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J Appl Physiol 105: 778, 2008; doi:10.1152/japplphysiol.00141.2008
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?

CONSIDERING THE ROLE OF SEX IN MODULATING DIRECT EFFECTS OF EXERCISE ON THE VASCULATURE

TO THE EDITOR: We commend the recent publication by Green et al. (2) regarding exercise and cardiovascular disease (CVD). However, we think it important to extend this line of thinking to involve sex-specific mechanisms that may modulate the impact of exercise on CVD, as both the vascular manifestations of CVD as well as the impact of exercise on the vasculature differs between men and women. For example, progression of diabetes in women involves greater endothelial dysfunction than in men (1) and measurements of C-reactive protein suggest that inflammation may play a more substantial role in increasing carotid artery atherosclerosis in women than men (5).

With respect to exercise, Martin et al. (3) found that exercise training resulted in large improvements in peak blood flow and vascular conductance in older men, whereas results in older women were marginally significant and much more variable. Recently we demonstrated that the influence of aerobic fitness on leg blood flow responses to small muscle mass (i.e., knee extensor) exercise in older adults may also be influenced by sex, as high and low VO2max values distinguished leg blood flow responses in older men but not women (4).

Vascular changes associated both with CVD and exercise may be sex specific. Accordingly, the suggestion that "future studies should focus on the direct impacts of exercise on vasculature function (2)" should be broadened such that researchers take into account the role of sex when investigating the direct effects of exercise on the vasculature with respect to reduction of cardiovascular risk.

FOOTNOTES


Address for reprint requests and other correspondence: D. Proctor, 105 Noll Laboratory, Univ. Park, PA 16802 (e-mail: dnp3{at}psu.edu)

REFERENCES

  1. Donahue RP, Rejman K, Rafalson LB, Dmochowski J, Stranges S, Trevisan M. Sex differences in endothelial function markers before conversion to pre-diabetes: does the clock start ticking earlier among women? The Western New York Study. Diabetes Care 30: 354–359, 2007.[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. Martin WH III, Kohrt WM, Malley MT, Korte E, Stoltz S. Exercise training enhances leg vasodilatory capacity of 65-yr-old men and women. J Appl Physiol 69: 1804–1809, 1990.[Abstract/Free Full Text]
  4. Parker BA, Smithmyer SL, Pelberg JA, Mishkin AD, Proctor DN. Sex-specific influence of aging on exercising leg blood flow. J Appl Physiol 104: 655–664, 2008.[Abstract/Free Full Text]
  5. Sander K, Horn CS, Briesenick C, Sander D. High-sensitivity C-reactive protein is independently associated with early carotid artery progression in women but not in men: the INVADE Study. Stroke 38: 2881–2886, 2007.[Abstract/Free Full Text]

Beth Parker
David Proctor
 Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania





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