Relation Between Endothelial Dysfunction and Exercise Training-Mediated Adaptation in Cardiovascular Risk Factors, Cardiorespiratory Fitness, and Vascular Health in Humans: A seconadary analysis

Purpose: A priori cardiovascular (CV) health status may impact reductions in risk factors and CV mortality and morbidity following exercise training, although this is not fully understood. Therefore, the purpose of the study was to examine if endothelial function (assessed via flow mediated dilation; FMD%), predicts the magnitude of change in CV risk factors or fitness following exercise training. Methods: We pooled data from 338 individuals who underwent supervised exercise training (8–26 weeks). Using recent sex- and age-specific reference values for flow-mediated dilation (FMD%), we categorised participants as having preserved endothelial function (P-EF) (> 50th percentile of reference value, 56 females, 67 males, 46 ± 17 years) or reduced endothelial function (R-EF) (< 50th percentile of reference value, 67 females, 148 males, 48 ± 17 years). The effects of exercise training on cardiovascular risk factors (BMI, cholesterol, glucose and triglycerides), cardiorespiratory fitness (VO_2peak) and vascular function (FMD%) were examined using a two-way mixed design general linear model. Results: Exercise training significantly improved physical fitness (P < 0.001), with no difference in the magnitude of improvement between P-EF and R-EF. Modest but significant reductions were present in BMI, blood pressure and total cholesterol (all P < 0.005), with no difference between P-EF and R-EF groups in the magnitude of changes in these variables with training. Exercise training did not significantly alter glucose, triglycerides, high density lipoprotein (HDL) and low-density lipoprotein (LDL) (all P > 0.05). Conclusion: Individuals with reduced and preserved a priori endothelial function status can obtain benefits from exercise in terms of risk factor modification and fitness change. Therefore, exercise has the potential to be beneficial in all clinical groups.