Kate S. Early

The Effects of Exercise Training on Brachial Artery Flow-Mediated Dilation: A Meta-analysis.

PURPOSE: Flow-mediated dilation, a barometer of cardiovascular (CV) health, is reported to increase with exercise training (ET); however, the potential moderating factors of ET are not clear to date. The purpose of this study was to determine the effect of ET assessed by brachial artery flow-mediated dilation (BAFMD). METHODS: Authors searched PubMed between January 1999 and December 2013, bibliographies, and reviews to identify studies examining ET and BAFMD. Two independent reviewers extracted quality, descriptive, exercise, and outcome data of eligible studies. Data were presented as weighted effect sizes (ESs) and 95% confidence limits. RESULTS: Analysis included 66 studies reporting BAFMD data (1865 ET and 635 control subjects). Overall, ET had significant improvements in BAFMD compared with controls (P < .0001). Exercise training at higher ET intensities resulted in a greater increase in BAFMD (9.29; 95% CI, 5.09-13.47) than lower ET intensities (3.63; 95% CI, −0.56 to 7.83) or control (−0.42; 95% CI, −2.06 to 1.21). Subjects whose ET duration was ≥150 min/wk (11.33; 95% CI, 7.15-15.51) had a significant improvement in BAFMD compared with those with <150 min/wk (4.79; 95% CI, 3.08-6.51) or control (−0.30; 95% CI, −1.99 to 1.39). Age (P = .11) and baseline artery diameter (P = .31) did not modify the BAFMD response to ET. CONCLUSION: Exercise training contributes to a significant increase in BAFMD. These results provide indirect evidence that ET alters a well-known factor associated with the primary and secondary prevention of CV diseases. Exercise training interventions, including greater intensity and duration, may optimize the increase in BAFMD.

Free‐living, continuous hypo‐hydration, and cardiovascular response to exercise in a heated environment

Chronic dehydration (DEH) and heat stress combined with poor cardiovascular (CV) health may influence physiological responses to exercise. We examined the effects of free‐living induced hypo‐hydration on physiological responses to exercise in a heated environment and whether resting CV health is related to these changes. Participants (N = 16, 20.6 ± 1.2 years) were randomized to 3 days of voluntary fluid restriction (DEH) or intake (hydration [HYD]) followed by an exercise bout. CV health was assessed by flow‐mediated dilation (FMD), pulse wave analysis, and heart rate variability (HRV). HYD was assessed by weight, urine color, and specific gravity (USG). Exercise trials were conducted in a heated environment (30.3 ± 0.8°C, 27.4 ± 7.4% RH) on a cycle ergometer for 30 min. Heart rate (HR), weighted skin (Tsk) and mean body temperature (Tb) and skin blood flow (SBF) were assessed during exercise. Pre‐exercise weight (P < 0.005), urine color, and USG (P < 0.001) were different in between trials. HR was greater in DEH (153 ± 26 bpm) versus HYD (144 ± 23 bpm, P = 0.02) after exercise. No group differences were found, but a time interaction P < 0.001) for all temperature responses and time‐by‐trial interaction for Tre (P < 0.01) and Tsk (P < 0.001) was observed. Greater changes in Tre (P = 0.02) and Tsk (P < 0.01) were associated with increased FMD. Free‐living, continuous DEH alters weight, blood, and urine markers of HYD as well as HR response during exercise. Resting CV health was related to increased change in Tre and Tsk, suggesting CV health plays a role in the mechanism of heat dissipation when DEH even in college‐age men and women.