Journal of Applied Physiology AJP: Gastrointestinal and Liver Physiology
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J Appl Physiol 105: 774, 2008; doi:10.1152/japplphysiol.00095.2008
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LETTER TO THE EDITOR

Commentary on Viewpoint: Exercise and cardiovascular risk reduction: Time to update the rationale for exercise?

TO THE EDITOR: I enjoyed Green et al.'s Viewpoint (1) on exercise and cardiovascular risk reduction suggesting that endothelial function improvement underlies much of the lower risk attributed to exercise training. I would be surprised if substantial opposition to this notion surfaced. We certainly know that exercise reduces risk and also improves endothelial function. This letter simply asks why wasn't the 2000 NEJM paper by Hambrecht et al. (2) discussed by Green et al? Much of Green et al.'s arguments are based on studies evaluating vessels other than coronary arteries. It is not clear how cardiac event risk would be directly reduced by endothelial improvement in other vascular beds (other than by blood pressure reduction). It would seem that the biggest bang for the exercise buck in terms of cardiovascular risk reduction would come from enhanced coronary endothelial function, and the Hambrecht paper above tackles this head-on in humans. Since it is unlikely that Green et al. were unaware of the Hambrecht paper, one wonders if there may be a concern with that study. If so, it would be important for Green et al. to explain it.

FOOTNOTES


Address for reprint requests and other correspondence: P. D. Wagner, 9500 Gilman Drive, Dept. 0623A Medical Teaching Facility, Univ. of California, San Diego, CA 92093-0623 (e-mail: pdwagner{at}ucsd.edu)

REFERENCES

  1. Green DJ, O'Driscoll G, Joyner MJ, Cable NT. Viewpoint: Exercise and cardiovascular risk reduction: Time to update the rationale for exercise? J Appl Physiol; doi:10.1152/japplphysiol.01028.2007.[Free Full Text]
  2. Hambrecht R, Wolf A, Gielen S, Linke A, Hofer J, Erbs S, Schoene N, Schuler G. Effect of exercise on coronary endothelial function in patients with coronary artery disease. N Engl J Med 342: 454–460, 2000.[Abstract/Free Full Text]

Peter D. Wagner
 University of California, San Diego, California





This Article
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