The benefits of exercise for arterial stiffness.

L ifestyle modifications—in particular aerobic (but not resistance) exercise training and sodium restriction— appear to be clinically efficient interventions for preventing and treating arterial stiffening. Interest in exercise training studies have been triggered by cross-sectional and prospective observational studies demonstrating that individuals with higher habitual physical activity levels have reduced arterial stiffness compared with their sedentary counterparts. Exercise training interventions that decrease the age-related increase in arterial stiffness may therefore have the potential to improve outcomes, particularly in individuals with increased cardiovascular risk. However, this may not apply to all risk groups. Indeed, exercise training has failed to exert any beneficial impact in patients with isolated systolic hypertension, which has been attributed to an irreversible level of arterial stiffening in these patients. Aerobic exercise training may thus be more effective when initiated early, as a preventive rather than a treatment measure. In the current issue of the Journal, Sugawara et al report exercise-related improvements in arterial stiffness in postmenopausal women enrolled in an aerobic exercise program for 12 weeks. This specific risk group has been examined in an earlier exercise intervention study aiming at arterial stiffness reduction. The considerable improvements in arterial stiffness of that study led the authors to propose exercise as a strategy for decreasing cardiovascular disease risk in postmenopausal women. This hypothesis was further investigated by Sugawara et al, who also attempted to investigate whether aerobic exercise performed at different intensities (moderate or vigorous) would have a different impact on arterial stiffness. They found that both moderate and vigorous physical activity led to comparable reductions in arterial stiffness. These findings have important implications because moderate physical activity intensity may be more palatable and easily incorporated into daily life. One should nevertheless note that the exercise volume (ie, duration intensity) undertaken by both exercise groups was the same ( 900 kcal/ week), suggesting that an energy expenditure threshold may be needed, through either short periods of vigorous