Endothelial function and physical exercise

Abstract

Endothelial function is a key factor in maintaining vascular health and also serves as a clinical marker for the development and/or progression of arteriosclerosis and cardiovascular disease. In healthy individuals, the stimulus provided by physical exercise improves the functioning of the healthy endothelium, making exercise a very important strategy in preventive medicine. In patients with increased cardiovascular risk or chronic heart disease, the pharmacological therapies currently in use have only a slight corrective effect on endothelial dysfunction, while regular training with physical exercise effectively restores a large part of the endothelial function. This effect of the exercise would be related to the metabolic and mechanical stimulus (shear stress) that brings about the physical effort and that leads to a increased production and/or nitric oxide bioavailability, the main vasodilator factor derived of the endothelium. However, owing to the marked variability in the duration and intensity of exercise studied in experimental protocols and in the types of exercise investigated (continuous or discontinuous aerobic exercise, or resistance training) a great deal of scientific evidence is available that requires systematic and ordered analysis. The objective of this review is, therefore, to summarize the principal phenomena that can explain the improvement in endothelial function observed after an acute session or a systematic program of physical exercise in both healthy individuals and in patients with cardiometabolic risk or cardiovascular disease.