Chronic aerobic exercise: targeting two birds with one stone.
Chronic aerobic exercise: targeting two birds with one stone.
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慢性有氧运动：一石二鸟。
DOI：
10.1113/jp280929
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Lesniewski LA
中科院分区：
文献类型：
--
作者：
Islam MT;Hall SA;Lesniewski LA
心血管疾病（CVD）是全球死亡的主要原因，与年龄增长，肥胖和久坐不动的生活方式密切相关（Donato，Machin和Lesniewski，2018）。内皮依赖性扩张（EDD）减少和大动脉硬度增加是血管功能障碍的标志，可预测未来的临床心血管事件（Donato等人，2018年）。作为对化学（即乙酰胆碱、胰岛素）和机械（即剪切应力）刺激的响应，血管内皮合成并释放一氧化氮（NO），随后扩散到血管平滑肌细胞（VSMC）中，启动信号级联反应，导致VSMC松弛和血管舒张（即EDD）。此外，NO抑制血管壁免疫细胞粘附和浸润、血小板聚集并增强组织氧递送（Gimbrone & Garcia-Cardena，2016）。动脉硬度的增加导致顺应性降低、血压升高、脉压升高、心室后负荷增加、心脏肥大和冠状动脉灌注减少（Donato等人，2018).年龄增长、久坐不动的生活方式和西方饮食模式会促进氧化应激和慢性无菌性炎症，其特征是活性氧（O2-、H2 O2等）增加。面对减弱或不变的抗氧化防御和增强的促炎细胞因子如IL-6、IL-1β、TNF-α和INF-γ（Donato等，2018年）。促进内皮功能障碍的氧化应激和炎症前馈、降低的NO生物利用度和结构变化，如促进动脉硬化的改变的胶原蛋白和弹性蛋白表达（Donato等人，2018年）。虽然预防内皮功能障碍和动脉僵硬随着年龄增长的发展的有效治疗方法是难以捉摸的，但生活方式的改变，如体育锻炼是一个关键的预防策略。
Cardiovascular diseases (CVDs) are the leading cause of death globally and are strongly associated with advancing age, obesity and sedentary lifestyle (Donato, Machin, & Lesniewski, 2018). Reduced endothelial dependent dilation (EDD) and increased large artery stiffness are hallmarks of vascular dysfunction, predicting future clinical cardiovascular events (Donato et al., 2018). In response to chemical (ie acetylcholine, insulin) and mechanical (ie shear stress) stimuli, the vascular endothelium synthesizes and releases nitric oxide (NO) that subsequently diffuses into vascular smooth muscle cells (VSMCs), initiating a signaling cascade resulting in VSMC relaxation and vasodilation ie EDD. Additionally, NO inhibits vascular wall immune cell adhesion and infiltration, platelet aggregation and enhances tissue oxygen delivery (Gimbrone & Garcia-Cardena, 2016). Increases in arterial stiffness lead to reduced compliance, increased blood pressure, elevated pulse pressure, increased ventricular afterload, cardiac hypertrophy and diminished coronary perfusion (Donato et al., 2018).Advancing age, sedentary lifestyle, and western dietary patterns promote oxidative stress and chronic sterile inflammation which are characterized by increases in reactive oxygen species (O2−, H2O2, etc.) in the face of attenuated or unchanged antioxidant defenses and enhanced proinflammatory cytokines such as IL-6, IL-1β, TNF-α, and INF-γ (Donato et al., 2018). Oxidative stress and inflammation feedforward to promote endothelial dysfunction, reduced NO bioavailability and structural changes such as altered collagen and elastin expression that promote arterial stiffening (Donato et al., 2018). While an effective therapeutic to prevent the development of endothelial dysfunction and arterial stiffness with aging is elusive, lifestyle modification such as physical exercise is a key preventive strategy.