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Exercise, Vascular Wall and Cardiovascular Diseases

An Update (Part 1)

  • Review Article
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Abstract

Cardiovascular disease (CVD) remains the leading cause of morbidity and premature mortality in both women and men in most industrialized countries, and has for some time also established a prominent role in developing nations. In fact, obesity, diabetes mellitus and hypertension are now commonplace even in children and youths. Regular exercise is rapidly gaining widespread advocacy as a preventative measure in schools, medical circles and in the popular media. There is overwhelming evidence garnered from a number of sources, including epidemiological, prospective cohort and intervention studies, suggesting that CVD is largely a disease associated with physical inactivity. A rapidly advancing body of human and animal data confirms an important beneficial role for exercise in the prevention and treatment of CVD.

In Part 1 of this review we discuss the impact of exercise on CVD, and we highlight the effects of exercise on (i) endothelial function by regulation of endothelial genes mediating oxidative metabolism, inflammation, apoptosis, cellular growth and proliferation, increased superoxide dismutase (SOD)-1, down-regulation of p67phox, changes in intracellular calcium level, increased vascular endothelial nitric oxide synthase (eNOS), expression and eNOS Ser-1177 phosphorylation; (ii) vascular smooth muscle function by either an increased affinity of the Ca2+ extrusion mechanism or an augmented Ca2+ buffering system by the superficial sarcoplasmic reticulum to increase Ca2+ sequestration, increase in K+ channel activity and/or expression, and increase in L-type Ca2+ current density; (iii) antioxidant systems by elevation of Mn-SOD, Cu/Zn-SOD and catalase, increases in glutathione peroxidase activity and activation of vascular nicotinamide adenine dinucleotide phosphate [(NAD(P)H] oxidase and p22phox expression; (iv) heat shock protein (HSP) expression by stimulating HSP70 expression in myocardium, skeletal muscle and even in human leucocytes, probably through heat shock transcription factor 1 activity; (v) inflammation by reducing serum inflammatory cytokines such as high-sensitivity C-reactive protein (hCRP), interleukin (IL)-6, IL-18 and tumour necrosis factor-α and by regulating Toll-like receptor 4 pathway.

Exercise also alters vascular remodelling, which involves two forms of vessel growth including angiogenesis and arteriogenesis. Angiogenesis refers to the formation of new capillary networks. Arteriogenesis refers to the growth of pre-existent collateral arterioles leading to formation of large conductance arteries that are well capable to compensate for the loss of function of occluded arteries. Another aim of this review is to focus on exercise-related cardiovascular protection against CVD and associated risk factors such as aging, coronary heart disease, hypertension, heart failure, diabetes mellitus and peripheral arterial diseases mediated by vascular remodelling. Lastly, this review examines the benefits of exercise in mitigating pre-eclampsia during pregnancy by mechanisms that include improved blood flow, reduced blood pressure, enhanced placental growth and vascularity, increased activity of antioxidant enzymes, reduced oxidative stress and restored vascular endothelial dysfunction.

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Acknowledgements

We are thankful to Prof. Bruce McManus and Dr Jonathan Wanagat for their helpful comments and suggestions on this manuscript. This study was funded by CUHK Direct Grant (2041380), Research Grants Council of Hong Kong SAR, CUHK Li Ka Shing Institute of Health Sciences, CUHK Focused Investment Scheme, and The Canadian Heart and Stroke Foundation (IL). LMY and FPL were supported by these grants. The authors have no conflicts of interest directly relevant to the contents of this review.

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Authors and Affiliations

  1. Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong, China

    Fung Ping Leung, Lai Ming Yung, Xiaoqiang Yao &  Yu Huang

  2. Institute of Vascular Medicine, Chinese University of Hong Kong, Hong Kong, China

    Xiaoqiang Yao &  Yu Huang

  3. Department of Physiology, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong, China

    Fung Ping Leung, Lai Ming Yung, Xiaoqiang Yao &  Yu Huang

  4. Department of Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada

    Ismail Laher

  5. Department of Biochemistry, Chinese University of Hong Kong, Hong Kong, China

    Zhen Yu Chen

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  1. Fung Ping Leung
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  2. Lai Ming Yung
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  4. Xiaoqiang Yao
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  6. Yu Huang
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Correspondence to Yu Huang.

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Leung, F.P., Yung, L.M., Laher, I. et al. Exercise, Vascular Wall and Cardiovascular Diseases. Sports Med 38, 1009–1024 (2008). https://doi.org/10.2165/00007256-200838120-00005

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