The Effect of Exercise on Different Body Systems, Especially the Heart and Various Components of Blood
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Abstract
It is widely accepted that regular physical activity is beneficial for cardiovascular health. Frequent exercise is robustly associated with a decrease in cardiovascular mortality as well as the risk of developing cardiovascular disease. Physically active individuals have lower blood pressure, higher insulin sensitivity, and a more favorable plasma lipoprotein profile. Animal models of exercise show that repeated physical activity suppresses atherogenesis and increases the availability of vasodilatory mediators such as nitric oxide. Exercise has also been found to have beneficial effects on the heart. Acutely, exercise increases cardiac output and blood pressure, but individuals adapted to exercise show lower resting heart rate and cardiac hypertrophy. Both cardiac and vascular changes have been linked to a variety of changes in tissue metabolism and signaling, although our understanding of the contribution of the underlying mechanisms remains incomplete. Even though moderate levels of exercise have been found to be consistently associated with a reduction in cardiovascular disease risk, there is evidence to suggest that continuously high levels of exercise (e.g., marathon running) could have detrimental effects on cardiovascular health. Nevertheless, a specific dose response relationship between the extent and duration of exercise and the reduction in cardiovascular disease risk and mortality remains unclear.
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References
CDC N (2015). Underlying Cause of Death 1999-2013 on CDC WONDER Online Database, Released 2015. Data are From the Multiple Cause of Death Files, 1999-2013, as Compiled From Data Provided by the 57 Vital Statistics Jurisdictions Through the Vital Statistics Cooperative Program (Accessed Feb. 3, 2015).
Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation (2017) 135:e146–603. 10.1161/CIR.0000000000000485 [DOI] [PMC free article] [PubMed] [Google Scholar]
Roth GA, Forouzanfar MH, Moran AE, Barber R, Nguyen G, Feigin VL, et al. Demographic and epidemiologic drivers of global cardiovascular mortality. N Engl J Med. (2015) 372:1333–41. 10.1056/NEJMoa1406656 [DOI] [PMC free article] [PubMed] [Google Scholar]
Paffenbarger RS, Jr, Hyde RT, Wing AL, Hsieh CC. Physical activity, all-cause mortality, and longevity of college alumni. N Engl J Med. (1986) 314:605–13. 10.1056/NEJM198603063141003 [DOI] [PubMed] [Google Scholar]
Blair SN, Kampert JB, Kohl HW, III, Barlow CE, Macera CA, Paffenbarger RS, Jr, et al. Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA (1996) 276:205–10. 10.1001/jama.1996.03540030039029 [DOI] [PubMed] [Google Scholar]
Stevens J, Cai J, Evenson KR, Thomas R. Fitness and fatness as predictors of mortality from all causes and from cardiovascular disease in men and women in the lipid research clinics study. Am J Epidemiol. (2002) 156:832–41. 10.1093/aje/kwf114 [DOI] [PubMed] [Google Scholar]
Hu FB, Willett WC, Li T, Stampfer MJ, Colditz GA, Manson JE. Adiposity as compared with physical activity in predicting mortality among women. N Engl J Med. (2004) 351:2694–703. 10.1056/NEJMoa042135 [DOI] [PubMed] [Google Scholar]
Vella CA, Allison MA, Cushman M, Jenny NS, Miles MP, Larsen B, et al. Physical activity and adiposity-related inflammation: the MESA. Med Sci Sports Exerc. (2017) 49:915–21. 10.1249/MSS.0000000000001179 [DOI] [PMC free article] [PubMed] [Google Scholar]
Florido R, Kwak L, Lazo M, Nambi V, Ahmed HM, Hegde SM, et al. Six-year changes in physical activity and the risk of incident heart failure: ARIC study. Circulation (2018) 137:2142–51.
Moholdt T, Lavie CJ, Nauman J. Sustained physical activity, not weight loss, associated with improved survival in coronary heart disease. J Am Coll Cardiol. (2018) 71:1094–101.
Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. (1985) 100:126–31.
Haskell WL. The influence of exercise on the concentrations of triglyceride and cholesterol in human plasma. Exerc Sport Sci Rev. (1984) 12:205–44.
Fuster V, Gotto AM, Libby P, Loscalzo J, McGill HC. 27th Bethesda Conference: matching the intensity of risk factor management with the hazard for coronary disease events. Task Force 1. Pathogenesis of coronary disease: the biologic role of risk factors. J Am Coll Cardiol. (1996) 27:964–76.
Leon AS, Sanchez OA. Response of blood lipids to exercise training alone or combined with dietary intervention. Med Sci Sports Exerc. (2001) 33(Suppl. 6):S502–15; discussion S528–509.
Kraus WE, Houmard JA, Duscha BD, Knetzger KJ, Wharton MB, McCartney JS, et al. Effects of the amount and intensity of exercise on plasma lipoproteins. N Engl J Med. (2002) 347:1483–92.
Gordon T, Castelli WP, Hjortland MC, Kannel WB, Dawber TR. High density lipoprotein as a protective factor against coronary heart disease. The Framingham Study. Am J Med. (1977) 62:707–14.
Assmann G, Schulte H. Relation of high-density lipoprotein cholesterol and triglycerides to incidence of atherosclerotic coronary artery disease (the PROCAM experience). Prospective Cardiovascular Munster study. Am J Cardiol. (1992) 70:733–7.
Schwartz GG, Olsson AG, Abt M, Ballantyne CM, Barter PJ, Brumm J, et al. Effects of dalcetrapib in patients with a recent acute coronary syndrome. N Engl J Med. (2012) 367:2089–99. 10.1056/NEJMoa1206797 [DOI] [PubMed] [Google Scholar]
Group HTC, Landray MJ, Haynes R, Hopewell JC, Parish S, Aung T, et al. Effects of extended-release niacin with laropiprant in high-risk patients. N Engl J Med. (2014) 371:203–12. 10.1056/NEJMoa1300955 [DOI] [PubMed] [Google Scholar]
Du XM, Kim MJ, Hou L, Le Goff W, Chapman MJ, Van Eck M, et al. HDL particle size is a critical determinant of ABCA1-mediated macrophage cellular cholesterol export. Circ Res. (2015) 116:1133–42. 10.1161/CIRCRESAHA.116.305485 [DOI] [PubMed] [Google Scholar]
Sarzynski MA, Ruiz-Ramie JJ, Barber JL, Slentz CA, Apolzan JW, McGarrah RW, et al. Effects of increasing exercise intensity and dose on multiple measures of HDL (High-Density Lipoprotein) function. Arterioscler Thromb Vasc Biol. (2018) 38:943–52. 10.1161/ATVBAHA.117.310307 [DOI] [PMC free article] [PubMed] [Google Scholar]
Lee IM, Paffenbarger RS, Jr, Hennekens CH. Physical activity, physical fitness and longevity. Aging (1997) 9:2–11. 10.1007/BF03340123 [DOI] [PubMed] [Google Scholar]
Sesso HD, Paffenbarger RS, Jr, Lee IM. Physical activity and coronary heart disease in men: the Harvard Alumni Health Study. Circulation (2000) 102:975–80. 10.1161/01.CIR.102.9.975 [DOI] [PubMed] [Google Schola
Blair SN, Jackson AS. Physical fitness and activity as separate heart disease risk factors: a meta-analysis. Med Sci Sports Exerc. (2001) 33:762–4.
Thompson PD, Buchner D, Pina IL, Balady GJ, Williams MA, Marcus BH, et al. Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: a statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity). Circulation (2003) 107:3109–16.
Hambrecht R, Niebauer J, Marburger C, Grunze M, Kalberer B, Hauer K, et al. Various intensities of leisure time physical activity in patients with coronary artery disease: effects on cardiorespiratory fitness and progression of coronary atherosclerotic lesions. J Am Coll Cardiol. (1993) 22:468–77.
Hambrecht R, Adams V, Erbs S, Linke A, Krankel N, Shu Y, et al. Regular physical activity improves endothelial function in patients with coronary artery disease by increasing phosphorylation of endothelial nitric oxide synthase. Circulation (2003) 107:3152–8.
Pynn M, Schafer K, Konstantinides S, Halle M. Exercise training reduces neointimal growth and stabilizes vascular lesions developing after injury in apolipoprotein e-deficient mice. Circulation (2004) 109:386–92. 10.1161/01.CIR.0000109500.03050.7C [DOI] [PubMed] [Google Scholar]
Laufs U, Wassmann S, Czech T, Munzel T, Eisenhauer M, Bohm M, et al. Physical inactivity increases oxidative stress, endothelial dysfunction, and atherosclerosis. Arterioscler Thromb Vasc Biol. (2005) 25:809–14.
Matsumoto Y, Adams V, Jacob S, Mangner N, Schuler G, Linke A. Regular exercise training prevents aortic valve disease in low-density lipoprotein-receptor-deficient mice. Circulation (2010) 121:759–67.
Ginsberg HN. Insulin resistance and cardiovascular disease. J Clin Invest. (2000) 106:453–8. 10.1172/JCI10762 [DOI] [PMC free article] [PubMed] [Google Scholar]
Lewis GF. Fatty acid regulation of very low density lipoprotein production. Curr Opin Lipidol. (1997) 8:146–53. 10.1097/00041433-199706000-00004 [DOI] [PubMed] [Google Scholar]
Borggreve SE, De Vries R, Dullaart RP. Alterations in high-density lipoprotein metabolism and reverse cholesterol transport in insulin resistance and type 2 diabetes mellitus: role of lipolytic enzymes, lecithin:cholesterol acyltransferase and lipid transfer proteins. Eur J Clin Invest. (2003) 33:1051–69. 10.1111/j.1365-2362.2003.01263.x [DOI] [PubMed] [Google Scholar]
Steinberg HO, Brechtel G, Johnson A, Fineberg N, Baron AD. Insulin-mediated skeletal muscle vasodilation is nitric oxide dependent. A novel action of insulin to increase nitric oxide release. J Clin Invest. (1994) 94:1172–9. 10.1172/JCI117433 [DOI] [PMC free article] [PubMed] [Google Scholar]
Zeng G, Quon MJ. Insulin-stimulated production of nitric oxide is inhibited by wortmannin. Direct measurement in vascular endothelial cells. J Clin Invest. (1996) 98:894–8. 10.1172/JCI118871 [DOI] [PMC free article] [PubMed] [Google Scholar]
Potenza MA, Marasciulo FL, Chieppa DM, Brigiani GS, Formoso G, Quon MJ, et al. Insulin resistance in spontaneously hypertensive rats is associated with endothelial dysfunction characterized by imbalance between NO and ET-1 production. Am J Physiol Heart Circ Physiol. (2005) 289:H813–22. 10.1152/ajpheart.00092.2005 [DOI] [PubMed]
Marasciulo FL, Montagnani M, Potenza MA. Endothelin-1: the yin and yang on vascular function. Curr Med Chem. (2006) 13:1655–65. 10.2174/092986706777441968 [DOI] [PubMed] [Google Scholar]
Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. JAMA (2002) 287:2570–81. 10.1001/jama.287.19.2570 [DOI] [PubMed] [Google Scholar]
Wang CC, Gurevich I, Draznin B. Insulin affects vascular smooth muscle cell phenotype and migration via distinct signaling pathways. Diabetes (2003) 52:2562–9. 10.2337/diabetes.52.10.2562 [DOI] [PubMed] [Google Scholar]
Schleicher ED, Wagner E, Nerlich AG. Increased accumulation of the glycoxidation product N(epsilon)-(carboxymethyl)lysine in human tissues in diabetes and aging. J Clin Invest. (1997) 99:457–68. 10.1172/JCI119180 [DOI] [PMC free article] [PubMed] [Google Scholar]
Sell DR, Monnier VM. Molecular basis of arterial stiffening: role of glycation - a mini-review. Gerontology (2012) 58:227–37. 10.1159/000334668 [DOI] [PubMed] [Google Scholar]
Wallberg-Henriksson H, Gunnarsson R, Henriksson J, DeFronzo R, Felig P, Ostman J, et al. Increased peripheral insulin sensitivity and muscle mitochondrial enzymes but unchanged blood glucose control in type I diabetics after physical training. Diabetes (1982) 31:1044–50. 10.2337/diacare.31.12.1044 [DOI] [PubMed] [Google Scholar]
Trovati M, Carta Q, Cavalot F, Vitali S, Banaudi C, Lucchina PG, et al. Influence of physical training on blood glucose control, glucose tolerance, insulin secretion, and insulin action in non-insulin-dependent diabetic patients. Diabetes Care (1984) 7:416–20. 10.2337/diacare.7.5.416 [DOI] [PubMed] [Google Scholar]
Koivisto VA, Yki-Jarvinen H, DeFronzo RA. Physical training and insulin sensitivity. Diabetes Metab Rev (1986) 1:445–81. 10.1002/dmr.5610010407 [DOI] [PubMed] [Google Scholar]
Newsom SA, Everett AC, Hinko A, Horowitz JF. A single session of low-intensity exercise is sufficient to enhance insulin sensitivity into the next day in obese adults. Diabetes Care (2013) 36:2516–22. 10.2337/dc12-2606 [DOI] [PMC free article] [PubMed] [Google Scholar
Richter EA, Garetto LP, Goodman MN, Ruderman NB. Muscle glucose metabolism following exercise in the rat: increased sensitivity to insulin. J Clin Invest. (1982) 69:785–93. 10.1172/JCI110517 [DOI] [PMC free article] [PubMed] [Google Scholar]
Craig BW, Garthwaite SM, Holloszy JO. Adipocyte insulin resistance: effects of aging, obesity, exercise, and food restriction. J Appl Physiol. (1987) 62:95–100. 10.1152/jappl.1987.62.1.95 [DOI] [PubMed] [Google Scholar]
Zheng C, Liu Z. Vascular function, insulin action, and exercise: an intricate interplay. Trends Endocrinol Metab. (2015) 26:297–304.
Olver TD, McDonald MW, Klakotskaia D, Richardson RA, Jasperse JL, Melling CWJ, et al. A chronic physical activity treatment in obese rats normalizes the contributions of ET-1 and NO to insulin-mediated posterior cerebral artery vasodilation. J Appl Physiol. (2017) 122:1040–50.
Kim Y, Inoue T, Nakajima R, Nakae K, Tamura T, Tokuyama K, et al. Effects of endurance training on gene expression of insulin signal transduction pathway. Biochem Biophys Res Commun. (1995) 210:766–73. 10.1006/bbrc.1995.1725
Houmard JA, Shaw CD, Hickey MS, Tanner CJ. Effect of short-term exercise training on insulin-stimulated PI 3-kinase activity in human skeletal muscle. Am J Physiol. (1999) 277(6 Pt 1):E1055–60.
Kirwan JP, del Aguila LF, Hernandez JM, Williamson DL, O'Gorman DJ, Lewis R, et al. Regular exercise enhances insulin activation of IRS-1-associated PI3-kinase in human skeletal muscle. J Appl Physiol (2000) 88:797–803
Richter EA, Mikines KJ, Galbo H, Kiens B. Effect of exercise on insulin action in human skeletal muscle. J Appl Physiol. (1989) 66:876–85.
Goodyear LJ, King PA, Hirshman MF, Thompson CM, Horton ED, Horton ES. Contractile activity increases plasma membrane glucose transporters in absence of insulin. Am J Physiol. (1990) 258(4 Pt 1):E667–72. 10.1152/ajpendo.1990.258.4.E667 [DOI] [PubMed] [Google Scholar]
Gao J, Ren J, Gulve EA, Holloszy JO. Additive effect of contractions and insulin on GLUT-4 translocation into the sarcolemma. J Appl Physiol. (1994) 77:1597–601. 10.1152/jappl.1994.77.4.1597 [DOI] [PubMed] [Google Scholar]
Hotamisligil GS, Murray DL, Choy LN, Spiegelman BM. Tumor necrosis factor alpha inhibits signaling from the insulin receptor. Proc Natl Acad Sci USA. (1994) 91:4854–8. 10.1073/pnas.91.11.4854 [DOI] [PMC free article] [PubMed] [Google Scholar]
del Aguila LF, Claffey KP, Kirwan JP. TNF-alpha impairs insulin signaling and insulin stimulation of glucose uptake in C2C12 muscle cells. Am J Physiol. (1999) 276(Pt 1):E849–55. [DOI] [PubMed] [Google Scholar]
Del Aguila LF, Krishnan RK, Ulbrecht JS, Farrell PA, Correll PH, Lang CH, et al. Muscle damage impairs insulin stimulation of IRS-1, PI 3-kinase, and Akt-kinase in human skeletal muscle. Am J Physiol Endocrinol Metab. (2000) 279:E206–12.
Kirwan JP, del Aguila LF. Insulin signalling, exercise and cellular integrity. Biochem Soc Trans. (2003). 31(Pt 6):1281–5. 10.1042/bst0311281 [DOI] [PubMed] [Google Scholar]
Shepherd JT. Circulatory response to exercise in health. Circulation (1987) 76(Pt 2):VI3–10. [PubMed] [Google Scholar]
Fagard RH. Exercise characteristics and the blood pressure response to dynamic physical training. Med Sci Sports Exerc. (2001) 33(Suppl. 6):S484–92.
Hardy ST, Loehr LR, Butler KR, Chakladar S, Chang PP, Folsom AR, et al. Reducing the blood pressure-related burden of cardiovascular disease: impact of achievable improvements in blood pressure prevention and control. J Am Heart Assoc. (2015) 4:e002276.
Cox KL, Puddey IB, Morton AR, Burke V, Beilin LJ, McAleer M. Exercise and weight control in sedentary overweight men: effects on clinic and ambulatory blood pressure. J Hypertens. (1996) 14:779–90.
Bacon SL, Sherwood A, Hinderliter A, Blumenthal JA. Effects of exercise, diet and weight loss on high blood pressure. Sports Med. (2004) 34:307–16.
Fagard RH. Exercise is good for your blood pressure: effects of endurance training and resistance training. Clin Exp Pharmacol Physiol. (2006) 33:853–6.
Niebauer J, Cooke JP. Cardiovascular effects of exercise: role of endothelial shear stress. J Am Coll Cardiol. (1996) 28:1652–60. 10.1016/S0735-1097(96)00393-2 [DOI] [PubMed] [Google Scholar]
Dominiczak AF, Bohr DF. Nitric oxide and its putative role in hypertension. Hypertension (1995) 25:1202–11. 10.1161/01.HYP.25.6.1202 [DOI] [PubMed] [Google Scholar]
Kim IJ, Bae J, Lim SW, Cha DH, Cho HJ, Kim S, et al. Influence of endothelial nitric oxide synthase gene polymorphisms (-786T>C, 4a4b, 894G>T) in Korean patients with coronary artery disease. Thromb Res. (2007) 119:579–85.
Cruz-Gonzalez I, Corral E, Sanchez-Ledesma M, Sanchez-Rodriguez A, Martin-Luengo C, Gonzalez-Sarmiento R. Association between -T786C NOS3 polymorphism and resistant hypertension: a prospective cohort study. BMC Cardiovasc Disord. (2009) 9:35.
Zago AS, Park JY, Fenty-Stewart N, Kokubun E, Brown MD. Effects of aerobic exercise on the blood pressure, oxidative stress and eNOS gene polymorphism in pre-hypertensive older people. Eur J Appl Physiol. (2010) 110:825–32.
Kuru O, Senturk UK, Kocer G, Ozdem S, Baskurt OK, Cetin A, et al. Effect of exercise training on resistance arteries in rats with chronic NOS inhibition. J Appl Physiol. (2009) 107:896–902.
Wilund KR. Is the anti-inflammatory effect of regular exercise responsible for reduced cardiovascular disease? Clin Sci. (2007) 112:543–55.
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