Active intervals between sets and exercise of resistance exercises potentiate the magnitude of post-exercise hypotension in middle-aged hypertensive women

BACKGROUND

Walking/run promotes greater post-exercise hypotension (PEH) than resistance exercise (RE) which can be associated nitric oxide production. Then, we investigated if adding walking between RE increases PEH.

METHODS

Thirteen hypertensive women (48 ± 1.9 years; 26.8 ± 0.3 kg/m2) performed five experimental sessions: 1-traditional RE with passive interval (PIBS); 2-RE with active interval between sets (AIBS); 3-RE with active interval between exercises (AIEX); 4-aerobic exercise (AE); 5-no exercise. Blood pressure was measured before and immediately after exercise and every 10 min of a 60-min post-exercise recovery period. Plasma nitrite (NO) and malondialdehyde (MDA) were also measured.

RESULTS

AIBS, AIEX, and AE sessions promoted systolic PEH (12 ± 1.53; 16 ± 2.13; 18 ± 1.34 mmHg, respectively) and diastolic PEH (8 ± 1.38; 8 ± 0.79; 8 ± 0.58 mmHg). In AIBS, AIEX and AE sessions, significant PEH was noted at 10 or 20 min; in PIBS, PEH was significant only at 40 min. In the PIBS session, NO did not change, but presented higher values after AIBS, AIEX and AE sessions. MDA showed no changes between sessions.

CONCLUSIONS

Passive or active intervals in resistance exercise promote PEH in hypertensive women. Active intervals shorten the PEH onset time as additional benefit.

Exercise in the Management of Metabolic-Associated Fatty Liver Disease (MAFLD) in Adults: A Position Statement from Exercise and Sport Science Australia

Metabolic-associated fatty liver disease (MAFLD) is the most prevalent chronic liver disease worldwide, affecting 25% of people globally and up to 80% of people with obesity. MAFLD is characterised by fat accumulation in the liver (hepatic steatosis) with varying degrees of inflammation and fibrosis. MAFLD is strongly linked with cardiometabolic disease and lifestyle-related cancers, in addition to heightened liver-related morbidity and mortality. This position statement examines evidence for exercise in the management of MAFLD and describes the role of the exercise professional in the context of the multi-disciplinary care team. The purpose of these guidelines is to equip the exercise professional with a broad understanding of the pathophysiological underpinnings of MAFLD, how it is diagnosed and managed in clinical practice, and to provide evidence- and consensus-based recommendations for exercise therapy in MAFLD management. The majority of research evidence indicates that 150-240 min per week of at least moderate-intensity aerobic exercise can reduce hepatic steatosis by ~ 2-4% (absolute reduction), but as little as 135 min/week has been shown to be effective. While emerging evidence shows that high-intensity interval training (HIIT) approaches may provide comparable benefit on hepatic steatosis, there does not appear to be an intensity-dependent benefit, as long as the recommended exercise volume is achieved. This dose of exercise is likely to also reduce central adiposity, increase cardiorespiratory fitness and improve cardiometabolic health, irrespective of weight loss. Resistance training should be considered in addition to, and not instead of, aerobic exercise targets. The information in this statement is relevant and appropriate for people living with the condition historically termed non-alcoholic fatty liver disease (NAFLD), regardless of terminology.

Vascular Ageing: Mechanisms, Risk Factors, and Treatment Strategies

Ageing constitutes the biggest risk factor for poor health and adversely affects the integrity and function of all the cells, tissues, and organs in the human body. Vascular ageing, characterised by vascular stiffness, endothelial dysfunction, increased oxidative stress, chronic low-grade inflammation, and early-stage atherosclerosis, may trigger or exacerbate the development of age-related vascular diseases, which each year contribute to more than 3.8 million deaths in Europe alone and necessitate a better understanding of the mechanisms involved. To this end, a large number of recent preclinical and clinical studies have focused on the exponential accumulation of senescent cells in the vascular system and paid particular attention to the specific roles of senescence-associated secretory phenotype, proteostasis dysfunction, age-mediated modulation of certain microRNA (miRNAs), and the contribution of other major vascular risk factors, notably diabetes, hypertension, or smoking, to vascular ageing in the elderly. The data generated paved the way for the development of various senotherapeutic interventions, ranging from the application of synthetic or natural senolytics and senomorphics to attempt to modify lifestyle, control diet, and restrict calorie intake. However, specific guidelines, considering the severity and characteristics of vascular ageing, need to be established before widespread use of these agents. This review briefly discusses the molecular and cellular mechanisms of vascular ageing and summarises the efficacy of widely studied senotherapeutics in the context of vascular ageing.

Voluntary wheel exercise training affects locomotor muscle, but not the diaphragm in the rat

Introduction: Functional tests and training regimens intensity-controlled by an individual are used in sport practice, clinical rehabilitation, and space medicine. The model of voluntary wheel running in rats can be used to explore molecular mechanisms of such training regimens in humans. Respiratory and locomotor muscles demonstrate diverse adaptations to treadmill exercise, but the effects of voluntary exercise training on these muscle types have not been compared yet. Therefore, this work aimed at the effects of voluntary ET on rat triceps brachii and diaphragm muscles with special attention to reactive oxygen species, which regulate muscle plasticity during exercise.

Methods: Male Wistar rats were distributed into exercise trained (ET) and sedentary (Sed) groups. ET group had free access to running wheels, running activity was continuously recorded and analyzed using the original hardware/software complex. After 8 weeks, muscle protein contents were studied using Western blotting.

Results: ET rats had increased heart ventricular weights but decreased visceral/epididymal fat weights and blood triglyceride level compared to Sed. The training did not change corticosterone, testosterone, and thyroid hormone levels, but decreased TBARS content in the blood. ET rats demonstrated higher contents of OXPHOS complexes in the triceps brachii muscle, but not in the diaphragm. The content of SOD2 increased, and the contents of NOX2 and SOD3 decreased in the triceps brachii muscle of ET rats, while there were no such changes in the diaphragm.

Conclusion: Voluntary wheel running in rats is intensive enough to govern specific adaptations of muscle fibers in locomotor, but not respiratory muscle.

Impact of Non-Pharmacological Interventions on the Mechanisms of Atherosclerosis

Atherosclerosis remains the leading cause of mortality and morbidity worldwide characterized by the deposition of lipids and fibrous elements in the form of atheroma plaques in vascular areas which are hemodynamically overloaded. The global burden of atherosclerotic cardiovascular disease is steadily increasing and is considered the largest known non-infectious pandemic. The management of atherosclerotic cardiovascular disease is increasing the cost of health care worldwide, which is a concern for researchers and physicians and has caused them to strive to find effective long-term strategies to improve the efficiency of treatments by managing conventional risk factors. Primary prevention of atherosclerotic cardiovascular disease is the preferred method to reduce cardiovascular risk. Fasting, a Mediterranean diet, and caloric restriction can be considered useful clinical tools. The protective impact of physical exercise over the cardiovascular system has been studied in recent years with the intention of explaining the mechanisms involved; the increase in heat shock proteins, antioxidant enzymes and regulators of cardiac myocyte proliferation concentration seem to be the molecular and biochemical shifts that are involved. Developing new therapeutic strategies such as vagus nerve stimulation, either to prevent or slow the disease’s onset and progression, will surely have a profound effect on the lives of millions of people.

Associations of physical activity with academic achievement and academic burden in Chinese children and adolescents: do gender and school grade matter?

Background

Physical activity (PA) was significantly associated with cognition and mental health in children and adolescent. However, there were few studies examining the associations of PA with academic achievement (AA) and academic burden (AB) by gender and school grade. Hence, this study aimed to 1) investigate the associations of moderate-to-vigorous PA (MVPA) with AA and AB in Chinese children and adolescents, and 2) assess whether these associations vary by gender and school grade.

Methods

Using a multi-stage stratified cluster sampling design (at four different regions in Southern east China), 2653 children and adolescents (8–19 years old, 51.2% girls) were included. A self-reported questionnaire was used to collect data on study participants’ gender, school grade, family social economic status (SES), parental education level, MVPA, AA and AB. Binary logistic regression was applied to examine the associations of MVPA with AA (groups: above-average AA, average and below-average AA) and AB (groups: reporting AB, reporting no AB) with odds ratios (ORs) and 95% confidence intervals (CIs). After testing gender*grade interaction, those associations were explored by gender and school grade separately.

Results

In the overall sample, compared with children and adolescents who did not meet the PA guidelines (at least 60 min MVPA daily), children and adolescents who met the PA guidelines were more likely to have above-average (OR = 1.61, 95% CI: 1.21–2.11) AA, and report no AB (OR = 1.61, 95% CI: 1.13–2.30). In both genders, meeting the PA guidelines was positively associated with above-average AA (OR = 1.43, 95% CI: 1.01–2.03 for boys; OR = 2.22, 95% CI: 1.43–3.44 for girls). However, the significant relationship between meeting the PA guidelines and AB was observed only in girls (OR = 1.99, 95% CI: 1.17–3.39). Meeting the PA guidelines was positively associated with above-average AA (OR = 1.68, 95% CI: 1.18–2.40), and reporting no AB (OR = 1.77, 95% CI: 1.08–2.91) only in middle school students.

Conclusions

This study suggested that sufficient PA may be a contributary factor of improved AA and lower level of AB in Chinese children and adolescents. However, associations of PA with AA and AB may be different across gender or school grade. Promoting PA among girls or middle school students may be a good approach to improve AA and reduce AB.

The Effect of Blood Flow-Restricted Low Resistance Training on Microvascular Circulation of Myocardium in Spontaneously Hypertensive Rats

Objective: The purpose of this study was to explore the effect of blood flow-restricted low resistance training on microvascular rarefaction in the myocardium of spontaneously hypertensive rats (SHRs).

Methods: Four-week-old male SHRs were randomly divided into the following groups: Wistar-Kyoto (WKY), SHR control (SHR-SED), high-intensity resistance training (HIRT), low-intensity resistance training (LIRT), and blood flow-restricted low resistance training (BFRT). The exercise groups began to receive exercise intervention for 8 weeks at the age of 7 weeks. Blood pressure (BP), heart rate (HR), cardiac function, capillary density, and Vascular endothelial growth factor -Phosphatidylinositol 3-kinase-Protein kinase B-Endothelial nitric oxide synthetase (VEGF-Pi3k-Akt-eNOS) were assessed.

Results: 1) BP and HR of BFRT decreased significantly, Ejection fraction (EF) and Fraction shortening (FS) increased, and the effect of BFRT on lowering BP and HR was better than that of other groups (p < 0.05); 2) The expression of VEGF, VEGFR2, p-VEGFR2, Pi3k, Akt, p-Akt, eNOS and p-eNOS in the myocardium of the BFRT was significantly upregulated, and eNOS expression was significantly higher than other groups (p < 0 05); 3) the expression of VEGF in the blood of the BFRT was significantly upregulated, higher than SHR-SED, lower than HIRT (p < 0.05), and there was no significant difference between BFRT and LIRT(p > 0.05); 4) the capillary density in the myocardium of BFRT was significantly higher than other exercise groups (p < 0 05).

Conclusion: Blood flow-restricted low resistance training can activate the VEGF-Pi3k-Akt-eNOS pathway, upregulate the expression of VEGF in blood, improve microvascular rarefaction, and promote myocardial microvascular circulation, thereby improving cardiac function and lowering blood pressure, achieving the preventive effect of early hypertension.

Changes in the Second Ventilatory Threshold Following Individualised versus Standardised Exercise Prescription among Physically Inactive Adults: A Randomised Trial

The second ventilatory threshold (VT2) is established as an important indicator of exercise intensity tolerance. A higher VT2 allows for greater duration of higher intensity exercise participation and subsequently greater reductions in cardiovascular disease (CVD) risk. This study aimed to compare the efficacy of standardised and individualised exercise prescription on VT2 among physically inactive adults. Forty-nine physically inactive male and female participants (48.6 ± 11.5 years) were recruited and randomised into a 12-week standardised (n = 25) or individualised (n = 24) exercise prescription intervention. The exercise intensity for the standardised and individualised groups was prescribed as a percentage of heart rate reserve (HRR) or relative to the first ventilatory threshold (VT1) and VT2, respectively. Participants were required to complete a maximal graded exercise test at pre-and post-intervention to determine VT1 and VT2. Participants were categorised as responders to the intervention if an absolute VT2 change of at least 1.9% was attained. Thirty-eight participants were included in the analysis. A significant difference in VT2 change was found between individualised (pre vs. post: 70.6% vs. 78.7% maximum oxygen uptake (VO2max)) and standardised (pre vs. post: 72.5% vs. 72.3% VO2max) exercise groups. Individualised exercise prescription was significantly more efficacious (p = 0.04) in eliciting a positive response in VT2 (15/19, 79%) when compared to the standardised exercise group (9/19, 47%). Individualised exercise prescription appears to be more efficacious than standardised exercise prescription in eliciting a positive VT2 change among physically inactive adults. Increasing VT2 allows for greater tolerance to higher exercise intensities and therefore greater cardiovascular health outcomes.

Exercise attenuates myocardial fibrosis and increases angiogenesis-related molecules in the myocardium of aged rats

OBJECTIVES

The present study aimed to investigate the effect of two different exercise training protocols on myocardial fibrosis and the expression of some growth factors in aged rats.

METHOD

Twenty-four male Wistar rats were randomly assigned to high-intensity interval training (HIIT) group, continuous exercise training (CET) group, and the control group. After 6 weeks of experiment, mRNA levels of fibroblast growth factor-2 (FGF-2), vascular endothelial growth factor (VEGF), adropin proteins, and myocardial fibrosis were assessed.

RESULTS

HIIT and CET induced a significant increase in the FGF-2 and adropin and a decrease in the myocardial fibrosis in compared with the control group. HIIT induced a significant increase in the VEGF if compared with the control group. There was no significant difference between CET and control group.

CONCLUSION

Six weeks of HIIT and CET attenuated age-related myocardial fibrosis thereby an increase in angiogenesis-related molecules in cardiac and endothelial tissues.

[Molecular mechanisms of adaptive and therapeutic effects of physical activity in patients with cardiovascular diseases]

Physical activity is one of the main components of the rehabilitation of patients with cardiovascular disease (CVD). As shown by practice and the results of evidence-based studies, the beneficial effects of physical activity on disease outcomes in a number of cardiac nosologies are comparable to drug treatment. This gives the doctor another tool to influence the unfavorable epidemiological situation in developed countries with the spread of diseases of the cardiovascular system and CVD mortality. Reliable positive results of cardiorehabilitation (CR) were obtained using various methods. The goal of CR is to restore the optimal physiological, psychological and professional status, reduce the risk of CVD and mortality. In most current CVD guidelines worldwide, cardiac rehabilitation is a Class I recommendation. The molecular mechanisms described in the review, initiated by physical activity, underlie the multifactorial effect of the latter on the function of the cardiovascular system and the course of cardiac diseases. Physical exercise is an important component of the therapeutic management of patients with CVD, which is supported by the results of a meta-analysis of 63 studies associated with various forms of aerobic exercise of varying intensity (from 50 to 95% VO₂) for 1 to 47 months, which showed that CR based on physical exercise improves cardiorespiratory endurance. Knowledge of the molecular basis of the influence of physical activity makes it possible to use biochemical markers to assess the effectiveness of rehabilitation programs.

Do coping strategies really affect cardiovascular events? The Isfahan cohort study of adults in Eastern Mediterranean Regional Office

AIMS

Psychological factors are among the most suspected indicators which may cause atherosclerosis. Coping strategies modifying psychological stress may be significantly associated with health outcomes. However, little is known about the influence of adaptive and maladaptive coping strategies on major adverse cardiovascular disease (CVD) events. The purpose of this study is to examine this idea among a sample of adults. Design: cohort study.

METHODS AND RESULTS

The Isfahan cohort study (ICS) is a longitudinal population-based, prospective study. Participants (N=6323 individuals aged 35 years or greater at baseline) were selected by multistage random sampling with 6-year intervals (i.e. 2001: 6323 individuals, 2007: 3296 individuals, and 2013: 1706 individuals). Adaptive and maladaptive coping strategies were evaluated by a multicomponent self-administered stress management paper-based questionnaire. All CVD events were confirmed by a blinded panel of experts and a marginal cox regression model was used to model the survival data. Adaptive coping strategies could be protective against CVD events with hazard ratios (95% confidence interval) [0.97 (0.95-0.99)] and maladaptive coping strategies seem to be a risk factor, 1.02 (1.01-1.04) in the whole population. Individuals younger than 60 showed similar results, with 0.96 (0.93-0.98) and 1.04 (1.01-1.07) for adaptive and maladaptive coping strategies, respectively. However, these findings were not replicated among seniors older than age 60.

CONCLUSION

Based on our results, coping strategies have an important role in cardiovascular events, particularly among young adults. According to the results, informing patients about adaptive stress management may promote primary prevention of CVD events.

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.

Responders and non-responders to aerobic exercise training: beyond the evaluation of V˙O2max

The evaluation of the maximal oxygen uptake ( V ˙ O 2 max ) following exercise training is the classical assessment of training effectiveness. Research has lacked in investigating whether individuals that do not respond to the training intervention ( V ˙ O 2 max ), also do not improve in other health-related parameters. We aimed to investigate the cardiovascular and metabolic adaptations (i.e., performance, body composition, blood pressure, vascular function, fasting blood markers, and resting cardiac function and morphology) to exercise training among participants who showed different levels of V ˙ O 2 max responsiveness. Healthy sedentary participants engaged in a 6-week exercise training program, three times a week. Our results showed that responders had a greater increase in peak power output, second lactate threshold, and microvascular responsiveness, whereas non-responders had a greater increase in cycling efficiency. No statistical differences were observed in body composition, blood pressure, fasting blood parameters, and resting cardiac adaptations. In conclusion, our study showed, for the first time, that in addition to the differences in the V ˙ O 2 max , a greater increase in microvascular responsiveness in responders compared to non-responders was observed. Additionally, responders and non-responders did not show differences in the adaptations on metabolic parameters. There is an increasing need for personalized training prescription, depending on the target clinical outcome.

Endurance Training Depletes Antioxidant System but Does Not Affect Endothelial Functions in Women with Abdominal Obesity: A Randomized Trial with a Comparison to Endurance-Strength Training

Limited data suggested that inclusion of a strength component into endurance exercises might intensify the beneficial effect of training. However, the available data is limited. Therefore, we aimed to compare the effect of endurance and endurance-strength training on anthropometric parameters, endothelial function, arterial stiffness, antioxidant status, and inflammatory markers in abdominally obese women without serious comorbidities. A total of 101 women were recruited and randomly divided into endurance (n = 52) and endurance-strength (n = 49) groups. During the three-month intervention, both groups performed supervised sixty-minute training three times a week. All studied parameters were measured pre- and post-intervention period. In total, 85 women completed the study. Both training significantly decreased anthropometric parameters. Besides, endurance training decreased endothelial nitric oxide synthase, central aortic systolic pressure, pulse wave velocity, glutathione (GSH), total antioxidant status (TAS), interleukin (IL) 8, matrix metalloproteinase (MMP) 9, and tumor necrosis factor alpha, while endurance-strength training decreased MMP-2 concentrations, and increased IL-6, monocyte chemoattractant protein-1, and MMP-9 levels. We observed significant differences between groups for GSH, TAS, and MMP-9 levels. In summary, endurance and endurance-strength training did not differ in the impact on endothelial function and arterial stiffness. However, endurance training significantly depleted the antioxidant defense, simultaneously reducing MMP-9 levels. The study was retrospectively registered with the German Clinical Trials Register within the number DRKS00019832.

Reshaping the path of vascular cognitive impairment with resistance training: a study protocol for a randomized controlled trial

Background

Subcortical ischemic vascular cognitive impairment (SIVCI) is the most common form of vascular cognitive impairment. Importantly, SIVCI is considered the most treatable form of cognitive impairment in older adults, due to its modifiable risk factors such as hypertension, diabetes mellitus, and hypercholesterolemia. Exercise training is a promising intervention to delay the progression of SIVCI, as it actively targets these cardiometabolic risk factors. Despite the demonstrated benefits of resistance training on cognitive function and emerging evidence suggesting resistance training may reduce the progression of white matter hyperintensities (WMHs), research on SIVCI has predominantly focused on the use of aerobic exercise. Thus, the primary aim of this proof-of-concept randomized controlled trial is to investigate the efficacy of a 12-month, twice-weekly progressive resistance training program on cognitive function and WMH progression in adults with SIVCI. We will also assess the efficiency of the intervention.

Methods

Eighty-eight community-dwelling adults, aged > 55 years, with SIVCI from metropolitan Vancouver will be recruited to participate in this study. SIVCI will be determined by the presence of cognitive impairment (Montreal Cognitive Assessment < 26) and cerebral small vessel disease using computed tomography or magnetic resonance imaging. Participants will be randomly allocated to a twice-weekly exercise program of (1) progressive resistance training or (2) balance and tone training (i.e., active control). The primary outcomes are cognitive function measured by the Alzheimer’s Disease Assessment Scale-Cognitive-Plus (ADAS-Cog-13 with additional cognitive tests) and WMH progression.

Discussion

The burden of SIVCI is immense, and to our knowledge, this will be the first study to quantify the effect of progressive resistance training on cognitive function and WMH progression among adults with SIVCI. Slowing the rate of cognitive decline and WMH progression could preserve functional independence and quality of life. This could lead to reduced health care costs and avoidance of early institutional care.

Trial registration

ClinicalTrials.gov NCT02669394. Registered on February 1, 2016

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-021-05156-1.

Influence of Ultra-Processed Foods Consumption on Redox Status and Inflammatory Signaling in Young Celiac Patients

The current study was designed to assess the influence of consumption of ultra-processed (UPF) on oxidative/antioxidant balance and evoked inflammatory signaling in young patients with celiac disease (CD). The study included 85 children. The celiac group (n = 53) included children with CD with a long (>18 months, n = 17) or recent (<18 months, n = 36) adherence to a gluten-free diet (GFD). The control group (n = 32) included healthy children with a significantly lower consumption of UPF compared to the CD group, both expressed as kcal/day (p = 0.043) and as percentage of daily energy intake (p = 0.023). Among children with CD, the group with the lowest consumption of UPF (below the 50% of daily energy intake) had a greater Mediterranean diet (MD) adherence and higher moderate physical activity levels. In addition, CD children with the lowest consumption of UPF had healthier redox (lower soluble superoxide dismutase-1 and 15-F2t-isoprostanes) and inflammatory profiles (lower macrophage inflammatory protein-1α) compared to the group with the highest consumption of UPF (all, p < 0.05) regardless of the time on a GFD. These findings highlight the importance of a correct monitoring of the GFD. An unbalanced GFD with high consumption of UPF and an unhealthy pattern with less physical activity and worse adherence to MD results in a worse inflammatory profile, which could act as a parallel pathway that could have important consequences on the pathophysiology of the disease.

Should Heartbeats/Training Session Be Considered When Comparing the Cardiovascular Benefits of High-Intensity Interval Aerobic and Moderate-Intensity Continuous Training? A Critical Appraisal

The prescription of physical training as a therapeutic measure in the treatment and control of chronic degenerative diseases, mainly cardiovascular disease and metabolic disease, is an increasingly used clinical approach, often preceding the pharmacological prescription. Despite the advances in exercise physiology and cardio functional performance in recent decades, the main challenge is to identify the most appropriate modality, intensity, and training volume for each pathophysiological situation. In this case, the superiority of high-intensity interval training (HIIT) over moderate-intensity continuous training (MICT) has been questioned, since many studies have shown similar results in the different physiological parameters evaluated, especially regarding cardiorespiratory fitness, cardiovascular autonomic control, and cardiac morpho functionality. The cause of conflicting results observed by different studies may be related to standardization, application, and comparison of the two protocols. HIIT would have a higher number of heartbeats compared to MICT, when maintaining high heart rate is disregarded. In this since, our hypothesis for the greatest gains in cardiorespiratory fitness and in the autonomic and cardiovascular adaptations promoted by HIIT is based on the higher volume of training performed as a function of the higher number of heartbeats per unit of time, since the intermittence was calculated based on a percentage of maximum heart rate or reserve heart rate. Nevertheless, the intermittency between the established heart rate percentages is not necessarily accompanied by the intermittent heart rate. Therefore, considering and matching the number of heartbeats performed per training session in both models seems to be a more appropriate way to compare the two training protocols.

Pathophysiology of Peripheral Arterial Disease (PAD): A Review on Oxidative Disorders

Peripheral arterial disease (PAD) is an atherosclerotic disease that affects a wide range of the world’s population, reaching up to 200 million individuals worldwide. PAD particularly affects elderly individuals (>65 years old). PAD is often underdiagnosed or underestimated, although specificity in diagnosis is shown by an ankle/brachial approach, and the high cardiovascular event risk that affected the PAD patients. A number of pathophysiologic pathways operate in chronic arterial ischemia of lower limbs, giving the possibility to improve therapeutic strategies and the outcome of patients. This review aims to provide a well detailed description of such fundamental issues as physical exercise, biochemistry of physical exercise, skeletal muscle in PAD, heme oxygenase 1 (HO-1) in PAD, and antioxidants in PAD. These issues are closely related to the oxidative stress in PAD. We want to draw attention to the pathophysiologic pathways that are considered to be beneficial in order to achieve more effective options to treat PAD patients.

Evening exercise is associated with lower odds of visual field progression in Chinese patients with primary open angle glaucoma

Background

Exercise is widely known to lower intraocular pressure and increase ocular blood flow, which may be beneficial for glaucoma management. However, there are few studies that have reported on the relationship between exercise and glaucoma progression. The aim of our study was to investigate the exercise habits of those with primary open angle glaucoma (POAG) and its association with the progression of visual field (VF) loss.

Methods

Daily physical activity (PA) was monitored by an accelerometer (ActiGraph wGT3x-BT) which patients wore for more than 10 h of being awake on their right wrists for 1 week.

Results

Seventy-one non-progressive and 27 progressive patients were enrolled in the study. 24-h moderate to vigorous physical activity (MVPA) exercise showed that POAG patients had similar variation trends consisting of 3 wave peaks and 2 wave hollows. Minutes spent in MVPA was 19.89 ± 15.81 and 21.62 ± 15.10 during 07:00–09:00 h (p = 0.204), 15.40 ± 14.49 and 15.67 ± 12.43 during 15:00–17:00 h (p = 0.822) and 17.26 ± 21.11 and 11.42 ± 11.58 during 18:00–20:00 h (p = 0.001) in the non-progressive and progressive group, respectively. Univariate analysis indicated that 10 min of MVPA (18:00–20:00 h) [odds ratio, OR (95% CI) = 0.82 (0.73, 0.92)], average mean arterial pressure [OR (95% CI) = 0.96 (0.94, 0.98)], age [OR (95% CI) = 1.06 (1.03, 1.08)], male [OR (95% CI) = 0.67 (0.48, 0.96)], spherical equivalent [OR (95% CI) = 1.14 (1.07, 1.22)] and IOP-lowering medications [OR (95% CI) = 1.54 (1.16, 2.05)] were significantly correlated with having progressive VF damage. Multivariable analysis showed that 10 min of MVPA (18:00–20:00 h) [OR (95% CI) = 0.85 (0.75, 0.97)] was associated with progressive VF loss even after adjusting for other risk factors.

Conclusions

Evening exercise may lower the odds of VF progression, suggesting that exercise habits possibly play an important role in glaucoma progression.

Long-term exercise results in morphological and biomechanical changes in coronary resistance arterioles in male and female rats

Background

Biomechanical remodeling of coronary resistance arteries in physiological left ventricular hypertrophy has not yet been analyzed, and the possible sex differences are unknown.

Methods

Wistar rats were divided into four groups: male and female sedentary controls (MSe and FSe) and male and female animals undergoing a 12-week intensive swim training program (MEx and FEx). On the last day, the in vitro contractility, endothelium-dependent dilatation, and biomechanical properties of the intramural coronary resistance arteries were investigated by pressure microarteriography. Elastica and collagen remodeling were studied in histological sections.

Results

A similar outer radius and reduced inner radius resulted in an elevated wall to lumen ratio in the MEx and FEx animals compared to that in the sedentary controls. The wall elastic moduli increased in the MEx and FEx rats. Spontaneous and TxA₂ agonist-induced tone was increased in the FEx animals, whereas endothelium-dependent relaxation became more effective in MEx rats. Arteries of FEx rats had stronger contraction, while arteries of MEx animals had improved dilation.

Conclusions

According to our results, the coronary arterioles adapted to an elevated load during long-term exercise, and this adaptation depended on sex. It is important to emphasize that in addition to differences, we also found many similarities between the sexes in the adaptive response to exercise. The observed sport adaptation in the coronary resistance arteries of rats may contribute to a better understanding of the physiological and pathological function of these arteries in active and retired athletes of different sexes.

Residential neighbourhood greenspace is associated with reduced risk of cardiovascular disease: A prospective cohort study

Background

Living in a greener neighbourhood may reduce the risk of developing incident cardiovascular disease, but evidence is limited by reliance on cross-sectional comparisons. We use data from a longitudinal study with a time-independent measure of risk to explore the association between exposure to greenspace and cardiovascular disease.

Methods

Data was from the European Prospective Investigation of Cancer Norfolk UK cohort, baseline 1993–1997 (n = 24,420). Neighbourhoods were defined as 800m radius zones around participants’ home, according to their home postcode (zip code) in the year 2000. Greenspace exposure was identified using classified satellite imagery. Adjusted Cox proportional hazards regression examined associations between greenspace and incident cardiovascular disease. Mediation analysis assessed if physical activity mediated associations, whilst modification by rurality, socio-economic status and age was explored.

Results

The mean age of participants was 59.2 years at baseline, 54.7% were female, and mean follow-up time was 14.5 years. Individuals living in the greenest neighbourhood quartile had a 7% lower relative hazard of developing cardiovascular disease than other neighbourhoods (HR 0.93; 95% CI 0.88, 0.97; p = 0.003) after adjusting for age, sex, BMI, prevalent diabetes and socio-economic status (SES). Physical activity did not mediate the relationship (greenest compared to the least green quartile HR 0.99; 95% CI 0.97, 1.01; p = 0.416). Models predicted incidence of cardiovascular disease in the least green neighbourhoods (19.4% greenspace on average) would fall by 4.8% (95% CI 1.6%, 8.2% p = 0.003) if they were as green as the average neighbourhood (59.0% greenspace). Occupation moderated the relationship, whereby exposure to greenspace was not associated with incident CVD for participants engaged in manual occupations.

Conclusions

Greener home neighbourhoods may protect against risk of cardiovascular disease even after accounting for SES, whilst the mechanism does not appear to be strongly associated with physical activity. Putative causal mechanisms require investigation.

Effects of Exercise to Improve Cardiovascular Health

Obesity is a complex disease that affects whole body metabolism and is associated with an increased risk of cardiovascular disease (CVD) and Type 2 diabetes (T2D). Physical exercise results in numerous health benefits and is an important tool to combat obesity and its co-morbidities, including cardiovascular disease. Exercise prevents both the onset and development of cardiovascular disease and is an important therapeutic tool to improve outcomes for patients with cardiovascular disease. Some benefits of exercise include enhanced mitochondrial function, restoration and improvement of vasculature, and the release of myokines from skeletal muscle that preserve or augment cardiovascular function. In this review we will discuss the mechanisms through which exercise promotes cardiovascular health.

Effects of a rehabilitation program on microvascular function of CHD patients assessed by near-infrared spectroscopy

This study aimed to evaluate whether near-infrared spectroscopy (NIRS)-derived reperfusion slope would detect the effects of a 12-week rehabilitation program on lower limb microvascular responsiveness in patients with coronary heart disease (CHD). Ten CHD patients (7 males and 3 females; 57.3 ± 7.6 years) underwent 12 weeks of drug treatment and high-intensity interval training (HIIT), 2 times per week (40 min/session). Microvascular responsiveness was assessed by using NIRS assessment of muscle oxygen saturation (StO2 ) combined with a vascular occlusion test (VOT) (NIRS-VOT). NIRS-VOT measures were taken at pre- and postintervention, and microvascular responsiveness was evaluated by examining the slope 2 of re-oxygenation rate (slope 2 StO2 ) and the area under the curve (StO2AUC ) of StO2 signal following cuff release subsequent to a 5-min occlusion period. The slope 2 StO2 was significantly steeper after 12 weeks of training (4.8 ± 1.6% sec-1 ) compared to the pretraining (3.1 ± 1.6% sec-1 ) (P < 0.05). The area under the curve for the change in the % StO2 signal during re-oxygenation increased significantly from 3494 ± 2372%∙sec at pretraining to 9006 ± 4311%∙sec at post-training (P < 0.05). NIRS-VOT technique detected the improvements of 12 weeks of rehabilitation program in the lower limb microvascular responsiveness of CHD patients.

Comparative effect of statins and types of physical exercise on arterial stiffness: Protocol for network meta-analysis

INTRODUCTION

The purpose of this study protocol is to provide the methodology for a review to compare the effect of statins vs physical exercise interventions and the effect of different types of physical exercise, on reducing arterial stiffness associated with cardiovascular diseases and mortality.

METHODS AND ANALYSIS

The literature search will be conducted in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Web of Science databases from their inception until July 31, 2019. We will include randomized controlled trials, nonrandomized experimental studies, and controlled pre-post studies assessing the effect in the general population of statins and physical exercise interventions on arterial stiffness measured by pulse wave velocity. The Cochrane Collaboration's tool and the Quality Assessment Tool for Quantitative Studies will be used to assess the risk of bias for studies included in the systematic review. A Bayesian network meta-analysis will be carried out to determine the comparative effect of the different physical exercise interventions and/or statin intervention.

ETHICS AND DISSEMINATION

This study will generate evidence about the effectiveness of both statins and exercise on reducing arterial stiffness that potentially can be transferred to patients and practitioners. Moreover, in light of the importance of reducing arterial stiffness for preventing cardiovascular disease, the evidence provided by this study will be potentially suitable to be included in cardiovascular clinical practice guidelines.

STRENGTHS AND LIMITATIONS

This protocol describes the methods of a study examining, using network meta-analysis strategies, the efficacy of statins and different types of exercise on improving arterial stiffness, which is an early marker of atherosclerosis. The results of this study could immediately help clinicians to recommend the best evidence-based intervention to their patients to reduce arterial stiffness and, as a consequence, prevent major complications, such as heart failure, stroke, or myocardial infarction.

TRIAL REGISTRATION NUMBER

PROSPERO CRD42019123120.

Is physical activity a modifier of the association between air pollution and arterial stiffness in older adults: The SAPALDIA cohort study

INTRODUCTION AND OBJECTIVES

Air pollution and insufficient physical activity have been associated with inflammation and oxidative stress, molecular mechanisms linked to arterial stiffness and cardiovascular disease. There are no studies on how physical activity modifies the association between air pollution and arterial stiffness. We examined whether the adverse cardiovascular effects of air pollution were modified by individual physical activity levels in 2823 adults aged 50-81 years from the well-characterized Swiss Cohort Study on Air Pollution and Lung and Heart Diseases (SAPALDIA).

METHODS

We assessed arterial stiffness as the brachial-ankle pulse wave velocity (baPWV [m/s]) with an oscillometric device. We administered a self-reported physical activity questionnaire to classify each subject's physical activity level. Air pollution exposure was estimated by the annual average individual home outdoor PM₁₀ and PM_2.5 (particulate matter <10μm and <2.5μm in diameter, respectively) and NO₂ (nitrogen dioxide) exposure estimated for the year preceding the survey. Exposure estimates for ultrafine particles calculated as particle number concentration (PNC) and lung deposited surface area (LDSA) were available for a subsample (N=1353). We used mixed effects logistic regression models to regress increased arterial stiffness (baPWV≥14.4m/s) on air pollution exposure and physical activity while adjusting for relevant confounders.

RESULTS

We found evidence that the association of air pollution exposure with baPWV was different between inactive and active participants. The probability of having increased baPWV was significantly higher with higher PM₁₀, PM_2.5, NO₂, PNC and LDSA exposure in inactive, but not in physically active participants. We found some evidence of an interaction between physical activity and ambient air pollution exposure for PM₁₀, PM_2.5 and NO₂ (p_interaction=0.06, 0.09, and 0.04, respectively), but not PNC and LDSA (p_interaction=0.32 and 0.35).

CONCLUSIONS

Our study provides some indication that physical activity may protect against the adverse vascular effects of air pollution in low pollution settings. Additional research in large prospective cohorts is needed to assess whether the observed effect modification translates to high pollution settings in mega-cities of middle and low-income countries.

The impact of acute high-intensity interval exercise on biomarkers of cardiovascular health in type 2 diabetes

PURPOSE

High-intensity interval training (HIIT) interventions improve cardiovascular health, yet the acute effects on circulating and functional biomarkers of cardiovascular function are unclear in individuals with type 2 diabetes (T2D). To explore this, we conducted two investigations to examine the acute response to HIIT in individuals with T2D.

METHODS

Study 1 measured blood pressure, endothelial-dependent dilation, circulating measures of endothelial activation, and troponin T, 30 min and 2 h after HIIT (7 × 1-min intervals) in T2D (n = 8) and age-matched normoglycemic controls (CTL; n = 8). Study 2 assessed circulating measures of endothelial activation and troponin T, 30 min, and 24 h after HIIT (10 × 1-min intervals) in ten previously trained T2D men.

RESULTS

In study 1, markers of endothelial function and activation within the first 2 h after HIIT did not differ from baseline between T2D and CTL participants, except at 30 min after HIIT for glucose, which was reduced more in T2D than CTL (by -0.8 ± 1.2 mmol/L, p = 0.04), and VCAM-1, which was reduced more 30 min after HIIT in CTL compared to T2D (by -187 ± 221 ng/mL, p = 0.05). Study 2 saw no significant difference in any circulating markers of endothelial activation and troponin T, 30 min, and 24 h after HIIT in trained T2D males.

CONCLUSION

Exploratory findings from these two studies suggest that acute HIIT does not substantially alter circulating and functional markers of cardio(vascular) health in individuals with T2D who are unaccustomed (study 1) and accustomed to HIIT (study 2).

Nitric Oxide Donor-Based Cancer Therapy: Advances and Prospects

The increasing understanding of the role of nitric oxide (NO) in cancer biology has generated significant progress in the use of NO donor-based therapy to fight cancer. These advances strongly suggest the potential adoption of NO donor-based therapy in clinical practice, and this has been supported by several clinical studies in the past decade. In this review, we first highlight several types of important NO donors, including recently developed NO donors bearing a dinitroazetidine skeleton, represented by RRx-001, with potential utility in cancer therapy. Special emphasis is then given to the combination of NO donor(s) with other therapies to achieve synergy and to the hybridization of NO donor(s) with an anticancer drug/agent/fragment to enhance the activity or specificity or to reduce toxicity. In addition, we briefly describe inducible NO synthase gene therapy and nanotechnology, which have recently entered the field of NO donor therapy.

Exploring Vascular Function Biomarkers: Implications for Rehabilitation

The endothelium plays an important role in maintaining vascular homeostasis and regulating blood vessel function. Endothelial function is considered an independent predictor for risk of future cardiovascular events in cardiovascular and non-cardiovascular patients, as well as a predictor for postoperative complications in cardiovascular surgery patients. Brachial artery flow-mediated dilation by high-resolution ultrasound is widely used to evaluate endothelium-dependent vasodilation, which is mainly mediated by nitric oxide release. Physical exercise exerts beneficial effects on endothelial function and can be used in both primary and secondary prevention of cardiac and peripheral artery diseases, even in the postoperative period of cardiovascular surgery.

Aerobic exercise promotes executive functions and impacts functional neural activity among older adults with vascular cognitive impairment

BACKGROUND

Vascular cognitive impairment (VCI) results from cerebrovascular disease, and worldwide, it is the second most common type of cognitive dysfunction. While targeted aerobic training is a promising approach to delay the progression of VCI by reducing cardiometabolic risk factors, few randomised controlled trials to date have specifically assessed the efficacy of aerobic training on cognitive and brain outcomes in this group at risk for functional decline.

AIM

To examine the effect of moderate-intensity aerobic training on executive functions and functional neural activity among older adults with mild subcortical ischaemic VCI (SIVCI).

METHODS

Older adults with mild SIVCI were randomly assigned to: (1) 6-month, 3×/week aerobic training (n=10) or (2) usual care (control; n=11). Participants completed functional MRI (fMRI) at baseline and trial completion. During the fMRI sessions, behavioural performance on the Eriksen flanker task and task-evoked neural activity were assessed.

RESULTS

At trial completion, after adjusting for baseline general cognition, total white matter lesion volume and flanker performance, compared with the control group, the aerobic training group significantly improved flanker task reaction time. Moreover, compared with the controls, the aerobic training group demonstrated reduced activation in the left lateral occipital cortex and right superior temporal gyrus. Reduced activity in these brain regions was significantly associated with improved (ie, faster) flanker task performance at trial completion.

SUMMARY

Aerobic training among older adults with mild SIVCI can improve executive functions and neural efficiency of associated brain areas. Future studies with greater sample size should be completed to replicate and extend these findings.

Brief communication (Original). The effect of physical activity on 6-minute walked distance among niqab wearing healthy Saudi women

Background: Wearing a face veil (niqab) was found to have a negative effect on the ventilatory function of Saudi adult women, which may challenge their functional exercise capacity.

Objectives: To investigate the effect of physical activity on a 6-minute walked distance (6-MWD) among young adult niqab-wearing healthy Saudi women.

Materials and Methods: Forty healthy young Saudi women were recruited for this study. The study participants (aged 22.8 ± 2.5 years) were selected from students and administrative staff at King Saud University. They were normotensive, nonsmokers, and of normal or mildly overweight. They were divided into 2 groups on basis of niqab wearing. A 6- minute walk test was implemented as measure of the participant’s functional exercise capacity. Their physical activity level was expressed as low, moderate, or high levels using the International Physical Activity Questionnaire-Short Form. Comparisons between the basal physiological characters of the 2 groups, 6-MWD, and physical activity level were conducted. A two-way independent ANOVA was used to study the interaction of niqab wearing and the physical activity level on the 6-MWD for niqab wearing women.

Results: Women in the niqab wearing group had a significantly higher physical activity level and longer 6-MWD than those in the niqab nonwearing group (370.7 ± 62.95 and 510.0 ± 81.75 m (mean ± SD) respectively).

Conclusion: A physically active lifestyle improves and preserves the functional exercise capacity reflected by longer 6-MWD among the physically active niqab-wearing Saudi adult healthy women compared with less active women who did not wear the niqab.

Physical Exercise Is a Potential "Medicine" for Atherosclerosis

Cardiovascular disease (CVD) has been recognized as the number one killer for decades. The most well-known risk factor is atherosclerosis. Unlike the acuity of CVD, atherosclerosis is a chronic, progressive pathological change. This process involves inflammatory response, oxidative reaction, macrophage activity, and different interaction of inflammatory factors. Physical exercise has long been known as good for health in general. In recent studies, physical exercise has been demonstrated to be a therapeutic tool for atherosclerosis. However, its therapeutic effect has dosage-dependent effect. Un-proper over exercise might also cause damage to the heart. Here we summarize the mechanism of Physical exercise's beneficial effects and its potential clinical use.

Frailty and sarcopenia as the basis for the phenotypic manifestation of chronic diseases in older adults

Frailty is a functional status that precedes disability and is characterized by decreased functional reserve and increased vulnerability. In addition to disability, the frailty phenotype predicts falls, institutionalization, hospitalization and mortality. Frailty is the consequence of the interaction between the aging process and some chronic diseases and conditions that compromise functional systems and finally produce sarcopenia. Many of the clinical manifestations of frailty are explained by sarcopenia which is closely related to poor physical performance. Reduced regenerative capacity, malperfusion, oxidative stress, mitochondrial dysfunction and inflammation compose the sarcopenic skeletal muscle alterations associated to the frailty phenotype. Inflammation appears as a common determinant for chronic diseases, sarcopenia and frailty. The strategies to prevent the frailty phenotype include an adequate amount of physical activity and exercise as well as pharmacological interventions such as myostatin inhibitors and specific androgen receptor modulators. Cell response to stress pathways such as Nrf2, sirtuins and klotho could be considered as future therapeutic interventions for the management of frailty phenotype and aging-related chronic diseases.

Venous Thromboembolism in Physically Active People: Considerations for Risk Assessment, Mainstream Awareness and Future Research

The global healthcare burden of venous thromboembolism (VTE) and associated comorbidities (e.g., obesity, heart disease and cancer) is significant. Physical activity-especially cardiovascular exercise-is popularly acclaimed for gold-standard prevention. Paradoxically, intensive training can expose athletes to several potentially thrombogenic risk factors (e.g., heat stress, dehydration, blood vessel injury and inflammation). However, awareness regarding the risk of VTE in physically active people is generally lacking. Given that the overall incidence of asymptomatic and/or occult blood clots that resolve spontaneously is uncharted, and because symptoms and sequelae are not always 'textbook', triage evaluation and diagnosis of VTE at large can be challenging. Front-line clinical evaluations, including the major Wells scoring criteria, are (versus the total number of possible factors and diagnoses) comparably reductionist, and the point at which a minor risk might be considered significant in one person-but not in another-is subjective. Considering the popular associations between VTE and inactivity, athletes might be at greater risk of a missed diagnosis quite simply because their cardiovascular conditioning presents as the polar opposite to standard assessment criteria. Undoubtedly, risk factors for VTE associated with exercise are not unique to cardiovascular training or athletes, but the extent to which they might increase the chances of blood clot precipitation in certain participants warrants attention. A multi-agency approach, including research to inform mainstream understanding and awareness about risk factors for VTE in patient groups across age, comorbidity and activity spectra, is required. In this article, the potential for pre-participatory thrombophilia screening, haemostatic monitoring and personalized prophylactic guidelines is discussed.

Nitric oxide and reactive oxygen species: Clues to target oxidative damage repair defective breast cancers

The identification of various biomolecules in cancer progression and therapy has led to the exploration of the roles of two cardinal players, namely Nitric Oxide (NO) and Reactive Oxygen Species (ROS) in cancer. Both ROS and NO display bimodal fashions of functional activity in a concentration dependent manner, by inducing either pro- or anti- tumorigenic signals. Researchers have identified the potential capability of NO and ROS in therapies owing to their role in eliciting pro-apoptotic signals at higher concentrations and their ability to sensitize cancer cells to one another as well as to other therapeutics. We review the prospects of NO and ROS in cancer progression and therapy, and analyze the role of a combinatorial therapy wherein an NO donor (SNAP) is used to sensitize the oxidative damage repair defective, triple negative breast cancer cells (HCC 1937) to a potent ROS inducer. Preliminary findings support the potential to employ various combinatorial regimes for anti-cancer therapies with regard to exploiting the chemo-sensitization property of NO donors.

Exercise protects against PCB-induced inflammation and associated cardiovascular risk factors

Polychlorinated biphenyls (PCBs) are persistent environmental pollutants that contribute to the initiation of cardiovascular disease. Exercise has been shown to reduce the risk of cardiovascular disease; however, whether exercise can modulate PCB-induced vascular endothelial dysfunction and associated cardiovascular risk factors is unknown. We examined the effects of exercise on coplanar PCB-induced cardiovascular risk factors including oxidative stress, inflammation, impaired glucose tolerance, hypercholesteremia, and endothelium-dependent relaxation. Male ApoE(-/-) mice were divided into sedentary and exercise groups (voluntary wheel running) over a 12-week period. Half of each group was exposed to vehicle or PCB 77 at weeks 1, 2, 9, and 10. For ex vivo studies, male C57BL/6 mice exercised via voluntary wheel training for 5 weeks and then were administered with vehicle or PCB 77 24 h before vascular reactivity studies were performed. Exposure to coplanar PCB increased risk factors associated with cardiovascular disease, including oxidative stress and systemic inflammation, glucose intolerance, and hypercholesteremia. The 12-week exercise intervention significantly reduced these proatherogenic parameters. Exercise also upregulated antioxidant enzymes including phase II detoxification enzymes. Sedentary animals exposed to PCB 77 exhibited endothelial dysfunction as demonstrated by significant impairment of endothelium-dependent relaxation, which was prevented by exercise. Lifestyle modifications such as aerobic exercise could be utilized as a therapeutic approach for the prevention of adverse cardiovascular health effects induced by environmental pollutants such as PCBs.

Exercise Modulates Oxidative Stress and Inflammation in Aging and Cardiovascular Diseases

Despite the wealth of epidemiological and experimental studies indicating the protective role of regular physical activity/exercise training against the sequels of aging and cardiovascular diseases, the molecular transducers of exercise/physical activity benefits are not fully identified but should be further investigated in more integrative and innovative approaches, as they bear the potential for transformative discoveries of novel therapeutic targets. As aging and cardiovascular diseases are associated with a chronic state of oxidative stress and inflammation mediated via complex and interconnected pathways, we will focus in this review on the antioxidant and anti-inflammatory actions of exercise, mainly exerted on adipose tissue, skeletal muscles, immune system, and cardiovascular system by modulating anti-inflammatory/proinflammatory cytokines profile, redox-sensitive transcription factors such as nuclear factor kappa B, activator protein-1, and peroxisome proliferator-activated receptor gamma coactivator 1-alpha, antioxidant and prooxidant enzymes, and repair proteins such as heat shock proteins, proteasome complex, oxoguanine DNA glycosylase, uracil DNA glycosylase, and telomerase. It is important to note that the effects of exercise vary depending on the type, intensity, frequency, and duration of exercise as well as on the individual's characteristics; therefore, the development of personalized exercise programs is essential.

EFEITOS DO TREINAMENTO FÍSICO NO ENDOTÉLIO APÓS CIRURGIA DE REVASCULARIZAÇÃO

Introdução A cirurgia de revascularização do miocárdio (CRM) é uma das mais frequentes cirurgias realizadas em todo o mundo, muitos estudos vêm relatando os benefícios do treinamento físico para a melhora da capacidade funcional, porém há poucos estudos sobre os efeitos na função endotelial vascular. Objetivo Analisar os efeitos do treinamento físico sobre a função endotelial vascular em pacientes submetidos à CRM, isoladamente na fase tardia da reabilitação após seis meses de programa de reabilitação cardíaca (PCR). Métodos Foram incluídos pacientes que haviam sido submetidos à CRM no período máximo de um ano após a cirurgia. O PRC foi empregado durante seis meses consecutivos, com três sessões semanais. Todos os pacientes realizaram exames laboratoriais, teste de força muscular de uma repetição máxima (1-RM) para os membros superiores e inferiores, teste de caminhada de 6 min (TC6M) e avaliação da função endotelial através da técnica de vasodilatação mediada pelo fluxo. Resultados Onze pacientes iniciaram o PRC, porém nove pacientes o completaram. A média de idade foi de 66 anos (50 a 82 anos) e o sexo masculino foi predominante (55,6%). Houve mudanças significativas nos exames laboratoriais bioquímicos: aumento do colesterol total (Basal: 162 ± 31mg/dL vs. 195 ± 39mg/dL; P=0,012) e diminuição da hemoglobina glicada (Basal: 6,74 ± 1,64% vs. 6,26 ± 1,62%; P=0,028). A força muscular aumentou significativamente nos membros superiores e inferiores (P=0,030 e P=0,038, respectivamente); no TC6M observou-se um aumento significativo de 20% na distância percorrida (P=0,020) após seis meses consecutivos de treinamento e houve uma melhora na vasodilatação mediada pelo fluxo (Basal: 6,35 ± 3,92% vs. 6 meses: 9,90 ± 4,19%; P=0,026). Conclusão O treinamento combinado realizado em seis meses ajudou a melhorar a função endotelial e a capacidade funcional de pacientes sedentários que foram submetidos à CRM na fase tardia da reabilitação.

A Systematic Review of the Acute Effects of Exercise on Immune and Inflammatory Indices in Untrained Adults

BACKGROUND

Cardiovascular disease (CVD) is the leading cause of global mortality. Although the incidence may be reduced with regular exercise, the health benefits of a single bout of exercise on selected CVD risk factors are not well understood. The primary objective of this review is to consider the transient effects of exercise on immune (neutrophil count) and inflammatory (interleukin-6 [IL-6], C-reactive protein [CRP]) markers in untrained adults.

METHODS

MEDLINE, EMBASE, CINAHL, Sports Discus and Cochrane were searched for relevant studies published from January 1946 to May 2013. Randomised controlled or crossover studies which measured any of these parameters in untrained but otherwise healthy participants in the 48 h following about of exercise, less than 1 h in duration were included.

RESULTS

Ten studies met the inclusion criteria. The results indicate a single bout of aerobic or resistance exercise of moderate to high intensity promotes an increase in IL-6 (145 %) and neutrophil counts (51 %). It appears that 30-60 min of moderate to high intensity exercise is necessary to elicit such changes although variables such as the mode, intensity and pattern of exercise also affect the response. The acute response of CRP within the included studies is equivocal.

CONCLUSIONS

Although responses to CRP are inconsistent, a single bout of exercise can increase the activity of both circulating IL-6 and neutrophil counts in untrained adults. These immune and inflammatory responses to a single bout of exercise may be linked to a range of health benefits.

Cardiovascular risk factors cause premature rarefaction of the collateral circulation and greater ischemic tissue injury

RATIONALE

Collaterals lessen tissue injury in occlusive disease. However, aging causes progressive decline in their number and smaller diameters in those that remain (collateral rarefaction), beginning at 16 months of age in mice (i.e., middle age), and worse ischemic injury-effects that are accelerated in even 3-month-old eNOS(-/-) mice. These findings have found indirect support in recent human studies.

OBJECTIVE

We sought to determine whether other cardiovascular risk factors (CVRFs) associated with endothelial dysfunction cause collateral rarefaction, investigate possible mechanisms, and test strategies for prevention.

METHODS AND RESULTS

Mice with nine different models of CVRFs of 4-12 months of age were assessed for number and diameter of native collaterals in skeletal muscle and brain and for collateral-dependent perfusion and ischemic injury after arterial occlusion. Hypertension caused collateral rarefaction whose severity increased with duration and level of hypertension, accompanied by greater hindlimb ischemia and cerebral infarct volume. Chronic treatment of wild-type mice with L-N (G)-nitro-arginine methylester caused similar rarefaction and worse ischemic injury which were not prevented by lowering arterial pressure with hydralazine. Metabolic syndrome, hypercholesterolemia, diabetes mellitus, and obesity also caused collateral rarefaction. Neither chronic statin treatment nor exercise training lessened hypertension-induced rarefaction.

CONCLUSION

Chronic CVRF presence caused collateral rarefaction and worse ischemic injury, even at relatively young ages. Rarefaction was associated with increased proliferation rate of collateral endothelial cells, effects that may promote accelerated endothelial cell senescence.

Physical activity in overweight and obese adolescents: systematic review of the effects on physical fitness components and cardiovascular risk factors

BACKGROUND

The increasing prevalence of obesity in the pediatric age range has become a major concern. Studies have investigated the role of physical activity (PA) to prevent obesity in this population. However, previous reviews did not focus on the effects of PA in overweight/obese adolescents on physical fitness and risk factors for cardiovascular disease altogether.

OBJECTIVE

The present systematic review analyzed trials investigating the effect of PA on aerobic capacity, muscle strength, body composition, hemodynamic variables, biochemical markers, and endothelial function in obese/overweight adolescents.

METHODS

PubMed, LILACS, Web of Science, Scopus (including Embase), and SPORTDiscus databases were searched for relevant reports without time limits. Inclusion criteria included studies published in English, with overweight and obese adolescents aged 12-17 years. The review was registered (Number CRD42013004632) on PROSPERO, the International Prospective Register of Systematic Reviews.

RESULTS

The results indicated that PA is associated with significant and beneficial changes in fat percentage, waist circumference, systolic blood pressure, insulin, low-density lipoprotein cholesterol, and total cholesterol, as well as with small non-significant changes in diastolic blood pressure, glucose, and high-density lipoprotein cholesterol.

CONCLUSION

Although limited, results from controlled trials suggest that PA intervention may improve physical fitness and risk factors for cardiovascular disease in adolescents who are overweight or obese.

Physical activity and resting pulse rate in older adults: findings from a randomized controlled trial

BACKGROUND

Elevated resting pulse rate (RPR) is a well-recognized risk factor for adverse outcomes. Epidemiological evidence supports the beneficial effects of regular exercise for lowering RPR, but studies are mainly confined to persons younger than 65 years. We set out to evaluate the utility of a physical activity (PA) intervention for slowing RPR among older adults.

METHODS

A total of 424 seniors (ages 70-89 years) were randomized to a moderate intensity PA intervention or an education-based "successful aging" health program. Resting pulse rate was assessed at baseline, 6 months, and 12 months. Longitudinal differences in RPR were evaluated between treatment groups using generalized estimating equation models, reporting unstandardized β coefficients with robust SEs.

RESULTS

Increased frequency and duration of aerobic training were observed for the PA group at 6 and 12 months as compared with the successful aging group (P < .001). In both groups, RPR remained unchanged over the course of the 12-month study period (P = .67). No significant improvement was observed (β [SE] = 0.58 [0.88]; P = .51) for RPR when treatment groups were compared using the generalized estimating equation method. Comparable results were found after omitting participants with a pacemaker, cardiac arrhythmia, or who were receiving β-blockers.

CONCLUSIONS

Twelve months of moderate intensity aerobic training did not improve RPR among older adults. Additional studies are needed to determine whether PA of longer duration and/or greater intensity can slow RPR in older persons.

Understanding the relationships between the physical environment and physical activity in older adults: a systematic review of qualitative studies

BACKGROUND

While physical activity (PA) provides many physical, social, and mental health benefits for older adults, they are the least physically active age group. Ecological models highlight the importance of the physical environment in promoting PA. However, results of previous quantitative research revealed inconsistencies in environmental correlates of older adults' PA that may be explained by methodological issues. Qualitative studies can inform and complement quantitative research on environment-PA relationships by providing insight into how and why the environment influences participants' PA behaviors. The current study aimed to provide a systematic review of qualitative studies exploring the potential impact of the physical environment on older adults' PA behaviors.

METHODS

A systematic search was conducted in databases of various disciplines, including: health, architecture and urban planning, transportation, and interdisciplinary databases. From 3,047 articles identified in the physical activity, initial search, 31 articles published from 1996 to 2012 met all inclusion criteria. An inductive content analysis was performed on the extracted findings to identify emerging environmental elements related to older adults' PA. The identified environmental elements were then grouped by study methodologies [indoor interviews (individual or focus groups) vs spatial methods (photo-voice, observations, walk-along interviews)].

RESULTS

This review provides detailed information about environmental factors that potentially influence older adults' PA behaviors. These factors were categorized into five themes: pedestrian infrastructure, safety, access to amenities, aesthetics, and environmental conditions. Environmental factors especially relevant to older adults (i.e., access to facilities, green open spaces and rest areas) tended to emerge more frequently in studies that combined interviews with spatial qualitative methods.

CONCLUSIONS

Findings showed that qualitative research can provide in-depth information on environmental elements that influence older adults' PA. Future qualitative studies on the physical environment and older adults' PA would benefit from combining interviews with more spatially-oriented methods. Multidisciplinary mixed-methods studies are recommended to establish quantitative relationships complemented with in-depth qualitative information.