Regular exercise significantly reduces cardiovascular risk and helps prevent primary and secondary cardiac events. However, the mechanisms through which exercise affects cardiovascular health remain unclear. This study investigates the acute effects of high-intensity interval training (HIIT) versus moderate-intensity continuous exercise (MOD) on endothelial function and glycemic control in patients with type 2 diabetes (T2D).

The study aimed to compare the acute effects of a single session of HIIT and MOD on endothelial function, hemodynamic parameters, and blood glucose levels in T2D patients.

This was a randomized controlled trial (RCT).

Conducted at the Laboratory of Cardiopulmonary Rehabilitation.

Fifty-seven sedentary patients with type 2 diabetes (39 women and 18 men) participated in the study.

Participants were randomly assigned to either HIIT (10 sprints of 30 s at 85-100% of maximum heart rate, with 1-min active pauses) or MOD (continuous exercise at 60-70% of maximum heart rate for 30 min). Brachial artery flow-mediated dilation (%FMD) and blood glucose levels were measured before and immediately after the sessions.

HIIT significantly increased %FMD (9.3 ± 5.3% vs 20.05 ± 9.3%, p < 0.01) and reduced glucose levels (189 [106-335] mg/dL vs 149 [70-448] mg/dL, p < 0.01). Although MOD also showed positive responses, HIIT yielded more pronounced improvements in endothelial function.

HIIT is more effective for cardiovascular protection than MOD, although both exercises improve glycemic control in T2D patients. Higher %FMD is associated with better physical capacity and heart rate recovery, indicating a favorable prognosis.

Epidemiological evidence suggests an inverse association between anthocyanin consumption and cardiovascular disease (CVD) risk. Modulation of vascular function and hemostasis may contribute to this, but there is limited clinical evidence.

The present study investigated the acute effects of an anthocyanin-rich blackcurrant beverage, compared with a matched placebo, on selected markers of CVD risk in healthy middle-aged subjects in response to a high-fat meal.

Twenty-three volunteers aged 39.9 ± 8.1 years (BMI 22.9 ± 2.3 kg/m2) completed a double-blind, randomized, placebo-controlled, crossover trial. Volunteers consumed either 200 mL blackcurrant beverage (744 mg polyphenols comprising 711 mg anthocyanins and 32 mg procyanidins) or a placebo, together with a high-fat breakfast (52.3 g fat) followed by a lunch (30 g fat) at 3 h, and the postprandial vascular response was compared. The primary endpoints were the assessment of vascular function by flow-mediated dilation (FMD) and the inhibition of collagen- and adenosine diphosphate-induced platelet aggregation. Secondary outcomes included blood pressure (BP), digital volume pulse waveforms, circulating numbers of endothelium- and platelet-derived extracellular vesicles (EVs), plasma concentrations of interleukin (IL)-8, and plasma and urinary concentrations of polyphenols and their metabolites were also evaluated.

There was a significant cumulative improvement in FMD following consumption of an anthocyanin-rich blackcurrant beverage compared with a matched placebo in conjunction with a high-fat meal over a 6 h postprandial period. There was a trend for an inhibitory effect of the blackcurrant beverage on agonist-induced platelet aggregation and significant effects on the secondary outcomes, SBP and IL-8, although these were exploratory and not adjusted for multiple testing. Plasma concentrations of hippuric acid and isovanillic acid were strong independent predictors of FMD and 4-hydroxybenzaldehyde and isoferulic acid glucuronide were predictors of SBP and DBP.

An anthocyanin-rich blackcurrant beverage mitigated the effects of a high fat meal on vascular function and markers of CVD risk, and this is associated with the appearance of specific plasma anthocyanin phenolic metabolites.

URL: https://classic.

gov/ct2/show/NCT02459756; Unique identifier: NCT02459756.

This review summarizes the current knowledge on the benefits of various exercise training modalities on subclinical atherosclerotic cardiovascular disease (ASCVD) risk factors (i.e., endothelial dysfunction, large artery stiffening, carotid artery intima-media thickening) across the adult lifespan and the moderating role of biological sex, with the goal of informing/being to inform research gaps and future research directions.

Regular exercise is an effective intervention to counter subclinical risk factors for ASCVD. However, sex-specific variation has been observed in exercise training benefits. For example, aerobic exercise improves large artery stiffening in both middle-aged/older men and women and enhances endothelial function in middle-aged/older men; however, similar exercise-mediated improvements in endothelial function are not consistently observed in postmenopausal women Sex differences in exercise benefits may be related to differences in the sex hormone environment across the adult lifespan that influence cellular-molecular mechanisms, disconnecting favorable signaling in the vasculature induced by exercise training. Moreover, differences could be explained by social and/or psychological factors that make women more susceptible, on average, to barriers to exercise training compared to age-matched men.

The specific effects of different exercises on cardiovascular health remain unclear. This study aimed to compare the effects of acute anaerobic threshold intensity continuous exercise (ATE), high-intensity interval training (HIIT), and stepwise incremental exercise (SIE) on heart rate variability (HRV) and vascular endothelial function in sedentary college students.

Thirty-five sedentary students were randomized to the ATE group (20.6 ± 2.4 years), the HIIT group (21.7 ± 4.2 years), or the SIE group (21.2 ± 2.8 years). Brachial artery flow-mediated dilation was measured at 10 and 30 minutes after exercise. HRV was measured within 35 minutes postexercise.

It showed that the normalized low frequency postexercise was lower than baseline in the ATE group (P < .05). Flow-mediated dilation was decreased (P = .006) 30 minutes after exercise (6.4 ± 2.2%) compared to baseline (8.1 ± 1.4%) in the HIIT group and increased (+1.4%) in the ATE group with no statistical difference (P > .05). Significant correlations were detected between HRV frequency domain indices and brachial artery baseline diameter (P < .05).

Acute HIIT impairs vascular function 30 minutes after exercise, whereas acute ATE improves vascular function 10 minutes after exercise. Changes in vascular function may be related to changes in autonomic nervous system activity induced by acute exercise.

This meta-analysis aimed to evaluate the effect of nut consumption on vascular endothelial function through the conduction of a comprehensive review of randomised controlled trials. We explored the major electronic databases for published RCTs examining the repercussions of nuts consumption on vascular endothelial function indicators in adults (>18 years). We used random-effects models to compute pooled estimates of weighted mean differences and confidence intervals. The protocol of the present study was registered in the international database of systematic review protocols (CRD42023472892). Nineteen articles, comprising 21 arms, were deemed eligible. According to the pooled estimations, eating nuts significantly improved flow-mediated dilation (FMD) (weighted mean difference (WMD): 1.12%, 95% CI 0.28 to 1.97, p < 0.05), and reactive hyperaemia index (RHI) (WMD: -0.04, 95% CI -0.07 to -0.00, p = 0.04). However, findings revealed that consuming nuts had no significant impact on pulse wave velocity (PWV), the index of augmentation (AIx), or heart rate. The endothelial function was considerably enhanced by nut consumption through the improvement of FMD, while the certainty of such evidence was assessed as very low.

The microvascular system is essential for delivering oxygen and nutrients to tissues while removing metabolic waste. During pregnancy, the uteroplacental microvascular system undergoes extensive remodeling to meet the increased demands of the fetus. Key adaptations include vessel dilation and increases in vascular volume, density, and permeability, all of which ensure adequate placental perfusion while maintaining stable maternal blood pressure. Structural and functional abnormalities in the uteroplacental microvasculature are associated with various gestational complications, posing both immediate and long-term risks to the health of both mother and infant. In this review, we describe the changes in uteroplacental microvessels during pregnancy, discuss the pathogenic mechanisms underlying diseases such as preeclampsia, fetal growth restriction, and gestational diabetes, and summarize current clinical and research approaches for monitoring microvascular health. We also provide an update on research models for gestational microvascular complications and explore solutions to several unresolved challenges. With advancements in research techniques, we anticipate significant progress in understanding and managing these diseases, ultimately leading to new therapeutic strategies to improve maternal and fetal health.

Our objective was to explore the effect of aerobic exercise on endothelial function in hypertensive and prehypertensive patients, and to ascertain the optimal duration and intensity of aerobic exercise. Data were synthesized using a random effects model to calculate the weighted mean difference (WMD) and 95% confidence interval (CI). Fifteen studies met the inclusion criteria. Aerobic exercise was found to significantly improve flow-mediated dilation (FMD) in prehypertensive and hypertensive patients (WMD, 2.23; 95% CI, 1.20-3.26; P  < 0.0001; I2  = 90%). Aerobic exercise, undertaken at a moderate or, even better, vigorous intensity, and lasting no less than 12 weeks, is an effective approach to improve flow-mediated dilation (FMD) in prehypertensive and hypertensive patients. The effect of aerobic exercise on endothelial function is influenced by participant characteristics: a better health status, a younger age, a larger basal body mass index, and a larger basal FMD were associated with larger improvement in FMD.

It remains controversial whether exercise training (EX) improves vascular endothelial function (VEF) independent of lipoprotein changes even though these are therapeutic goals for coronary artery disease (CAD).

The purpose of this study was to systematically review the effects of EX on VEF and blood lipid variables in patients with CAD.

This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We searched five electronic databases (CINAHL, Embase, PubMed, SportDiscus, and Web of Science) until March 2024 for studies that met the following criteria: (i) patients with CAD aged ≥ 18 years; (ii) structured EX for ≥ 1 week in randomized or nonrandomized controlled studies; and (iii) measured brachial artery flow-mediated dilation (FMD) with or without blood lipid variables. We calculated effect sizes (ESs) and 95% confidence intervals (CIs) using a random-effects model and conducted subgroup analyses to identify the effect of training factors (duration, intensity, and weekly volume) on outcomes.

In total, 11 studies with 19 trials (629 patients, 60 ± 9 years) met the inclusion criteria. We conducted a separate meta-analysis for each of the four outcome measures: FMD (13 ESs), high-density lipoprotein-cholesterol (HDL-C; eight ESs), low-density lipoprotein cholesterol (LDL-C; eight ESs), and triglycerides (TGs; eight ESs). EX significantly increased FMD (mean ES 0.57; 95% CI 0.44-0.70; P < 0.001) and HDL-C levels (mean ES 0.25; 95% CI 0.12-0.39; P < 0.001) but had no effect on LDL-C and TG. Subgroup analyses for FMD found no significant variation in effect by training factor (duration, intensity, and weekly volume).

EX improves VEF with increased HDL-C, but we found no changes in LDL-C and TG in patients with CAD, suggesting that HDL-C is preferentially associated with exercise-induced VEF improvement.

Obesity can impair cardiometabolism, but low-carbohydrate diets (LCDs) may be beneficial for mitigating risk. We aimed to investigate the effects of LCDs versus low-fat diets (LFDs), under hypocaloric conditions, on flow-mediated dilation (FMD) in individuals with overweight/obesity. Secondarily, we assessed other cardiovascular markers (systolic blood pressure, diastolic blood pressure, C-reactive protein [CRP], high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides [TG], total cholesterol [TC]), and anthropometric and body composition measurements. PubMed, Scopus, and Web of Science were searched through May 2023 for studies involving hypocaloric LCDs versus LFDs on FMD. Meta-analyses were conducted for LCDs vs. LFDs to calculate weighted mean differences (WMD), including 10 studies reporting FMD (n = 475). Overall, hypocaloric LCDs resulted in a non-significant decrease in FMD compared with hypocaloric LFDs [WMD = -1.04% (95% CI -2.28 to 0.20), p = 0.10], while very-low-carbohydrate diets (VLCDs) significantly reduced FMD when compared with LFDs [WMD = -2.12% (95% CI: -3.35 to -0.9) p = 0.001]. LCDs did not change anthropometric and body composition measurements, nor CRP, blood pressure, HDL, or TC when compared with LFDs. However, LCDs significantly decreased TG [WMD = -19.94 mg/dL (95% CI -31.83 to -8.06), p = 0.001] and increased LDL [WMD = 20.00 mg/dL (95% CI 14.09 to 25.90), p = 0.001] when compared with LFDs. In conclusion, LCDs did not exert superior effects on cardiovascular markers or body composition when compared with LFDs in individuals with overweight or obesity, but LCDs reduced TG and increased LDL levels more than LFDs. Yet, vascular function (FMD) was reduced primarily for VLCDs.

Patients with chronic kidney disease (CKD) demonstrate accelerated vascular aging which contributes to an increased risk of cardiovascular disease (CVD). Impaired vascular health in CKD is characterized by both functional and structural alterations to the vasculature including hypertension, arterial stiffness, vascular endothelial dysfunction, and autonomic dysfunction. These detriments persist despite pharmacological intervention. Habitual aerobic exercise can be protective of vascular health; however, the feasibility in patients with CKD is low due to numerous barriers to exercise. In this perspective we emphasize the need for novel and non-pharmacological strategies that can rescue vascular health and reduce the development of CVD in patients with CKD, explain the unique barriers to aerobic exercise in CKD, present a novel physical training intervention-high-resistance inspiratory muscle strength training (IMST) that addresses the barriers to exercise, and provide our opinion on why this lifestyle intervention may be particularly efficacious for patients with CKD.

Primary aldosteronism is one of the most common types of secondary endocrine hypertension. Treatment with mineralocorticoid receptor antagonists is recommended for bilateral idiopathic hyperaldosteronism (IHA). The purpose of this study was to evaluate the effects of esaxerenone, a nonsteroidal mineralocorticoid receptor antagonist with high mineralocorticoid receptor-binding specificity, on vascular function and peripheral arterial stiffness in patients with IHA.

This study was a single-center, observational prospective cohort study. Forty-four patients with IHA (18 men and 26 women; 52 ± 11 years) were enrolled from Hiroshima University Hospital. Vascular function, including flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID) and peripheral arterial stiffness, including brachial-ankle pulse wave velocity (baPWV) and brachial artery intima-media thickness (bIMT) were measured before and after 12 weeks of treatment with esaxerenone.

Esaxerenone treatment increased FMD (3.1 ± 2.0% to 5.7 ± 2.2%, P < 0.01) and NID (10.7 ± 3.8% to 15.7 ± 6.2%, P < 0.01) and decreased baPWV (1605 ± 263 to 1428 ± 241 cm/s, P < 0.01), while esaxerenone treatment did not significantly alter bIMT. The changes in FMD and NID posttreatment with esaxerenone were significantly correlated with the changes in plasma aldosterone concentration (PAC) and plasma renin activity (PRA). The change in baPWV was significantly correlated with the changes in PRA, aldosterone-to-renin ratio, and systolic blood pressure.

Esaxerenone improved vascular function and peripheral arterial stiffness in patients with IHA. These findings suggest aldosterone inhibition is a potential mechanism governing improvement in cardiovascular health.

Hypertension and vascular dysfunction are major health concerns, and studies have suggested different interventions, including dietary nitrate (NO3), to improve it. We sought to elucidate the effects of dietary NO3 on plasma NO3 and nitrite (NO2) levels and to determine the shape of the effect of dietary NO3 on blood pressure (BP) and vascular health biomarkers.

PubMed, Scopus, and Web of Science were searched up to February 2024 for eligible randomized controlled trials (RCTs). The pooled results were reported as weighted mean differences (WMD) and 95% confidence intervals (CIs).

Our analysis of 75 RCTs involving 1823 participants revealed that per each millimole (mmol) increase in the administered NO3 dose, both acute (WMD: 32.7µmol/L; 95%CI: 26.1, 39.4) and chronic-term (WMD: 19.6µmol/L; 95%CI: 9.95, 29.3) plasma NO3 levels increased. Per each mmol increase in NO3 intake, a reduction in systolic BP levels was observed in the acute (WMD: -0.28mmHg; 95%CI: -0.40, -0.17), short-term (WMD: -0.24mmHg; 95%CI: -0.40, -0.07), and medium-term (WMD: -0.48mmHg; 95%CI: -0.71, -0.25) periods. Furthermore, a decrease in diastolic BP for each mmol increase in NO3 intake (WMD: -0.12 mmHg; 95% CI: -0.21, -0.03) was shown. Moreover, a linear dose-response relationship was indicated between each mmol of NO3 intake and medium-term pulse wave velocity (WMD: -0.07 m/s; 95%CI: -0.11, -0.03), medium-term flow-mediated dilation (WMD: 0.30%; 95%CI: 0.15, 0.46), and medium-term augmentation index (WMD: -0.57%; 95%CI: -0.98, -0.15).

We observed dose-dependent increases in plasma NO3 and NO2 levels, along with consequent reductions in BP and enhancements in vascular health following dietary NO3 supplementation. Future high-quality, population-specific studies with optimized dietary NO3 dosages are needed to strengthen the certainty of the evidence.

The protocol for this systematic review was registered in PROSPERO under the registration number CRD42024535335.

Increasing long-term observations suggest that coronavirus disease 2019 (COVID-19) vasculopathy may persist even 1.5 years after the acute phase, potentially accelerating the development of atherosclerotic cardiovascular diseases. This study systematically reviewed the variability of brachial flow-mediated dilation (FMD) and carotid-femoral pulse wave velocity (cfPWV) from the acute phase of COVID-19 through 16 months of follow-up (F/U). Databases including PubMed, Web of Science, MEDLINE, and Embase were screened for a meta-analysis without language or date restrictions (PROSPERO reference CRD42025642888, last search conducted on 1 February 2025). The quality of the included studies was assessed using the Newcastle-Ottawa Quality Scale. We considered all studies (interventional pre-post studies, prospective observational studies, prospective randomized, and non-randomized trials) that assessed FMD or cfPWV in adults (aged ≥ 18 years) with or after laboratory-confirmed COVID-19 compared with non-COVID-19 controls or that assessed changes in these parameters during the F/U. Twenty-one studies reported differences in FMD, and 18 studies examined cfPWV between COVID-19 patients and control groups during various stages: acute/subacute COVID-19 (≤30 days from disease onset), early (>30-90 days), mid-term (>90-180 days), late (>180-270 days), and very late (>270 days) post-COVID-19 recovery. Six studies assessed variability in FMD, while nine did so for cfPWV during the F/U. Data from 14 FMD studies (627 cases and 694 controls) and 15 cfPWV studies (578 cases and 703 controls) were included in our meta-analysis. FMD showed a significant decrease compared to controls during the acute/subacute phase (standardized mean difference [SMD]= -2.02, p < 0.001), with partial improvements noted from the acute/subacute phase to early recovery (SMD = 0.95, p < 0.001) and from early to mid-term recovery (SMD = 0.92, p = 0.006). Normalization compared to controls was observed in late recovery (SMD = 0.12, p = 0.69). In contrast, cfPWV values, which were higher than controls in the acute/subacute phase (SMD = 1.27, p < 0.001), remained elevated throughout the F/U, with no significant changes except for a decrease from mid-term to very late recovery (SMD= -0.39, p < 0.001). In the very late recovery, cfPWV values remained higher than those of controls (SMD = 0.45, p = 0.010). In the manuscript, we discuss how various factors, including the severity of acute COVID-19, the persistence of long-term COVID-19 syndrome, and the patient's initial vascular age, depending on metrics age and cardiovascular risk factors, influenced the time and degree of FMD and cfPWV improvement.

The endothelium modulates vascular homeostasis owing to a variety of vasoconstrictors and vasodilators. Endothelial dysfunction (ED), characterized by impaired vasodilation, inflammation, and thrombosis, triggers future cardiovascular (CV) diseases. Chronic kidney disease, a state of chronic inflammation caused by oxidative stress, metabolic abnormalities, infection, and uremic toxins damages the endothelium. ED is also associated with a decline in estimated glomerular filtration rate. After kidney transplantation, endothelial functions undergo immediate but partial restoration, promising graft longevity and enhanced CV health. However, the anticipated CV outcomes do not happen due to various transplant-related and unrelated risk factors for ED, culminating in poor CV health and graft survival. ED in kidney transplant recipients is an under-recognized and poorly studied entity. CV diseases are the leading cause of death among kidney transplant candidates with functioning grafts. ED contributes to the pathogenesis of many of the CV diseases. Various biomarkers and vasoreactivity tests are available to study endothelial functions. With an increasing number of transplants happening every year, and improved graft rejection rates due to the availability of effective immunosuppressants, the focus has now shifted to endothelial protection for the prevention, early recognition, and treatment of CV diseases.

This study aimed to determine whether interrupting prolonged sitting with brief bouts of light-intensity activity (ISIT), undertaking structured high-intensity interval training (HIIT), or the combination of both interventions would elicit greater cardiometabolic benefits. Seventeen healthy adults (22-50 yr) were recruited to undertake three 2-wk interventions in a random order: 1) HIIT (6 HIIT sessions + <5,000 steps following the session and on the next day), 2) ISIT (2.5-min light-intensity walking every hour for 12 h/day on weekdays), and 3) HIIT + ISIT. Participants underwent a 6-day lead-in phase prior to each condition (days 1-3: normal activity, days 4-6 sedentary: <5,000 steps/day). Pre- and postassessments included glycemic control (2-h postprandial glucose), endothelial function via flow-mediated dilation (FMD), cardiorespiratory fitness, and body composition. Changes in primary and secondary outcomes were assessed via repeated measures ANOVA. Eleven participants completed all conditions (8 female, 33 ± 5 yr, 23 ± 4 kg/m2, habitual activity 7,156 ± 2,272 steps/day). FMD significantly improved following HIIT + ISIT when compared with ISIT (+1.04 ± 1.20%, P = 0.02), but there were no differences when ISIT was directly compared with HIIT. Cardiorespiratory fitness improved significantly following HIIT + ISIT when compared with ISIT (+1.88 ± 2.03 mL/kg/min, P = 0.01), but there were no differences when ISIT alone was compared with HIIT. There were no significant differences between groups for outcomes related to glucose control or body composition. HIIT + ISIT elicits greater improvements in cardiovascular outcomes when compared with ISIT but not HIIT. The benefits of structured exercise, such as HIIT, may go beyond those achieved by limiting sedentary behavior alone.NEW & NOTEWORTHY Although the adverse health effects of sedentary behavior are well-recognized, effective strategies for interrupting such behavior remain unclear. This study demonstrates that combining light-intensity activity breaks throughout the day with structured high-intensity exercise every other day can mitigate some of the cardiovascular consequences associated with prolonged sedentary periods in healthy young adults. Furthermore, our findings also suggest that merely incorporating regular breaks of light-intensity activity may not suffice. These results underscore the importance of regular exercise for cardiovascular health amid sedentary lifestyles.

We investigated the presence of impaired endothelial function in individuals with post-acute sequelae of coronavirus disease-2019 (PASC) compared to healthy individuals and explored the efficacy of combined exercise training in restoring or improving endothelial function in those with PASC.

Study I was a cross-sectional study which compared endothelial function between individuals with PASC (n = 29, mean age 22.9 ± 3.9 year) and healthy individuals (n = 42, mean age 21.7 ± 2.0 year). Study II, an intervention design, explored if combined exercise training (n = 14) could reverse the decline in endothelial function associated with PASC compared to controls (n = 14). The combined exercise program included aerobic, resistance, and inspiratory muscle training administered for 8 weeks. We measured endothelial function using flow-mediated dilation of the brachial artery and assessed peak oxygen uptake (VO2peak), dyspnea, and fatigue before and after the intervention.

Individuals with PASC exhibited significantly lower endothelial function compared to healthy controls (4.95 ± 2.0% vs 8.00 ± 2.4%, P < .001). The exercise group showed a significant increase in endothelial function (4.73 ± 1.5% to 7.98 ± 2.4%) as opposed to the control group (5.31 ± 2.5% to 6.30 ± 2.5%) (interaction effect: P = .008), reaching levels similar to those in healthy individuals. Additionally, the exercise group demonstrated improvement in VO2peak (38.3 ± 6.4 ml/min/kg to 42.8 ± 7.3 ml/min/kg, P < .001) and a reduction in dyspnea and fatigue compared to the control group (P < .001).

Having PASC is associated with impaired endothelial function, but combined exercise training effectively restores it, making it a promising lifestyle intervention for vascular function in PASC.

Previous studies have presented conflicting results on the correlation between metabolic syndrome (MetS) and subclinical atherosclerosis. However, the binary MetS definition cannot reflect the severity of metabolic disorders continuously and dynamically. The present study calculated the MetS score and explored the association between MetS score and subclinical atherosclerosis.

A total of 840 participants were included in this observational, cross-sectional study; 66.55% of participants were men, and the median age was 61.00 years (53.00, 67.00). Brachial-ankle pulse wave velocity (baPWV) and brachial flow-mediated dilation (bFMD) values were measured from October 2016 to January 2020. Spearman's correlation and multiple linear regression analyses were conducted to explore the correlation between the MetS score and baPWV and bFMD. Arterial stiffness was defined as baPWV ≥1400 cm/s, while endothelial dysfunction was described as bFMD >6%. Multiple logistic regression was performed to explore the effects of MetS and MetS score on arterial stiffness and endothelial dysfunction.

The MetS score was significantly associated with baPWV (β = 73.59, 95% CI (42.70, 104.48); p < 0.001) and bFMD (β = -0.43, 95% CI (-0.75, -0.10); p = 0.010) after adjusting for covariates. Compared with the binary definition of MetS, the MetS score was a more significant predictor for arterial stiffness (odds ratio, OR = 2.63, 95% CI (1.85, 3.74); p < 0.001) and endothelial dysfunction (OR = 1.33, 95% CI (1.01, 1.76); p = 0.040). Leukocyte count (r = 0.32; p < 0.001) and high-sensitivity C-reactive protein (hs-CRP) (r = 0.17; p < 0.001) values were related to the MetS score.

The MetS score is a clinically accessible assessment of metabolic status that can identify individuals at higher risk of subclinical atherosclerosis.

A high serum phosphorus (P) level is a risk factor for cardiovascular disease (CVD) and mortality in patients with chronic kidney disease (CKD). Moreover, increased postprandial serum P levels after high dietary P intake impair vascular endothelial function. Therefore, management of postprandial serum P levels is important in CKD patients. Recently, a genome-wide association study identified single nucleotide polymorphisms (SNPs) associated with fasting serum P levels in individuals of European ancestry. However, the effects of these SNPs on postprandial serum P levels and vascular endothelial function remain unclear.

A randomized, single-blind, crossover study in 99 healthy Japanese was performed to determine the association between SNPs and postprandial serum P levels, flow-mediated dilation (FMD) or alkaline phosphatase activity. The impact of SNP on gene transcriptional activity was also analyzed using in vitro experiment.

The participants who were TT homozygotes of SNP rs1697421 (located near the tissue nonspecific alkaline phosphatase [TNAP] gene) had higher postprandial serum P levels than C allele carriers. FMD was more significantly impaired in the TT homozygotes than in the CC homozygotes in men. In the in vitro experiment, TNAP transcriptional activity was significantly lower in TT homozygotes than in the others.

These results suggest that in TT homozygotes of SNP rs1697421, hepatic P uptake is affected through changes in serum TNAP levels, leading to high postprandial serum P levels and impairment of FMD. The present findings can contribute to the development of gene-based therapeutic approaches for the management of serum P levels.

Passive heat therapy is gaining popularity as an intervention to promote cardiovascular, physiological, and, to a lesser degree, thermoregulatory adaptations in patients with cardiovascular disease. Despite this, the efficacy of heat therapy to elicit these adaptations remains unknown. We searched five databases for original research, screening 2913 studies and identifying 18 eligible studies. Heat therapies included Waon therapy, balneotherapy, water perfused trousers, Finnish sauna, and foot immersion. Interventions were administered across various time frames (20-90 min) and performed 3-7 times per week, for durations of 2-8 weeks. The studies collectively involved a diverse population (mean age: 67 (10) years) with cardiovascular diseases. Heat therapy was consistently shown to improve ejection fraction, flow-mediated dilation, brain natriuretic peptide levels, New York Heart Association classification, and 6 min walk distance. However, positive effects on resting heart rate and blood pressure were infrequently observed, and thermoregulatory responses scarcely reported. Heat therapy may increase sweat rate during heat exposure and reduce resting core temperature, but adaptive skin blood flow responses were not observed. Passive heat therapy shows promising utility in patients with cardiovascular disease, while secondary benefits such as markers of thermoregulatory adaptation may also be observed, these require further investigation.

Congenital heart disease (CHD) affects 1% of live births and is a risk factor for cardiovascular disease and reduced life expectancy. Previous studies have suggested CHD is associated with impaired vascular health, but this has not been established. Therefore, the objective of this study was to examine the effect of CHD on vascular health.

Eight electronic databases were searched through April 12, 2024. Studies of all designs (except case studies and reviews) that reported on the population (individuals with CHD of any age), comparator (individuals without CHD), and outcomes of interest: endothelial dependent (flow-mediated vasodilation, reactive hyperemia index) and independent (nitroglycerin-mediated dilation) vascular function, arterial stiffness (pulse wave velocity, stiffness index, augmentation index, distensibility, and compliance), and carotid intima-media thickness were included. Results are presented as standardized mean difference (SMD) with 95% confidence interval (CI) and as effect size.

We included 138 studies (N = 16,115) in the meta-analysis. Individuals with CHD exhibited decreased vascular function compared with those without including decreased low-mediated vasodilation (SMD, -0.96 [95% CI, -1.22 to -0.70]; I2 = 85%; large effect size), reactive hyperemia index using ultrasound (SMD, -2.88 [95% CI, -4.85 to -0.90]; I2 = 96%; large effect size), and nitroglycerin-mediated dilation (SMD, -0.98 [95% CI, -1.35 to -0.61]; I2 = 87%; large effect size). Various CHD subtypes including coarctation of the aorta, transposition of the great arteries, and tetralogy of Fallot, after the Fontan procedure showed significant vascular dysfunction. Shunt lesions did not show significant vascular dysfunction.

CHD is associated with vascular dysfunction, increased arterial stiffness, and greater carotid intima-media thickness in pediatric and adult patients.

Against the current backdrop of population ageing, the correlation between cardiovascular diseases and endothelial dysfunction is increasingly important. Exercise, a simple and accessible method of preventing and ameliorating numerous diseases, has been demonstrated to significantly enhance endothelial function. This study aimed to assess the effects of aerobic exercise (AE), resistance exercise (RE), combined exercise (CE) and high-intensity interval training (HIIT) on vascular endothelial function in middle-aged and older adults. Flow-mediated dilation (FMD) is a non-invasive ultrasound technique used to measure endothelial function. Direct and indirect comparisons were used to determine which exercise modality most effectively improved vascular endothelial function in this demographic.

This comprehensive systematic review and network meta-analysis examined randomised controlled trials (RCTs) comparing the effects of four different exercise interventions (AE, RE, CE and HIIT) to a control intervention on FMD in middle-aged and older adults.

The analysis included 20 RCTs involving 1,123 participants. The surface under the cumulative ranking curve (SUCRA) analysis indicated that AE was the most effective in improving FMD (SUCRA = 68.9 %), followed by HIIT (SUCRA = 62.5 %), RE (SUCRA = 58.8 %), CE (SUCRA = 54.9 %) and CON (SUCRA = 4.9 %).

This network meta-analysis of various interventions for FMD in middle-aged and older adults found that AE was the most effective in improving FMD (SUCRA = 68.9 %). These findings suggest that AE could be a valuable intervention in clinical practice for enhancing vascular health in this population.

The cardiovascular impact of cannabis use is incompletely understood. Although evidence links chronic use to an increased risk of disease and adverse cardiovascular events, few studies have investigated the acute effects of cannabis inhalation on subclinical dysfunction. Furthermore, it remains unknown how method of inhalation and cannabinoid profile modify risk. While controlling for inhalation method and the effects of either Δ-9-tetrahydrocannabinol (THC) or cannabidiol (CBD), we examined the acute cardiovascular effects of cannabis use on arterial stiffness, vascular endothelial responsiveness, and cardiac function, as markers of cardiovascular impairment.

Twenty-two young, healthy, cannabis users were assessed for arterial stiffness via pulse wave velocity, vascular endothelial function via brachial artery flow mediated dilation, and cardiac function via echocardiography, before and after (1) smoking THC-predominant cannabis (S-THC), (2) vaporizing THC-predominant THC (V-THC), and (3) vaporizing cannabidiol-predominant cannabis (V-CBD). S-THC and V-THC increased heart rate (S-THC: ∆17±15 bpm, V-THC: ∆16±16 bpm;both P<0.0001) and mean arterial pressure (S-THC: ∆7±6 mm Hg, V-THC: ∆5±5 mm Hg;both P<0.0001) whereas V-CBD did not (∆1±4 bpm, ∆3±4 mm Hg;both P>0.05). After inhalation, pulse wave velocity increased (S-THC: ∆0.29±0.75 m/s, V-THC: ∆0.42±0.74 m/s, V-CBD: ∆0.10±0.44 m/s; P=0.002) and diastolic function was reduced ([early/late ratio] S-THC: ∆-0.2±0.53, V-THC: ∆-0.33±58, V-CBD: ∆0.01±66; P=0.03). Differences in heart rate were related to changes in pulse wave velocity (r2=0.2; P=0.0002) and diastolic function (r2=0.26; P<0.0001). Inhalation method did not alter these cannabinoid-dependent responses.

THC predominant, but not cannabidiol predominant, cannabis elicits increases in heart rate and blood pressure irrespective of inhalation method, which may increase arterial stiffness and reduce diastolic function. These findings implicate THC as a relevant factor for cannabis-related subclinical cardiovascular dysfunction.

URL: https://www.clinicaltrials.gov; Unique identifier: NCT04693884.

We conducted a systematic review of randomized clinical trials evaluating the effects of aerobic, resistance and/or combined training on flow-mediated dilation (FMD) and/or pulse wave velocity (PWV) in older adults. The studies were selected from the electronic databases PubMed, Cochrane, LILACS, EMBASE, Web of Science, and the gray literature. We assessed the studies using Cochrane risk of bias (RoB2) tool and the GRADE tool. The GRADE assessment showed moderate quality of evidence for aerobic training and resistance training and very low for combined training. The measures of effects are presented as mean differences of the intervention group versus the control group and related 95% confidence intervals (95% CIs) pooled by a random-effects model using an inverse variance method. Our analysis of 24 RCTs (Intervention group [n = 251]: 67.7 ± 5.6 years old; control group [n = 228]: 68.7 ± 5.9 years old) showed that aerobic training was effective to improve FMD (0.64% [95% CI 0.24 to 1.03], p = 0.002) and PWV (-1.21 m/s [95% CI -1.37 to -1.05], p< 0.001) by compared to the control group. The subgroup analyses showed no FMD differences following aerobic training in healthy adults when compared to those with any health condition. Combined training was effective in improving FMD (0.60% [95% CI 0.50 to 0.71], p< 0.001) and PWV (-0.79 m/s [95% CI -1.23 to -0.35], p = 0.002). But these same parameters did not show any improvement in response to resistance training. A major limitation of this study is that the analysis to evaluate the effect of resistance training on PWV include only one study, and no inferences could be made from the data. Aerobic and combined training, but not resistant training, improve flow-mediated dilation and pulse wave velocity in the elderly. PROSPERO: CRD42021275282.

Near-infrared spectroscopy (NIRS) is an optical technique that can be used to non-invasively interrogate haemodynamic changes within skeletal muscle. It can be combined with a short (3-5 min) arterial cuff-occlusion to quantify post-occlusive reactive hyperaemia (PORH). This technique has utility in tracking changes in vascular health in relation to exercise, disease progression or treatment efficacy. However, methods for assessing PORH vary widely and there is little consensus on methodological approaches such as sampling frequency, correction for adipose tissue or the analysis endpoints. The purpose of this review was to: (1) summarise recent advances; (2) compare different methodological approaches and (3) identify current knowledge gaps and future objectives for use of NIRS for vascular assessment. We propose key areas for future work, including optimising occlusion duration and comparing methods of correction for the ischemic stimulus, standardising methods for adjustment of adipose tissue thickness, cross-device comparisons and establishing a standard for minimum sampling rate. Comparisons with alternative methods of capturing PORH or upstream vasodilatory responses would be valuable. Addressing these methodological considerations will aid our understanding of this useful, non-invasive tool for characterising PORH within skeletal muscle and facilitate interpretation of results across studies.

Food choices during stressful periods often worsen, which can influence the impact of stress on vascular health. For instance, fat consumption impairs the recovery of endothelial function following mental stress, while flavanols have been shown to enhance recovery. This randomised, counterbalanced, double-blinded, crossover, postprandial intervention study examined whether flavanols consumed in combination with fat can mitigate the negative impact of fat on stress-induced impairments in endothelial function. Twenty-three young, healthy males and females ingested a high-fat meal (56.5 g fat) with high-flavanol (150 mg (-)-epicatechin) or low-flavanol (<6 mg (-)-epicatechin) cocoa 1.5 hours before an 8-minute mental stress task. The primary outcome, brachial flow-mediated dilatation (FMD), was assessed at pre-intervention baseline and 30 and 90 minutes post-stress. Pre-frontal cortical oxygenation was assessed post-meal at rest and during stress. Forearm blood flow (FBF), blood pressure (BP), cardiovascular activity, common carotid artery (CCA) diameter and blood flow and mood were assessed before, during and/or after stress. FMD was impaired at 30 and 90 minutes post-stress after the low-flavanol cocoa. High-flavanol cocoa attenuated FMD impairments at 30 minutes and improved FMD at 90 minutes post-stress. Mental stress induced similar increases in cortical oxygenation, FBF, BP, cardiovascular activity, and disruptions to mood, in both conditions. CCA diameter increased and CCA retrograde blood flow decreased post-stress, with no difference between conditions. In summary, flavanols can counteract declines in endothelial function induced by consuming fat in the context of stress, but do not impact cerebral oxygenation. These findings can have important implications for flavanol-rich dietary choices to protect the vasculature from stress.

Vascular function serves as a prognostic marker for cardiovascular disease and may exhibit seasonal variations due to lifestyle and environmental factors. Our systematic review aimed to determine whether seasonal variations in vascular function are present. We conducted a search of five databases (MEDLINE via PubMed, CINAHL, Web of Science, Cochrane Library, and Biomed Central) to identify evidence of seasonal variations in vascular function. Studies were eligible for inclusion if they assessed vascular function in adult humans during two or more seasons and were published in English. Of the 20,420 studies screened, 12 were eligible and none were excluded due to bias. Nine studies reported significant seasonal variations in vascular function, whereas three studies found no significant seasonal variations. The seasonality of vascular function remains unclear. However, current literature indicates that vascular dysfunction may exhibit a seasonal pattern, with vascular function reduced in the winter. Seasonal variations in endothelial function necessitate further exploration, particularly concerning factors such as exercise, temperature, light exposure, and air pollution. Future research should adopt standardised protocols, involve diverse and larger populations, employ longitudinal designs to minimise confounding factors, systematically measure and adjust for environmental variables, and accurately assess the impact of seasonal variation on vascular function.

Endothelial dysfunction is recognized as an early modification involved in the pathogenesis of vascular diseases. Evidence suggests that the Mediterranean Diet (MD) is associated with endothelial function improvement and, in turn, plays an important role in atherosclerosis development and progression.

To evaluate both acute and sustained effects of the MD on endothelial function in patients with high cardiometabolic risk.

A total of 25 subjects were randomly assigned to either the MD group or the Control Diet (CD) group according to a single-blind, parallel-group study design. Endothelial function was evaluated through non-invasive flow-mediated dilation (FMD) measurements at baseline (T0) and after 8 weeks (Tw8) of the MD or CD intervention, under both 12 h fast condition (fasting) and 2 h post-meal resembling the assigned diet (2 h). Assessments were conducted by a blinded sonographer.

FMD at T0-fasting was similar between MD and CD groups (6.11% ± 0.67 vs. 7.90% ± 1.65; p = 0.266). A significant difference in FMD between MD and CD groups was observed at T0-2h (12.14% ± 1.93 vs. 4.01% ± 1.03; p = 0.004), T8w-fasting (9.76% ± 1.18 vs. 5.03% ± 0.89; p = 0.008), and T8w-2h (8.99% ± 1.22 vs. 3.86% ± 0.52; p = 0.003). Oral glucose insulin sensitivity (OGIS) at T0 correlated with FMD percent changes from T0-fasting to T0-2h (r = 0.414, p = 0.044). After adjusting for age, gender, and OGIS, MD was an independent predictor of percent changes in FMD from T0-fasting to T0-2h (β: -0.582, p = 0.003), from T0-fasting to T8w-fasting (β: -0.498, p = 0.013), and from T0-fasting to T8w-2h (β: -0.479, p = 0.018).

Adherence to the MD may improve endothelial function in both the short- and medium-term among patients at high cardiometabolic risk.

Inflammation and endothelial dysfunction are important risk factors for chronic diseases, including cardiovascular diseases and related mortality.

This systematic review and meta-analysis aimed to assess the effects of 2 popular dietary patterns-a Mediterranean (MED) diet supplemented with olive oil and a low-fat diet (LFD)-on factors related to inflammation and endothelial function in adults.

The following online databases were searched for related studies published until August 7, 2024: PubMed/Medline, Scopus, Clarivate Analytics Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar. Two independent researchers selected the studies based on the eligibility criteria.

The effect sizes were expressed as Hedges' g with 95% CIs. A total of 16 eligible trials with 20 effect sizes were included in the analyses. This meta-analysis revealed that the MED diet supplemented with olive oil significantly improved all of the indicators of the study compared with the LFD, except in the case of E-selectin, in which a low and nonsignificant decrease was reported.

Available evidence suggests that a MED diet supplemented with olive oil compared with the LFD significantly improves inflammation and serum endothelial function in adults.

PROSPERO registration no. CRD42023485718.

Endothelial dysfunction is an early predictor of atherosclerosis and cardiovascular disease. Flow-mediated dilation (FMD) is the gold standard to assess endothelial function in humans. FMD reproducibility has been mainly assessed in the brachial artery (BA) with limited research in lower limb arteries. The purpose of this study was to compare FMD reproducibility in the upper limb BA and lower limb superficial femoral artery (SFA) in young healthy adults.Fifteen young healthy adults (nine males; six females) underwent FMD, resting diameter, velocity, and shear rate measurements on three occasions to determine intra-and inter-day reproducibility in both BA and SFA, assessed by coefficient of variation (CV), intraclass correlation coefficient (ICC), and Bland-Altman plots.BA FMD CVs (intra-day: 4.2%; inter-day: 8.7%) and ICCs (intra-day: 0.967; inter-day: 0.903) indicated excellent reproducibility and reliability, while for SFA FMD, both CVs (intra-day: 11.6%; inter-day: 26.7%) and ICCs (intra-day: 0.898; inter-day: 0.651) showed good/moderate reproducibility and reliability. BA FMD was significantly more reproducible than SFA FMD (p < 0.05). Diameter reproducibility was excellent and similar between arteries, while resting velocity and shear rate have lower reproducibility in the BA compared to SFA. Bland-Altman plots displayed no proportional and fixed bias between measurements.In summary, SFA FMD is less reproducible than BA FMD, with identical volume of ultrasound training. Given the increasing interest in using SFA FMD to test the efficacy of interventions targeting lower limb's vascular health and as a potential biomarker for peripheral arterial disease risk, future studies should ensure higher levels of training for adequate reproducibility.

Breakfast skipping has been suggested to be associated with cardiovascular diseases. However, whether breakfast skipping affects vascular endothelial function (VEF), a marker of cardiovascular diseases, remains unclear. This study aimed to investigate the impact of breakfast consumption (Eating trial) and skipping (Skipping trial) on brachial artery (BA) VEF in healthy breakfast eaters. A total of nine healthy individuals (4 females and 5 males) either had breakfast between 830 and 900 or skipped it and had lunch between 1200 and 1230, followed by a 3-h rest period until 1530. For BA VEF evaluation, flow-mediated dilation (FMD) was measured by ultrasound before and after breakfast and lunch. FMD was calculated as the percent change in BA diameter normalized to the shear rate area under the curve (FMD/SRAUC). Blood glucose, plasma insulin, and plasma free fatty acid levels in capillaries were measured before and after breakfast and lunch. At 1530, the Eating trial, but not the Skipping trial, significantly increased FMD/SRAUC from baseline (P = 0.006). The Skipping trial showed significantly lower changes in FMD/SRAUC from 830 than the Eating trial at 1530 (P < 0.001). We found a significant inverse correlation between changes in FMD/SRAUC between 830 and 1530 and peak glucose levels after lunch (r = -0.882, P < 0.001) and with an incremental area under the curve for glucose between 830 and 1530 (r = -0.668, P < 0.001). These results suggest that a single bout of breakfast skipping can suppress BA VEF in the afternoon because of postlunch hyperglycemia.NEW & NOTEWORTHY Skipping breakfast does not affect vascular endothelial function (VEF) before lunch. However, after lunch on normal meals (i.e., not oral glucose tolerance test), VEF was found to be lower in those who skipped breakfast than those who ate breakfast. Such reduced postlunch VEF after skipping breakfast was associated with postprandial hyperglycemia. These results provide important insight into the impact of eating breakfast on VEF and glycemic control in healthy adults.

Erectile dysfunction (ED) is associated with several vascular disorders, but the associations between ED and vascular parameters are still unclear.

We analyzed and synthesized a comprehensive range of studies from PubMed, Web of Science, and Scopus regarding the associations between ED and the following measures: ankle-brachial index (ABI), pulse wave velocity (PWV), intima-media thickness (IMT), nitrate-mediated dilation (NMD), flow-mediated dilation (FMD), augmentation index (AI), endothelial progenitor cells (EPCs) and other vascular parameters. Subgroup analysis was conducted according to specific types of parameters. Study quality was assessed by using the Newcastle-Ottawa Scale. Sensitivity analysis was conducted to confirm the robustness of the pooled results.

Fifty-seven studies with 7,312 individuals were included. Twenty-eight studies were considered to be high-quality. ED patients had a 0.11 mm higher IMT (95% confidence interval [CI]: 0.07, 0.15), a 2.86% lower FMD (95% CI: -3.56, -2.17), a 2.34% lower NMD (95% CI: -3.37, -1.31), a 2.83% higher AI (95% CI: 0.02, 5.63), a 1.11 m/s higher PWV (95% CI: 0.01, 2.21), and a 0.72% lower percentage of EPCs (95% CI: -1.19, -0.24) compared to those without ED. However, ABI was similar between ED patients and non-ED individuals. According to sensitivity analysis, the pooled results were robust.

Our study confirmed the associations between ED and several vascular parameters and highlighted the importance of prevention and management of vascular and endothelial dysfunction in ED patients.

Type 2 diabetes mellitus (T2DM) is a complex, chronic metabolic disease that carries with it a high prevalence of comorbid conditions, making T2DM one of the leading causes of death in the U.S. Traditional lifestyle interventions (e.g., diet, exercise) can counter some adverse effects of T2DM, however, participation in these activities is low with reasons ranging from physical discomfort to lack of time. Thus, there is a critical need to develop novel management strategies that effectively reduce cardiometabolic disease risk and address barriers to adherence. High-resistance inspiratory muscle strength training (IMST) is a time-efficient and simple breathing exercise that significantly reduces systolic and diastolic BP and improves vascular endothelial function in adults with above-normal blood pressure. Herein we describe the study protocol for a randomized clinical trial to determine the effects of a 6-week IMST regimen on glycemic control and insulin sensitivity in adults with T2DM. Our primary outcome measures include fasting plasma glucose, fasting serum insulin, and insulin resistance utilizing homeostatic model assessment for insulin resistance (HOMA-IR). Secondary outcome measures include resting systolic BP and endothelium-dependent dilation. Further, we will collect plasma for exploratory proteomic analyses. This trial seeks to establish the cardiometabolic effects of 6 weeks of high-resistance IMST in patients with T2DM.

Sex differences exist in cardiovascular disease risk factors including elevated blood pressure and arterial stiffness, and decreased endothelial function in males compared to females. Feminine gender expression may be associated with elevated risk of acute coronary syndrome. However, no study has investigated the associations between sex, gender identity, and gender expression and cardiovascular disease risk factors in young adults.

One hundred and thirty participants (22 ± 3 years) underwent assessments of hemodynamics, arterial stiffness [pulse wave velocity (PWV)], and brachial artery endothelial function (flow-mediated dilation; %FMD). Participants completed a questionnaire capturing sex category (50 male/80 female), gender identity category (49 men/79 women/2 non-binary), and aspects of gender expression assessed by the Bem Sex Role Inventory-30 (39 androgynous/33 feminine/29 masculine/29 undifferentiated). Sex/gender identity category groups were compared using unpaired t-tests and gender expression groups compared using one-way ANOVAs.

Resting systolic and mean arterial pressure (p < 0.01) were elevated in males vs. females. Central PWV was elevated in males [median (interquartile range): 6.4 (1.8) vs. 5.8 (2.2) m/s, p = 0.02]; however, leg and arm PWV were not different between sexes. %FMD was elevated in males vs. females, after accounting for a larger baseline artery diameter in males (8.8 ± 3.3% vs. 7.2 ± 3.1%, p = 0.02); since the majority of participants were cisgender, the same results were found examining gender identity (men vs. women). There were no differences across gender expression groups (p > 0.05).

Sex/gender identity category, but not gender expression, influence cardiovascular risk factors (blood pressure, arterial stiffness, endothelial function) in cisgender adults; further research is needed in gender-diverse populations.

We compared the effects of low-volume combined aerobic and resistance high-intensity interval training (C-HIIT), combined moderate-intensity continuous training (C-MICT) and waitlist control (CON) on vascular health after 8-weeks of supervised training, and an additional 10-months of self-directed training, in adults with type 2 diabetes (T2D).

Sixty-nine low active adults with T2D were randomised to 8-weeks of supervised C-HIIT (3 times/week, 78-min/week), C-MICT (current exercise guidelines, 4 times/week, 210-min/week) or CON. CON underwent usual care for 8-weeks before being re-randomised to C-HIIT or C-MICT. This was followed by 10-months of self-directed training for participants in C-HIIT and C-MICT. Vascular outcomes were evaluated at baseline, 8-weeks, and 12-months.

After 8-weeks, supervised C-HIIT significantly improved relative flow-mediated dilation (FMD) compared with CON (mean difference [MD] 0.8% [0.1, 1.4], p = 0.025). Although not significantly different from CON, the magnitude of change in relative FMD following 8-weeks of supervised C-MICT was similar (MD 0.8% [-0.1, 1.7], p = 0.080). There were no differences in haemodynamic indices, carotid-femoral pulse wave velocity (cfPWV), or aortic reservoir pressure between groups at 8-weeks. After 12-months, there was a significant reduction in haemodynamic indices (time effect, p < 0.05) for both C-HIIT and C-MICT, with no between-group difference. The reduction in cfPWV over 12-months was significantly greater in C-MICT than C-HIIT (group × time effect, p = 0.018). There was no difference in FMD over time or between groups at 12-months.

Short-term supervised C-HIIT and C-MICT both increased brachial artery FMD compared with CON. Long-term C-HIIT and C-MICT were beneficial for improving haemodynamic indices, but not brachial artery FMD. C-MICT was superior to C-HIIT for improving cfPWV at 12-months.

Australian New Zealand Clinical Trials Registry Identifier ACTRN12615000475549.

Habitual short sleep durations are associated with several cardiovascular diseases. Experimental research generally supports these findings as metrics of arterial function are impaired after complete deprivation of sleep and after longer periods of partial sleep restriction. The acute influence of a single instance of partial sleep restriction (PSR), however, has not been defined. We evaluated arterial structure and function among 32 university-aged participants on two occasions: once after normal habitual sleep (NS), and again the morning after an acute partial sleep restriction (PSR) intervention involving only 3 h of sleep for a single night. Endothelial function was measured using ultrasonography at the brachial artery via flow-mediated dilatation (FMD), and a ramp peak oxygen uptake test was used to evaluate cardiorespiratory fitness. Blood samples were collected from a subset of participants to investigate the influence of circulatory factors on cellular mechanisms implicated in endothelial function. Sleep duration was lower after a night of PSR compared to NS (P < 0.001); however, there were no appreciable differences in any haemodynamic outcome between conditions. FMD was not different between NS and PSR (NS: 6.5 ± 2.9%; PSR: 6.3 ± 2.9%; P = 0.668), and cardiorespiratory fitness did not moderate the haemodynamic response to PSR (all P > 0.05). Ex vivo cell culture results aligned with in vivo data, showing that acute PSR does not alter intracellular processes involved in endothelial function. No differences in arterial structure or function were observed between NS and acute PSR in healthy and young participants, and cardiorespiratory fitness does not modulate the arterial response to acute sleep restriction.

Supraphysiological doses of anabolic-androgenic steroids (AAS) is popular among recreational weightlifters and bodybuilders due to the performance-enhancing properties but is also associated with adverse cardiovascular effects. The knowledge about how AAS affect the vasculature is limited, although results from previous studies suggest alterations in vasoreactivity and morphology. In the present study we investigate the association between long-term use of AAS and vascular function. Hundred and twenty-three males were included in the study, 56 of them current AAS users and 67 weightlifting controls. Vascular function was evaluated by carotid artery reactivity and flow-mediated dilation. AAS users had significantly reduced carotid artery reactivity (p < 0.001) and flow-mediated dilation (p < 0.001) compared to weightlifting controls. Results from the present study indicate that long-term use of AAS affect the cardiovascular system negatively, measured as reduced carotid artery reactivity and flow-mediated dilation. These findings could partly explain sudden cardiovascular events among young long-term users of AAS.

Aging is associated with vascular endothelial dysfunction observed through a progressive loss of flow-mediated dilation caused partly by a decreased nitric oxide bioavailability. Intermittent hypoxia, consisting of alternating short bouts of breathing hypoxic and normoxic air, was reported to either maintain or improve vascular function in young adults. The aim of this study was to determine the impact of age on the vascular response to intermittent hypoxia. Twelve young adults and 11 older adults visited the laboratory on two occasions. Plasma nitrate concentrations and brachial artery flow-mediated dilation were assessed before and after exposure to either intermittent hypoxia or a sham protocol. Intermittent hypoxia consisted of eight 4-min hypoxic cycles at a targeted oxygen saturation of 80% interspersed with breathing room air to resaturation, and the sham protocol consisted of eight 4-min normoxic cycles interspersed with breathing room air. Vascular responses were assessed during intermittent hypoxia and the sham protocol. Intermittent hypoxia elicited a brachial artery vasodilation but did not change brachial artery shear rate in both young and older adults. Plasma nitrate concentrations were not significantly affected by intermittent hypoxia compared with the sham protocol in both groups. Brachial artery flow-mediated dilation was not acutely affected by intermittent hypoxia or the sham protocol in either young or older adults. In conclusion, the brachial artery vasodilatory response to intermittent hypoxia was not influenced by age. Intermittent hypoxia increased brachial artery diameter but did not acutely affect endothelium-dependent vasodilation in young or older adults.NEW & NOTEWORTHY The objective of this study was to determine the impact of age on the vascular response to intermittent hypoxia. Eight 4-min bouts of hypoxia at a targeted oxygen saturation of 80% induced a brachial artery vasodilation in both young and older adults, indicating that age does not influence the vasodilatory response to intermittent hypoxia. Intermittent hypoxia did not acutely affect brachial artery flow-mediated dilation in young or older adults.

Endothelial dysfunction decreases exercise limb blood flow (BF) and muscle oxygenation. Acute L-Citrulline supplementation (CIT) improves muscle tissue oxygen saturation index (TSI) and deoxygenated hemoglobin (HHb) during exercise. Although CIT improves endothelial function (flow-mediated dilation [FMD]) in hypertensive women, the impact of CIT on exercise BF and muscle oxygenation (TSI) and extraction (HHb) are unknown. We examined the effects of CIT (10 g/day) and a placebo for 4 weeks on blood pressure (BP), arterial vasodilation (FMD, BF, and vascular conductance [VC]), and forearm muscle oxygenation (TSI and HHb) at rest and during exercise in 22 hypertensive postmenopausal women. Compared to the placebo, CIT significantly (p < 0.05) increased FMD (Δ-0.7 ± 0.6% vs. Δ1.6 ± 0.7%) and reduced aortic systolic BP (Δ3 ± 5 vs. Δ-4 ± 6 mmHg) at rest and improved exercise BF (Δ17 ± 12 vs. Δ48 ± 16 mL/min), VC (Δ-21 ± 9 vs. Δ41 ± 14 mL/mmHg/min), TSI (Δ-0.84 ± 0.58% vs. Δ1.61 ± 0.46%), and HHb (Δ1.03 ± 0.69 vs. Δ-2.76 ± 0.77 μM). Exercise BF and VC were positively correlated with improved FMD and TSI during exercise (all p < 0.05). CIT improved exercise artery vasodilation and muscle oxygenation via increased endothelial function in hypertensive postmenopausal women.

Sedentary behavior has been shown to negatively affect parameters of endothelial function and central hemodynamics, both of which are closely associated with vascular health. Exercise prior to sedentary behavior has demonstrated potential as a preventive strategy to mitigate these detrimental effects. To evaluate the impact of exercise prior to sedentary behavior on vascular health parameters in the adult population, a systematic review and meta-analysis were conducted, synthesizing the available body of knowledge.

A literature search was carried out in 6 databases. For each outcome, standard error and mean difference or standardized mean difference were calculated, as appropriate. An analysis was performed using a random effects model with a 95% confidence interval, using the inverse variance statistical method. Risk of bias assessment was performed using ROB2 and considerations for crossover trials. The quality of evidence was assessed using the GRADE system.

Exercise performed prior to prolonged sedentary behavior resulted in increased flow-mediated vasodilation at the first and third hours of sedentary time, compared with the control condition of sedentary behavior without prior exercise [MD: 1.51% (95% CI: 0.57 to 2.45) and MD: 1.36% (95% CI: 0.56 to 2.16), respectively]. Moreover, prior exercise led to increased shear rate at the first and third hours of sedentary time [MD: 7.70 s^-1 (95% CI: 0.79 to 14.61) and MD: 5.21 s^-1 (95% CI: 1.77 to 8.43), respectively]. Furthermore, it increased blood flow at the third hour [SMD: 0.40 (95%CI: 0.07 to 0.72)], compared with the control condition of prolonged sedentary behavior without prior exercise. Regarding hemodynamic parameters, exercise prior to prolonged sedentary behavior decreased mean arterial pressure during the first and third hours of sedentary behavior [MD: -1.94 mmHg (95% CI: -2.77 to -1.11) and MD: -1.90 mmHg (95% CI: -3.27 to -0.53), respectively], and an increase in heart rate during the first hour [MD: 4.38 beats per minute (95%CI: 2.78 to 5.98)] compared with the control condition of prolonged sedentary behavior without prior exercise.

The findings of this research suggest that prior exercise may prevent the impairment of vascular health parameters caused by sedentary behavior. However, the quality of the evidence was estimated as moderate. Therefore, further experimental studies and high-quality clinical trials are needed in this field to strengthen the results and conclusions drawn.

CRD42023393686.

The study aimed to systematically review the effects of exercise training (EX) on brachial artery flow-mediated dilation (FMD) and inflammatory biomarkers in patients with peripheral artery disease (PAD). Five electronic databases were searched: (i) patients with PAD aged ≥ 18; (ii) structured EX ≥ 2 weeks; (iii) measured brachial artery FMD; and (iv) measured blood inflammatory biomarkers. Eighteen studies met the inclusion criteria. EX increased FMD but had no effect on C-reactive protein, interleukin-6, and tumor necrosis factor-α. Subgroups with moderate intensity had a greater increase in FMD than subgroups with vigorous intensity. There was no difference in effect on FMD and three inflammatory biomarkers between subgroups training for ≤ 12 weeks and > 12 weeks of EX, < 50 min and ≥ 50 min of session duration, and < 150 min and ≥ 150 min of weekly volume, respectively. These results suggest that EX-induced improvement in vascular function can be independent of the improvement of systemic inflammation.

Endothelial dysfunction is crucial factor to the hypertension occurrence, and controversy remains regarding the effect of exercise on improving endothelial function in hypertensive patients. The authors used meta-analysis to evaluate the intervention effect of exercise on endothelial function in hypertensive patients and to investigate exercise protocols that may have a greater intervention effect. A total of 37 studies and a total of 2801 participants were included. The results were as follows: endogenous nitric oxide (NO)[SMD = .89, 95% CI (.48, 1.30), p < .0001], endothelin-1 (ET-1): [SMD = -.94, 95% CI (-1.15, -.73), p <. 0001], flow-mediated dilation (FMD) [SMD = -.57, 95% CI (.36, .79), p < .000001]. In subgroup analysis, high-intensity aerobic exercise, with a single exercise duration of 35-50 min, 3-4 times/week for a total of 10-12 weeks, had the largest amount of intervention effect on NO, and moderate-intensity resistance exercise, with a single exercise duration of ≥60 min, 6 times/week for a total of 15-18 weeks, had the largest amount of intervention effect on ET-1. In conclusion, exercise can improve NO levels, FDM levels, and reduce ET-1 secretion of hypertension patients, thereby improve their endothelial function. The ideal intervention effect of improving NO level was more likely to be obtained by taking the exercise prescription of high-intensity aerobic exercise with a single exercise duration of 35-50 min, 3-4 times/week for 10-12 weeks; the ideal intervention effect of improving ET-1 was more likely to be obtained by taking the exercise prescription of oderate -intensity resistance exercise with a single exercise duration of ≥60 min, 6 times/week for 15-18 weeks.