-1β were decreased in both groups, while no interactions were found for flow mediated dilation and basal artery diameter. No significant differences were found for blood lipid profile and glycated hemoglobin for both groups after the intervention period.

CONCLUSIONS

No significant changes were found between the RT and AC groups, regarding inflammatory profile and endothelial function, which does not prove the superiority of this intervention model in the studied period.

Autonomic modulation and baroreflex sensitivity after acute resistance exercise: responses between sexes

BACKGROUND

The aim of this study was to evaluate autonomic modulation, blood pressure variability and baroreflex sensitivity (BRS) responses to an acute bout of free-weight resistance exercise in resistance-trained men (N.=14) and women (N.=13).

METHODS

Participants underwent both an acute bout of resistance exercise (RE) consisting of 3 sets of 10 repetitions at 75% 1-repetition maximum on the squat, bench press, and deadlift, and a quiet control. Autonomic modulation, blood pressure variability (LFSAP), and cardiovagal BRS were assessed at rest, 15-20 minutes (Rec1) and 25-30 minutes (Rec2) postexercise. Log transformed measures of autonomic modulation included root square of the mean ssquared differences of successive RR intervals (LnRMSSD), high-frequency power (LnHFRR) and low-frequency power (LnLFRR) and sympathovagal balance (LnLFRR/HFRR). LFSAP was used as a measurement of vasomotor tone. Cardiovagal BRS was assessed using the sequence method.

RESULTS

There were no significant sex differences at rest and no significant sex by time by condition interactions for any variable. Compared with rest there were augmentations in LnLFRR/HFRR (P=0.002) and LFSAP (P=0.001) at Rec1 and Rec2. RMSSD and cardiovagal BRS were significantly (P=0.0001) decreased at Rec1 and Rec2 compared to rest after the acute RE.

CONCLUSIONS

Both sexes demonstrated that acute resistance exercise using free weights has a profound impact on autonomic modulation, blood pressure variability and cardiovagal BRS.

The combination of exercise training and Zataria multiflora supplementation increase serum irisin levels in postmenopausal women

Background

We examined the effect of antioxidant supplementation and exercise on irisin within postmenopausal women.

Methods

Forty-eight participants (age: 55.7 ± 4.9 years; weight: 68.0 ± 6.3 kg; BMI 27.0 ± 2.7; mean ± SD) were randomized into four groups for the eight week intervention: control group (CG; n = 12), resistance training group (RTG; n = 12), supplementation with Zataria multiflora group (ZG; n = 12), or supplementation with Z. multiflora and resistance training group (ZRTG; n = 12). RTG and ZRTG performed circuit resistance training, and both ZG and ZRTG consumed 500 mg of Z. multiflora every day during the intervention. Blood samples were taken 48 hours before and after the intervention.

Results

There was a significant difference in irisin at post-training, with greater levels in ZRTG compared to CG. A significant increase was noted for irisin at post-training compared to pre-training for ZG, RTG, and ZRTG. Moreover, we identified a significant decrease in malondialdehyde in the RTG and ZRTG groups and increase in glutathione in the ZG, RTG, and ZRTG groups when compared to CG.

Conclusion

These findings showed that exercise, Z. multiflora supplementation or their combination led to an increase in irisin.

Acute Effect of Static Stretching Exercise on Arterial Stiffness in Healthy Young Adults

OBJECTIVE

Habitual stretching exercise increases carotid arterial compliance, and acute stretching exercise increases arterial compliance in patients with myocardial infarction. However, it is not known whether this arterial adaptation is sustained after exercise. The aim of this study was to examine the effect of a single bout of stretching exercise on the time course of systemic, central, and peripheral arterial stiffness in healthy young subjects.

DESIGN

Twenty-six healthy young men performed static stretching exercise involving the entire body (trunk, upper limb, and lower limb) for 40 mins. Pulse-wave velocity (PWV; an index of arterial stiffness), blood pressure, and heart rate were measured before and 0, 15, 30, and 60 mins after stretching exercise.

RESULTS

Femoral-ankle PWV and brachial-ankle PWV were reduced relative to baseline 15 and 30 mins after acute stretching (P < 0.05); however, these arterial responses were not sustained for longer periods, and both PWV values returned to the baseline levels within 60 mins. By contrast, carotid-femoral PWV was unchanged.

CONCLUSION

These results suggest that chronic and sufficient repetition of muscle stretch stimulation may result in chronic high arterial compliance, although a single bout of stretch exercise acutely affects arterial compliance.

Dynamic Resistance Training as Stand-Alone Antihypertensive Lifestyle Therapy: A Meta-Analysis

Background

Aerobic exercise (AE) is recommended as first‐line antihypertensive lifestyle therapy based on strong evidence showing that it lowers blood pressure (BP) 5 to 7 mm Hg among adults with hypertension. Because of weaker evidence showing that dynamic resistance training (RT) reduces BP 2 to 3 mm Hg among adults with hypertension, it is recommended as adjuvant lifestyle therapy to AE training. Yet, existing evidence suggests that dynamic RT can lower BP as much or more than AE.

Methods and Results

We meta‐analyzed 64 controlled studies (71 interventions) to determine the efficacy of dynamic RT as stand‐alone antihypertensive therapy. Participants (N=2344) were white (57%), middle‐aged (47.2±19.0 years), and overweight (26.8±3.4 kg/m²) adults with prehypertension (126.7±10.3/76.8±8.7 mm Hg); 15% were on antihypertensive medication. Overall, moderate‐intensity dynamic RT was performed 2.8±0.6 days/week for 14.4±7.9 weeks and elicited small‐to‐moderate reductions in systolic BP (SBP; d₊=−0.31; 95% CIs, −0.43, −0.19; −3.0 mm Hg) and diastolic BP (DBP; d₊=−0.30; 95% CIs, −0.38, −0.18; −2.1 mm Hg) compared to controls (Ps<0.001). Greater BP reductions occurred among samples with higher resting SBP/DBP: ≈6/5 mm Hg for hypertension, ≈3/3 mm Hg for prehypertension, and ≈0/1 mm Hg for normal BP (Ps<0.023). Furthermore, nonwhite samples with hypertension experienced BP reductions that were approximately twice the magnitude of those previously reported following AE training (−14.3 mm Hg [95% CIs, −19.0, −9.4]/−10.3 mm Hg [95% CIs, −14.5, −6.2]).

Conclusions

Our results indicate that for nonwhite adult samples with hypertension, dynamic RT may elicit BP reductions that are comparable to or greater than those reportedly achieved with AE training. Dynamic RT should be further investigated as a viable stand‐alone therapeutic exercise option for adult populations with high BP.

Physical Fitness, Activity and Hand-Grip Strength Are Not Associated with Arterial Stiffness in Older Individuals

OBJECTIVES

Whereas evidence exists about the benefits of intensive exercise on cardiovascular outcomes in older adults, data are lacking regarding long-term effects of physical fitness and physical activity on cardiovascular health. Therefore, we aimed to investigate the longitudinal association of physical fitness, physical activity and muscle strength with arterial stiffness measures.

DESIGN

a longitudinal follow-up study (2 years) of data from the B-PROOF study.

SETTING

a subgroup of the B-PROOF study (n=497).

PARTICIPANTS

Four hundred ninety-seven participants with a mean age of 72.1 years (SD 5.4) of which 57% was male.

MEASUREMENTS

All performed at baseline and after two-year follow-up. Arterial stiffness was estimated by pulse wave velocity (PWV) measured with applanation tonometry. Furthermore, augmentation index (AIx) and aortic pulse pressure (PP) were assessed. Physical activity was estimated using a validated questionnaire regarding daily activities. Physical fitness was measured with a physical performance score, resulting from a walking, chair-stand and balance test. Muscle strength was assessed with hand-grip strength using a handheld dynamometer.

RESULTS

The median performance score was 9.0 [IQR 8.0-11.0], the mean physical activity was 744.4 (SD 539.4) kcal/day and the mean hand-grip strength was 33.1 (SD 10.2) kg. AIx differed between the baseline and follow-up measurement (26.2% (SD 10.1) vs. 28.1% (SD 9.9); p < 0.01), whereas PWV and aortic PP did not. In multivariable linear regression analysis, physical performance, physical activity and hand-grip strength at baseline were not associated with the amount of arterial stiffness after two years of follow-up.

CONCLUSION

Physical fitness, activity and muscle strength were not associated with arterial stiffness. More research is warranted to elucidate the long-term effects of daily and intensive physical activity on arterial stiffness in an elderly population.

Athletic differences in the characteristics of the photoplethysmographic pulse shape: effect of maximal oxygen uptake and maximal muscular voluntary contraction

This study aimed to investigate the athletic differences in the characteristics of the photoplethysmographic (PPG) pulse shape. 304 athletes were enrolled and divided into three subgroups according to a typical sport classification in terms of the maximal oxygen uptake (MaxO₂_low, MaxO₂_middle and MaxO₂_high groups) or the maximal muscular voluntary contraction (MMVC_low, MMVC_middle, and MMVC_high groups). Finger PPG pulses were digitally recorded and then normalized to derive the pulse area, pulse peak time T_p, dicrotic notch time T_n, and pulse reflection index (RI). The four parameters were finally compared between the three subgroups categorized by MaxO₂ or by MMVC. In conclusion, it has been demonstrated by quantifying the characteristics of the PPG pulses in different athletes that MaxO₂, but not MMVC, had significant effect on the arterial properties.

Exercise, vascular stiffness, and tissue transglutaminase

Background

Vascular aging is closely associated with increased vascular stiffness. It has recently been demonstrated that decreased nitric oxide (NO)‐induced S‐nitrosylation of tissue transglutaminase (TG2) contributes to age‐related vascular stiffness. In the current study, we tested the hypothesis that exercise restores NO signaling and attenuates vascular stiffness by decreasing TG2 activity and cross‐linking in an aging rat model.

Methods and Results

Rats were subjected to 12 weeks of moderate aerobic exercise. Aging was associated with diminished phosphorylated endothelial nitric oxide synthase and phosphorylated vasodilator‐stimulated phosphoprotein abundance, suggesting reduced NO signaling. TG2 cross‐linking activity was significantly increased in old animals, whereas TG2 abundance remained unchanged. These alterations were attenuated in the exercise cohort. Simultaneous measurement of blood pressure and pulse wave velocity (PWV) demonstrated increased aortic stiffness in old rats, compared to young, at all values of mean arterial pressure (MAP). The PWV‐MAP correlation in the old sedentary and old exercise cohorts was similar. Tensile testing of the vessels showed increased stiffness of the aorta in the old phenotype with a modest restoration of mechanical properties toward the young phenotype with exercise.

Conclusions

Increased vascular stiffness during aging is associated with decreased TG2 S‐nitrosylation, increased TG2 cross‐linking activity, and increased vascular stiffness likely the result of decreased NO bioavailability. In this study, a brief period of moderate aerobic exercise enhanced NO signaling, attenuated TG cross‐linking activity, and reduced ex vivo tensile properties, but failed to reverse functional vascular stiffness in vivo, as measured by PWV.

Eight weeks of stretching training reduces aortic wave reflection magnitude and blood pressure in obese postmenopausal women

The augmentation index (AIx, a marker of wave reflection) is reduced and peripheral artery vasodilation increased following acute stretching exercise. We examined the effects of stretching training (ST) on arterial function, blood pressure (BP) and sympathetic vasomotor modulation. Twenty-eight obese postmenopausal women (57±1 years) were randomized to a ST (n=14) or no-exercise control (CON) group ( n=14). ST included stretching exercises 3 days week(-1) for 8 weeks. Brachial (b) and aortic (a) systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), heart rate (HR), brachial-ankle pulse wave velocity (baPWV), carotid-femoral PWV (aPWV), femoral-ankle PWV (faPWV), AIx, low-frequency component of SBP (LFSBP) and sit/reach score (SRS) were measured before and after interventions. There were significant decreases in bSBP (P<0.05), aSBP (P<0.01), aDBP (P<0.05), aMAP (P<0.01), aAIx (P<0.05) and LFSBP (P<0.05) after ST compared with CON. SRS significantly (P<0.01) increased after ST but not after CON. There were no significant effects (P>0.05) on HR, baPWV, aPWV and faPWV after ST or CON. Eight weeks of ST decreases BP, AIx and LFSBP in obese postmenopausal women. Our findings show that ST reduces peripheral and central BP, wave reflection magnitude and vascular sympathetic activity in obese postmenopausal women with prehypertension and hypertension.

Blood flow restricted exercise and vascular function

It is established that regular aerobic training improves vascular function, for example, endothelium-dependent vasodilatation and arterial stiffness or compliance and thereby constitutes a preventative measure against cardiovascular disease. In contrast, high-intensity resistance training impairs vascular function, while the influence of moderate-intensity resistance training on vascular function is still controversial. However, aerobic training is insufficient to inhibit loss in muscular strength with advancing age; thus, resistance training is recommended to prevent sarcopenia. Recently, several lines of study have provided compelling data showing that exercise and training with blood flow restriction (BFR) leads to muscle hypertrophy and strength increase. As such, BFR training might be a novel means of overcoming the contradiction between aerobic and high-intensity resistance training. Although it is not enough evidence to obtain consensus about impact of BFR training on vascular function, available evidences suggested that BFR training did not change coagulation factors and arterial compliance though with inconsistence results in endothelial function. This paper is a review of the literature on the impact of BFR exercise and training on vascular function, such as endothelial function, arterial compliance, or other potential factors in comparison with those of aerobic and resistance training.