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CLINICAL STUDIES

Exercise training enhances endothelial function in young men

Peter Clarkson, BSc, MBBS, MRCP^a, Hugh E. Montgomery, MD, MRCP^*, Michael J. Mullen, MBBS, MRCP^a, Ann E. Donald^a, Amanda J. Powe, RN^a, Teresa Bull, BSc^a, Michael Jubb, BSc, Michael World, FRCP and John E. Deanfield, MBBChir, FRCP^a

^a Cardiothoracic Unit, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
^* Hatter Institute of Cardiovascular Studies, University College Medical Schools, University College Hospital, London, United Kingdom
Physiotherapy Department, Army Training Regiment, Bassingbourn, Cambridgeshire, United Kingdom
Royal Army Medical College, London, United Kingdom

Manuscript received March 24, 1998; revised manuscript received December 1, 1998, accepted January 11, 1999.

Reprint requests and correspondence: Professor J. E. Deanfield, Cardiothoracic Unit, Great Ormond Street for Children NHS Trust, Great Ormond Street, London WC1N 3JH, United Kingdom
paula.hurley{at}gosh-tr.nthames.nhs.uk

OBJECTIVES

The present study was designed to assess whether exercise training can enhance endothelium-dependent dilatation in healthy young men.

BACKGROUND

Exercise has been shown to reduce cardiovascular morbidity and mortality, but the mechanisms for this benefit are unclear. Endothelial dysfunction is an early event in atherogenesis, and animal studies have shown that exercise training can enhance endothelial function.

METHODS

We have examined the effect of a standardized, 10-week, aerobic and anaerobic exercise training program on arterial physiology in 25 healthy male military recruits, aged 17 to 24 (mean 20) years, of average fitness levels. Each subject was studied before starting, and after completing the exercise program. Baseline vascular reactivity was compared with that of 20 matched civilian controls. At each visit, the diameter of the right brachial artery was measured at rest, during reactive hyperemia (increased flow causing endothelium-dependent dilation) and after sublingual glyceryltrinitrate (GTN; an endothelium-independent dilator), using high-resolution external vascular ultrasound.

RESULTS

At baseline, flow-mediated dilatation (FMD) and GTN-mediated dilatation were similar in the exercise and control groups (FMD 2.2 ± 2.4% and 2.4 ± 2.8%, respectively, p = 0.33; GTN 13.4 ± 6.2 vs. 16.7 ± 5.9, respectively, p = 0.53). In the military recruits, FMD improved from 2.2 ± 2.4% to 3.9 ± 2.5% (p = 0.01), with no change in the GTN-mediated dilation (13.4 ± 6.2% vs. 13.9 ± 5.8%, p = 0.31) following the exercise program.

CONCLUSION

Exercise training enhances endothelium-dependent dilation in young men of average fitness. This may contribute to the benefit of regular exercise in preventing cardiovascular disease.

Abbreviations and Acronyms   CAD = coronary artery disease   FMD = flow-mediated dilatation   GTN = glyceryl trinitrate   HDL = high-density lipoprotein   LDL = low-density lipoprotein   NO = nitric oxide   NOS = nitric oxide synthase

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