This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Higashi, Y. Articles by Oshima, T. Search for Related Content PubMed PubMed Citation Articles by Higashi, Y. Articles by Oshima, T. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB CHOLESTEROL Medline Plus Health Information Exercise for Children Exercise and Physical Fitness High Blood Pressure

(Hypertension. 1999;33:591-597.)
© 1999 American Heart Association, Inc.

Scientific Contributions

Daily Aerobic Exercise Improves Reactive Hyperemia in Patients With Essential Hypertension

Yukihito Higashi, MD, PhD; Shota Sasaki, MD; Nobuo Sasaki, MD; Keigo Nakagawa, MD; Tomohiro Ueda, MD; Atsunori Yoshimizu, MD; Satoshi Kurisu, MD; Hideo Matsuura, MD, PhD; Goro Kajiyama, MD, PhD; Tetsuya Oshima, MD, PhD

Correspondence to Yukihito Higashi, MD, PhD, Hiroshima University School of Medicine, First Department of Internal Medicine, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. E mail yhigashi@mcai.med.hiroshima-u.ac.jp

Abstract—The effects of long-term aerobic exercise on endothelial function in patients with essential hypertension remain unclear. To determine whether endothelial function relating to forearm hemodynamics in these patients differs from normotensive subjects and whether endothelial function can be modified by continued physical exercise, we randomized patients with essential hypertension into a group that engaged in 30 minutes of brisk walking 5 to 7 times weekly for 12 weeks (n=20) or a group that underwent no activity modifications (control group, n=7). Forearm blood flow was measured using strain-gauge plethysmography during reactive hyperemia to test for endothelium-dependent vasodilation and after sublingual nitroglycerin administration to test endothelium-independent vasodilation. Forearm blood flow in hypertensive patients during reactive hyperemia was significantly less than that in normotensive subjects (n=17). Increases in forearm blood flow after nitroglycerin were similar between hypertensive and normotensive subjects. Exercise lowered mean blood pressure from 115.7±5.3 to 110.2±5.1 mm Hg (P<0.01) and forearm vascular resistance from 25.6±3.2 to 23.2±2.8 mm Hg/mL per minute per 100 mL tissue (P<0.01); no change occurred in controls. Basal forearm blood flow, body weight, and heart rate did not differ with exercise. After 12 weeks of exercise, maximal forearm blood flow response during reactive hyperemia increased significantly, from 38.4±4.6 to 47.1±4.9 mL/min per 100 mL tissue (P<0.05); this increase was not seen in controls. Changes in forearm blood flow after sublingual nitroglycerin administration were similar before and after 12 weeks of exercise. Intra-arterial infusion of the nitric oxide synthase inhibitor N^G-monomethyl-L-arginine abolished the enhancement of reactive hyperemia induced by 12 weeks of exercise. These findings suggest that through increased release of nitric oxide, continued physical exercise alleviates impairment of reactive hyperemia in patients with essential hypertension.

Key Words: exercise, aerobic • hyperemia, reactive • nitroglycerin • nitric oxide • N^G-monomethyl-L-arginine • endothelium • hypertension, essential

This article has been cited by other articles:

				P. K. Garg, K. Liu, L. Tian, J. M. Guralnik, L. Ferrucci, M. H. Criqui, J. Tan, and M. M. McDermott Physical Activity During Daily Life and Functional Decline in Peripheral Arterial Disease Circulation, January 20, 2009; 119(2): 251 - 260. [Abstract] [Full Text] [PDF]

				M. R. Cesarone, A. Di Renzo, S. Errichi, F. Schonlau, J. L. Wilmer, and J. Blumenfeld Improvement in Circulation and in Cardiovascular Risk Factors With a Proprietary Isotonic Bioflavonoid Formula OPC-3(R) Angiology, August 1, 2008; 59(4): 408 - 414. [Abstract] [PDF]

				S. Kodama, S. Tanaka, K. Saito, M. Shu, Y. Sone, F. Onitake, E. Suzuki, H. Shimano, S. Yamamoto, K. Kondo, et al. Effect of Aerobic Exercise Training on Serum Levels of High-Density Lipoprotein Cholesterol: A Meta-analysis Arch Intern Med, May 28, 2007; 167(10): 999 - 1008. [Abstract] [Full Text] [PDF]

				C. L. McGowan, A. S. Levy, P. J. Millar, J. C. Guzman, C. A. Morillo, N. McCartney, and M. J. MacDonald Acute vascular responses to isometric handgrip exercise and effects of training in persons medicated for hypertension Am J Physiol Heart Circ Physiol, October 1, 2006; 291(4): H1797 - H1802. [Abstract] [Full Text] [PDF]

				S. E. Petersen, F. Wiesmann, L. E. Hudsmith, M. D. Robson, J. M. Francis, J. B. Selvanayagam, S. Neubauer, and K. M. Channon Functional and Structural Vascular Remodeling in Elite Rowers Assessed by Cardiovascular Magnetic Resonance J. Am. Coll. Cardiol., August 15, 2006; 48(4): 790 - 797. [Abstract] [Full Text] [PDF]

				V. A. Cornelissen and R. H. Fagard Effects of Endurance Training on Blood Pressure, Blood Pressure-Regulating Mechanisms, and Cardiovascular Risk Factors Hypertension, October 1, 2005; 46(4): 667 - 675. [Abstract] [Full Text] [PDF]

				C. K. Roberts and R. J. Barnard Effects of exercise and diet on chronic disease J Appl Physiol, January 1, 2005; 98(1): 3 - 30. [Abstract] [Full Text] [PDF]

				D. J Green, A. Maiorana, G. O'Driscoll, and R. Taylor Effect of exercise training on endothelium-derived nitric oxide function in humans J. Physiol., November 15, 2004; 561(1): 1 - 25. [Abstract] [Full Text] [PDF]

				D. A. Graham and J. W. E. Rush Exercise training improves aortic endothelium-dependent vasorelaxation and determinants of nitric oxide bioavailability in spontaneously hypertensive rats J Appl Physiol, June 1, 2004; 96(6): 2088 - 2096. [Abstract] [Full Text] [PDF]

				K. F. Harris, K. A. Matthews, K. Sutton-Tyrrell, and L. H. Kuller Associations Between Psychological Traits and Endothelial Function in Postmenopausal Women Psychosom Med, May 1, 2003; 65(3): 402 - 409. [Abstract] [Full Text] [PDF]

				K. J. Stewart, W. R. Hiatt, J. G. Regensteiner, and A. T. Hirsch Exercise Training for Claudication N. Engl. J. Med., December 12, 2002; 347(24): 1941 - 1951. [Full Text] [PDF]

				E. S. Buhl, N. Jessen, R. Pold, T. Ledet, A. Flyvbjerg, S. B. Pedersen, O. Pedersen, O. Schmitz, and S. Lund Long-Term AICAR Administration Reduces Metabolic Disturbances and Lowers Blood Pressure in Rats Displaying Features of the Insulin Resistance Syndrome Diabetes, July 1, 2002; 51(7): 2199 - 2206. [Abstract] [Full Text] [PDF]

				S. P. Whelton, A. Chin, X. Xin, and J. He Effect of Aerobic Exercise on Blood Pressure: A Meta-Analysis of Randomized, Controlled Trials Ann Intern Med, April 2, 2002; 136(7): 493 - 503. [Abstract] [Full Text] [PDF]

				Y. Higashi, S. Sasaki, K. Nakagawa, H. Matsuura, G. Kajiyama, and T. Oshima Effect of the angiotensin-converting enzyme inhibitor imidapril on reactive hyperemia in patients with essential hypertension: relationship between treatment periods and resistance artery endothelial function J. Am. Coll. Cardiol., March 1, 2001; 37(3): 863 - 870. [Abstract] [Full Text] [PDF]

				T. Rankinen, T. Rice, L. Perusse, Y. C. Chagnon, J. Gagnon, A. S. Leon, J. S. Skinner, J. H. Wilmore, D. C. Rao, and C. Bouchard NOS3 Glu298Asp Genotype and Blood Pressure Response to Endurance Training : The HERITAGE Family Study Hypertension, November 1, 2000; 36(5): 885 - 889. [Abstract] [Full Text] [PDF]

				B. A. KINGWELL Nitric oxide-mediated metabolic regulation during exercise: effects of training in health and cardiovascular disease FASEB J, September 1, 2000; 14(12): 1685 - 1696. [Abstract] [Full Text]