Journal of Applied Physiology
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J Appl Physiol 105: 775, 2008; doi:10.1152/japplphysiol.90329.2008
8750-7587/08 $8.00
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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: Green and colleagues (2) present an important discussion of the mechanisms by which regular exercise improves cardiovascular health. These authors particularly highlight adaptations of the vasculature in response to regular exercise, although these changes may not explain all of the beneficial responses to exercise. Regular exercise fails to improve endothelial function in some patients who have coronary artery disease for example (5). An equally important effect of regular exercise appears to be adaptation of the autonomic nervous system (ANS). Lower heart rate variability (HRV) is associated with sudden death and coronary heart disease incidence and mortality (1, 4), suggesting that normal or increased ANS function is fundamental for cardiovascular health. Regular exercise induces ANS improvements in an intensity-dependent manner (3), supporting the link between exercise, ANS function, and cardiovascular health. Changes in shear stress during exercise may induce localized vascular changes that increase peripheral feedback to the cardiorespiratory centers and ANS modifications. Significant improvements in the management of cardiovascular disease have resulted from our increasing knowledge of the risk factors of atherosclerosis. The mechanisms underlying the benefit of exercise however require further study. As pointed out by Green and colleagues (2), improved understanding of the interaction between exercise, the vasculature, and the ANS may provide a pathway to important new treatment targets.

FOOTNOTES


Address for reprint requests and other correspondence: A. Leicht, Institute of Sport and Exercise Science, James Cook Univ., Townsville QLD 4811, Australia (e-mail: anthony.leicht{at}jcu.edu.au)

REFERENCES

  1. Carnethon MR, Liao D, Evans GW, Cascio WE, Chambless LE, Rosamond WD, Heiss G. Does the cardiac autonomic response to postural change predict incident coronary heart disease and mortality? The Atherosclerosis Risk in Communities Study. Am J Epidemiol 155: 48–56, 2002.[Abstract/Free Full Text]
  2. 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]
  3. Leicht AS, Allen GD, Hoey AJ. Influence of intensive cycling training on heart rate variability during rest and exercise. Can J Appl Physiol 28: 898–909, 2003.[Web of Science][Medline]
  4. Makikallio TH, Huikuri HV, Makikallio A, Sourander LB, Mitrani RD, Castellanos A, Myerburg RJ. Prediction of sudden cardiac death by fractal analysis of heart rate variability in elderly subjects. J Am Coll Cardiol 37: 1395–1402, 2001.[Abstract/Free Full Text]
  5. Paul JD, Powell TM, Thompson M, Benjamin M, Rodrigo M, Carlow A, Annavajjhala V, Shiva S, Dejam A, Gladwin MT, McCoy JP, Zalos G, Press B, Murphy M, Hill JM, Csako G, Waclawiw MA, Cannon RO 3rd. Endothelial progenitor cell mobilization and increased intravascular nitric oxide in patients undergoing cardiac rehabilitation. J Cardiopulm Rehabil Prev 27: 65–73, 2007.[Medline]

Anthony S. Leicht1
Mikko P. Tulppo2
Jonathan Golledge3
 1Institute of Sport and Exercise Science and 3Vascular Biology Unit, James Cook University, Townsville, Queensland, Australia; and 2Department of Exercise and Medical Physiology, Verve, Oulu, Finland





This Article
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