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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: In the primary prevention of cardiovascular disease, the assessment of traditional risk factors and the subsequent calculation of Framingham risk scores are useful initial steps in the stratification of cardiovascular risk. However, a considerable number of at-risk patients cannot be identified on the basis of these conventional risk factors (4). This has prompted the search for new markers of subclinical disease. In this context, clinical measurements of vascular function and structure have gathered enormous attention in recent years. In the excellent article by Green et al. (3), this concept was applied to exercise training by stating that traditional risk factors fail to encompass the cardiovascular benefits of exercise and that direct effects of exercise training on vasculature should not be overlooked. We fully agree with the authors' main point. It has been demonstrated that detectable reductions in vascular function precede significant changes in traditional cardiovascular risk factors (1). Additionally, evaluating vascular function, using such measurements as arterial stiffness and endothelium-dependent vasodilatation, yield clinically significant differences between active and sedentary lifestyles (2, 5). Moreover, aerobic exercise training lowers arterial stiffness and improves endothelial function in the absence of any significant change in traditional risk factors (2, 5). Thus regular exercise has a direct effect on the vascular wall and may be the best strategy for the primary and secondary prevention of vascular disease.

FOOTNOTES

Address for reprint requests and other correspondence: H. Tanaka, 1 Univ. Station, D3700 Austin, TX 78712 (e-mail: htanaka{at}mail.utexas.edu)

REFERENCES

1. Clarkson P, Celermajer DS, Powe AJ, Donald AE, Henry RM, Deanfield JE. Endothelium-dependent dilatation is impaired in young healthy subjects with a family history of premature coronary disease. Circulation 96: 3378–3383, 1997.[Abstract/Free Full Text]
2. DeSouza CA, Shapiro LF, Clevenger CM, Dinenno FA, Monahan KD, Tanaka H, Seals DR. Regular aerobic exercise prevents and restores age-related declines in endothelium-dependent vasodilation in healthy men. Circulation 102: 1351–1357, 2000.[Abstract/Free Full Text]
3. 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.010128.2007.[CrossRef]
4. Greenland P, Smith SC Jr, Grundy SM. Improving coronary heart disease risk assessment in asymptomatic people: role of traditional risk factors and noninvasive cardiovascular tests. Circulation 104: 1863–1867, 2001.[Free Full Text]
5. Tanaka H, Dinenno FA, Monahan KD, Clevenger CM, DeSouza CA, Seals DR. Aging, habitual exercise, and dynamic arterial compliance. Circulation 102: 1270–1275, 2000.[Abstract/Free Full Text]

This Article Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Barnes, J. N. Articles by Tanaka, H. Search for Related Content PubMed PubMed Citation Articles by Barnes, J. N. Articles by Tanaka, H.