Arterial Stiffness Response to Regular Aerobic Training in Hypercholesterolemia Patients

Abstract

Physical exercise increase is confirmed as a fundamental treatment for hypercholesterolemia patients, but the effect on the arterial stiffness and oxidative stress is still unclear. 74 hypercholesterolemia patients were divided into 2 groups. The exercise group received dietary recommendations and a 3-month exercise program, prescribed according to their first cardiopulmonary exercise tests(CPET), while the control group only received dietary recommendations. All patients underwent blood tests, CPET and brachial-ankle pulse wave velocity (baPWV) studies at enrollment and at 3 months’ follow-up. At the end of 3 months, there was no change in total cholesterol (TC) level in either group. However, in the exercise group, we found maximal exercise parameters increased and baPWV values declined. Meanwhile, there were significant changes in the level of malondialdehyde, 8-isoprostane-F2_α and superoxide dismutase. Moreover, the change of baPWV was positively correlated with the change of 8-isoprostane-F2_α (r=0.36, P<0.01). In the control group, no change in baPWV or oxidative biomarker was observed. Our findings suggested that regular aerobic exercise could lessen arterial stiffness in hypercholesterolemia patients, even in the context of no obvious TC decrease. During this process, favorable adjustment in oxidative stress might be an important pathway, which remains to be further explored.

Key words

arterial stiffness - aerobic training - hypercholesterolemia - oxidative stress

^# Contributed equally.

• References

• 1 Alghadir AH, Gabr SA, Al-Eisa ES. Effects of moderate aerobic exercise on cognitive abilities and redox state biomarkers in older adults. Oxid Med Cell Longev 2016; 2016: 2545168
• 2 Beltran Valls MR, Dimauro I, Brunelli A, Tranchita E, Ciminelli E, Caserotti P, Duranti G, Sabatini S, Parisi P, Parisi A, Caporossi D. Explosive type of moderate-resistance training induces functional, cardiovascular, and molecular adaptations in the elderly. Age (Dordr) 2014; 36: 759-772
• 3 Brown WJ, McLaughlin D, Leung J, McCaul KA, Flicker L, Almeida OP, Hankey GJ, Lopez D, Dobson AJ. Physical activity and all-cause mortality in older women and men. Br J Sports Med 2012; 46: 664-668
• 4 Cavalcante JL, Lima JA, Redheuil A, Al-Mallah MH. Aortic stiffness: Current understanding and future directions. J Am Coll Cardiol 2011; 57: 1511-1522
• 5 Cervellati C, Bergamini CM. Oxidative damage and the pathogenesis of menopause related disturbances and diseases. Clin Chem Lab Med 2016; 54: 739-753
• 6 Collier SR, Sandberg K, Moody AM, Frechette V, Curry CD, Ji H, Gowdar R, Chaudhuri D, Meucci M. Reduction of plasma aldosterone and arterial stiffness in obese pre- and stage1 hypertensive subjects after aerobic exercise. J Hum Hypertens 2015; 29: 53-57
• 7 Cornelissen VA, Fagard RH. Effects of endurance training on blood pressure, blood pressure-regulating mechanisms, and cardiovascular risk factors. Hypertension 2005; 46: 667-675
• 8 Fujie S, Hasegawa N, Kurihara T, Sanada K, Hamaoka T, Iemitsu M. Association between aerobic exercise training effects of serum adropin level, arterial stiffness, and adiposity in obese elderly adults. Appl Physiol Nutr Metab 2017; 42: 8-14
• 9 Gaesser GA. Exercise for prevention and treatment of cardiovascular disease, type 2 diabetes, and metabolic syndrome. Curr Diab Rep 2007; 7: 14-19
• 10 Harriss DJ, Macsween A, Atkinson G. Standards for ethics in sport and exercise science research: 2018 Update. Int J Sports Med 2017; 38: 1126-1131
• 11 Hasegawa N, Fujie S, Horii N, Uchida M, Kurihara T, Sanada K, Hamaoka T, Iemitsu M. Aerobic exercise training-induced changes in serum C1q/TNF-related protein levels are associated with reduced arterial stiffness in middle-aged and older adults. Am J Physiol Regul Integr Comp Physiol 2018; 314: R94-R101
• 12 Hasegawa N, Fujie S, Kurihara T, Homma T, Sanada K, Sato K, Hamaoka T, Iemitsu M. Effects of habitual aerobic exercise on the relationship between intramyocellular or extramyocellular lipid content and arterial stiffness. J Hum Hypertens 2016; 30: 606-612
• 13 Juránek I, Bezek S. Controversy of free radical hypothesis: Reactive oxygen species–cause or consequence of tissue injury?. Gen Physiol Biophys 2005; 24: 263-278
• 14 Kang SJ, Kim EH, Ko KJ. Effects of aerobic exercise on the resting heart rate, physical fitness, and arterial stiffness of female patients with metabolic syndrome. J Phys Ther Sci 2016; 28: 1764-1768
• 15 Knez WL, Jenkins DG, Coombes JS. The effect of an increased training volume on oxidative stress. Int J Sports Med 2014; 35: 8-13
• 16 Kokkinos P, Myers J, Faselis C, Panagiotakos DB, Doumas M, Pittaras A, Manolis A, Kokkinos JP, Karasik P, Greenberg M, Papademetriou V, Fletcher R. Exercise capacity and mortality in older men: A 20-year follow-up study. Circulation 2010; 122: 790-797
• 17 Lavie CJ, Berra K, Arena R. Formal cardiac rehabilitation and exercise training programs in heart failure: evidence for substantial clinical benefits. J Cardiopulm Rehabil Prev 2013; 33: 209-211
• 18 Montero D, Roche E, Martinez-Rodriguez A. The impact of aerobic exercise training on arterial stiffness in pre- and hypertensive subjects: A systematic review and meta-analysis. Int J Cardiol 2014; 173: 361-368
• 19 Nocon M, Hiemann T, Müller-Riemenschneider F, Thalau F, Roll S, Willich SN. Association of physical activity with all-cause and cardiovascular mortality: A systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil 2008; 15: 239-246
• 20 O'Rourke MF, Franklin SS. Arterial stiffness: Reflections on the arterial pulse. Eur Heart J 2006; 27: 2497-2248
• 21 Park SY, Kwak YS. Impact of aerobic and anaerobic exercise training on oxidative stress and antioxidant defense in athletes. J Exerc Rehabil 2016; 12: 113-117
• 22 Rodrigo R, Libuy M, Feliú F, Hasson D. Oxidative stress-related biomarkers in essential hypertension and ischemia-reperfusion myocardial damage. Dis Markers 2013; 35: 773-790
• 23 Sallam N, Laher I. Exercise modulates oxidative stress and inflammation in aging and cardiovascular diseases. Oxid Med Cell Longev 2016; 2016: 7239639
• 24 San Miguel SM, Opperman LA, Allen EP, Svoboda KK. Reactive oxygen species and antioxidant defense mechanisms in the oral cavity: A literature review. Compend Contin Educ Dent 2011; 32: E10-E15
• 25 Satoh H, Kishi R, Tsutsui H. Metabolic syndrome is a significant and independent risk factor for increased arterial stiffnessin Japanese subjects. Hypertens Res 2009; 32: 1067-1071
• 26 Siasos G, Athanasiou D, Terzis G, Stasinaki A, Oikonomou E, Tsitkanou S, Kolokytha T, Spengos K, Papavassiliou AG, Tousoulis D. Acute effects of different types of aerobic exercise on endothelial function and arterial stiffness. Eur J Prev Cardiol 2016; 23: 1565-1572
• 27 Slentz CA, Houmard JA, Johnson JL, Bateman LA, Tanner CJ, McCartney JS, Duscha BD, Kraus WE. Inactivity, exercise training and detraining, and plasma lipoproteins. STRRIDE: A randomized, controlled study of exercise intensity and amount. J Appl Physiol 2007; 103: 432-442
• 28 Slivovskaja I, Ryliskyte L, Serpytis P, Navickas R, Badarienė J, Celutkiene J, Puronaite R, Ryliskiene K, Cypiene A, Rinkuniene E, Sileikiene V, Petrauskiene B, Juocevicius A, Laucevicius A. Aerobic training effect on arterial stiffness in metabolic syndrome. Am J Med 2018; 131: 148–155
• 29 Sugawara J, Hayashi K, Yokoi T, Cortez-Cooper MY, DeVan AE, Anton MA, Tanaka H. Brachial-ankle pulse wave velocity: An index of central arterial stiffness?. J Hum Hypertens 2005; 19: 401-406
• 30 Tambalis K, Panagiotakos DB, Kavouras SA, Sidossis LS. Responses of blood lipids to aerobic, resistance, and combined aerobic with resistance exercise training: A systematic review of current evidence. Angiology 2009; 60: 614-632
• 31 Townsend RR, Tomiyama H. Arterial Stiffness, kidney function, and chronic kidney disease progression. Pulse1 2013; 1: 123-130
• 32 Van Craenenbroeck AH, Van Craenenbroeck EM, Van Ackeren K, Vrints CJ, Conraads VM, Verpooten GA, Kouidi E, Couttenye MM. Effect of moderate aerobic exercise training on endothelial function and arterial stiffness in CKD stages 3-4: A randomized controlled trial. Am J Kidney Dis 2015; 66: 285-296
• 33 Vlachopoulos C, Aznaouridis K, Terentes-Printzios D, Ioakeimidis N, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with brachial-ankle elasticity index: A systematic review and meta-analysis. Hypertension 2012; 60: 556-562
• 34 Wang Y, Xu D. Effects of aerobic exercise on lipids and lipoproteins. Lipids Health Dis 2017; 16: 132
• 35 Xu L, Jiang CQ, Lam TH, Yue XJ, Cheng KK, Liu B, Jin YL, Zhang WS, Thomas GN. Brachial-ankle pulse wave velocity and cardiovascular risk factors in the non-diabetic and newly diagnosed diabetic Chinese: Guangzhou Biobank Cohort Study-CVD. Diabetes Metab Res Rev 2016; 26: 133-139
• 36 Yamashina A, Tomiyama H, Takeda K, Tsuda H, Arai T, Hirose K, Koji Y, Hori S, Yamamoto Y. Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res 2002; 25: 359-364