Exercise training and vascular function in postmenopausal individuals: a systematic review and meta-analysis.
Journal
Menopause (New York, N.Y.)
ISSN: 1530-0374
Titre abrégé: Menopause
Pays: United States
ID NLM: 9433353
Informations de publication
Date de publication:
01 08 2022
01 08 2022
Historique:
pubmed:
27
7
2022
medline:
3
8
2022
entrez:
26
7
2022
Statut:
ppublish
Résumé
Cardiovascular disease (CVD) is a leading cause of morbidity and mortality for menopausal individuals. Flow-mediated dilation (FMD), a surrogate marker of CVD, improves with aerobic exercise training in healthy and nonhealthy cohorts. However, systematic evaluation and precise estimate of this effect for menopausal individuals are unknown. We conducted a systematic review with meta-analysis to evaluate the influence of exercise training on FMD in postmenopausal individuals. Studies were identified from systematic search of major electronic databases (PubMed, ScienceDirect, and Cochrane Library) from inception to February 2021. Healthy, postmenopausal individuals were included, following an aerobic exercise intervention assessing FMD. A random-effects meta-analysis was used to calculate a pooled effect size (mean difference [MD]) with 95% confidence interval. Heterogeneity was assessed using I2 statistics. Metaregression was used to assess the association between changes in FMD and physical characteristics (eg, blood pressure, age, baseline FMD) and intervention details (metabolic equivalents and change in maximal oxygen uptake [∆V˙ o2max ]). For variables that significantly correlated, a multiple metaregression model was used to assess the accounted variance in between-study ∆FMD%. Study quality was assessed using the National Heart, Lung, and Blood Institute assessment tool. Nine studies, including 11 interventions (6 controlled interventions and 5 pre-post interventions; N = 182), with age range of 52 ± 4 to 64 ± 7 years underwent quantitative pooling of data. Exercise training significantly improved ∆FMD% (MD, 0.99; 95% confidence interval, 0.46-1.52; P < 0.001). Between-study heterogeneity was large and statistically significant ( I2 = 93.8%, P < 0.001). Post hoc analysis based on study design identified significant heterogeneity in the MD in ∆FMD% between controlled and pre-post study interventions ( P < 0.05). According to multiple metaregression, diastolic and systolic blood pressure and ∆V˙ o2max significantly predicted ∆FMD% ( Q = 15.74, df = 3, P < 0.01, R2 = 0.72). Aerobic exercise training improves FMD for postmenopausal individuals, and this observation was greater among controlled versus pre-post interventions. A higher resting blood pressure and the greatest ∆V˙ o2max yielded the largest improvements in FMD.
Identifiants
pubmed: 35881939
doi: 10.1097/GME.0000000000002000
pii: 00042192-990000000-00020
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
982-992Informations de copyright
Copyright © 2022 by The North American Menopause Society.
Déclaration de conflit d'intérêts
Financial disclosures/conflicts of interest: M.H.D. reports institutional funding as a Christenson Professor in Active Healthy Living. M.H.D. reports past institutional funding from Heart and Stroke Foundation of Canada, National New Investigator Award. The other authors have nothing to disclose.
Références
Benjamin EJ, Muntner P, Alonso A, et al. Heart disease and stroke statistics—2019 update: a report from the American Heart Association. Circulation 2019;139:e56–e528. doi: 10.1161/CIR.0000000000000659
doi: 10.1161/CIR.0000000000000659
WHO. Research on the menopause in the 1990s. Report of a WHO Scientific Group. World Health Organ Tech Rep Ser 1996;866:1–107.
Novella S, Pérez-Cremades D, Mompeón A, Hermenegildo C. Mechanisms underlying the influence of oestrogen on cardiovascular physiology in women. J Physiol 2019;597:4873–4886. doi: 10.1113/JP278063
doi: 10.1113/JP278063
Thijssen DHJ, Bruno RM, van Mil ACCM, et al. Expert consensus and evidence-based recommendations for the assessment of flow-mediated dilation in humans. Eur Heart J 2019;40:2534–2547. doi: 10.1093/eurheartj/ehz350
doi: 10.1093/eurheartj/ehz350
Ras RT, Streppel MT, Draijer R, Zock PL. Flow-mediated dilation and cardiovascular risk prediction: a systematic review with meta-analysis. Int J Cardiol 2013;168:344–351. doi:10.1016/j.ijcard.2012.09.047
doi: 10.1016/j.ijcard.2012.09.047
Inaba Y, Chen JA, Bergmann SR. Prediction of future cardiovascular outcomes by flow-mediated vasodilatation of brachial artery: a meta-analysis. Int J Cardiovasc Imaging 2010;26:631–640. doi: 10.1007/s10554-010-9616-1
doi: 10.1007/s10554-010-9616-1
Matsuzawa Y, Kwon TG, Lennon RJ, Lerman LO, Lerman A. Prognostic value of flow-mediated vasodilation in brachial artery and fingertip artery for cardiovascular events: a systematic review and meta-analysis. J Am Heart Assoc 2015;4:e002270. doi: 10.1161/JAHA.115.002270
doi: 10.1161/JAHA.115.002270
Xu Y, Arora RC, Hiebert BM, et al. Non-invasive endothelial function testing and the risk of adverse outcomes: a systematic review and meta-analysis. Eur Heart J Cardiovasc Imaging . 2014;15:736–746. doi: 10.1093/ehjci/jet256
doi: 10.1093/ehjci/jet256
Celermajer DS, Sorensen KE, Spiegelhalter DJ, Georgakopoulos D, Robinson J, Deanfield JE. Aging is associated with endothelial dysfunction in healthy men years before the age-related decline in women. J Am Coll Cardiol 1994;24-:471–476. doi: 10.1016/0735-1097(94)90305-0
doi: 10.1016/0735-1097(94)90305-0
Proctor DN, Parker BA. Vasodilation and vascular control in contracting muscle of the aging human. Microcirculation 2006;13:315–327. doi: 10.1080/10739680600618967
doi: 10.1080/10739680600618967
Black MA, Cable NT, Thijssen DH, Green DJ. Impact of age, sex, and exercise on brachial artery flow-mediated dilatation. Am J Physiol Heart Circ Physiol 2009;297:H1109–H1116. doi: 10.1152/ajpheart.00226.2009
doi: 10.1152/ajpheart.00226.2009
Moreau KL, Hildreth KL, Meditz AL, Deane KD, Kohrt WM. Endothelial function is impaired across the stages of the menopause transition in healthy women. J Clin Endocrinol Metab 2012;97:4692–4700. doi: 10.1210/jc.2012-2244
doi: 10.1210/jc.2012-2244
Celermajer DS, Sorensen KE, Gooch VM, et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992;340:1111–1115. doi: 10.1016/0140-6736(92)93147-F
doi: 10.1016/0140-6736(92)93147-F
Moreau KL, Stauffer BL, Kohrt WM, Seals DR. Essential role of estrogen for improvements in vascular endothelial function with endurance exercise in postmenopausal women. J Clin Endocrinol Metab 2013;98:4507–4515. doi: 10.1210/jc.2013-2183
doi: 10.1210/jc.2013-2183
Ozemek C, Hildreth KL, Blatchford PJ, et al. Effects of resveratrol or estradiol on postexercise endothelial function in estrogen-deficient postmenopausal women. J Appl Physiol 2020;128:739–747. doi: 10.1152/japplphysiol.00488.2019
doi: 10.1152/japplphysiol.00488.2019
Chlebowski RT, Schwartz AG, Wakelee H, et al. Oestrogen plus progestin and lung cancer in postmenopausal women (Women's Health Initiative trial): a post-hoc analysis of a randomised controlled trial. Lancet 2009;374:1243–1251. doi: 10.1016/S0140-6736(09)61526-9
doi: 10.1016/S0140-6736(09)61526-9
Vandenbroucke JP. The HRT controversy: observational studies and RCTs fall in line. Lancet 2009;373:1233–1235. doi: 10.1016/S0140-6736(09)60708-X
doi: 10.1016/S0140-6736(09)60708-X
Prentice RL, Langer RD, Stefanick ML, et al. Combined analysis of Women's Health Initiative observational and clinical trial data on postmenopausal hormone treatment and cardiovascular disease. Am J Epidemiol 2006;163:589–599. doi: 10.1093/aje/kwj079
doi: 10.1093/aje/kwj079
Vinogradova Y, Coupland C, Hippisley-Cox J. Use of hormone replacement therapy and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases. BMJ 2019;364, k4810. doi: 10.1136/bmj.k4810
doi: 10.1136/bmj.k4810
Anderson GL, Chlebowski RT, Rossouw JE, et al. Prior hormone therapy and breast cancer risk in the Women's Health Initiative randomized trial of estrogen plus progestin. Maturitas 2006;55:103–115. doi: 10.1016/j.maturitas.2006.05.004
doi: 10.1016/j.maturitas.2006.05.004
Stefanick ML, Anderson GL, Margolis KL, et al. Effects of conjugated equine estrogens on breast cancer and mammography screening in postmenopausal women with hysterectomy. JAMA 2006;295:1647–1657. doi: 10.1001/jama.295.14.1647
doi: 10.1001/jama.295.14.1647
Ashor AW, Lara J, Siervo M, et al. Exercise modalities and endothelial function: a systematic review and dose-response meta-analysis of randomized controlled trials. Sports Med . 2015;45:279296. doi: 10.1007/s40279-014-0272-9
doi: 10.1007/s40279-014-0272-9
Early KS, Stewart A, Johannsen N, Lavie CJ, Thomas JR, Welsch M. The effects of exercise training on brachial artery flow-mediated dilation: a meta-analysis. J Cardiopulm Rehabil Prev 2017;37:77–89. doi: 10.1097/HCR.0000000000000206
doi: 10.1097/HCR.0000000000000206
Gliemann L, Hellsten Y. The exercise timing hypothesis: can exercise training compensate for the reduction in blood vessel function after menopause if timed right? J Physiol 2019;597:4915–4925. doi:10.1113/jp277056
doi: 10.1113/jp277056
Hellsten Y, Nyberg M. Cardiovascular adaptations to exercise training. Compr Physiol 2015;6:1–32. doi: 10.1002/cphy.c140080
doi: 10.1002/cphy.c140080
Page MJ, Moher D, Bossuyt PM, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ 2021;372:n160. doi: 10.1136/bmj.n160
doi: 10.1136/bmj.n160
Moher D, Shamseer L, Clarke M, et al. Preferred Reporting Items for Systematic Review and Meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 2015;4:1. doi: 10.1186/2046-4053-4-1
doi: 10.1186/2046-4053-4-1
Campbell A, Grace F, Ritchie L, Beaumont A, Sculthorpe N. Long-term aerobic exercise improves vascular function into old age: a systematic review, meta-analysis and meta regression of observational and interventional studies. Front Physiol 2019;10:31. doi: 10.3389/fphys.2019.00031
doi: 10.3389/fphys.2019.00031
Beaumont A, Grace F, Richards J, Hough J, Oxborough D, Sculthorpe N. Left ventricular speckle tracking-derived cardiac strain and cardiac twist mechanics in athletes: a systematic review and meta-analysis of controlled studies. Sports Med 2017;47:1145–1170. doi: 10.1007/s40279-016-0644-4
doi: 10.1007/s40279-016-0644-4
Abràmoff MD, Magalhães PJ, Ram SJ. Image processing with ImageJ. Biophotonics Int 2004;11:36–42.
Akazawa N, Choi Y, Miyaki A, et al. Curcumin ingestion and exercise training improve vascular endothelial function in postmenopausal women. Nutr Res 2012;32:795–799. doi: 10.1016/j.nutres.2012.09.002
doi: 10.1016/j.nutres.2012.09.002
Azadpour N, Tartibian B, Koşar ŞN. Effects of aerobic exercise training on ACE and ADRB2 gene expression, plasma angiotensin II level, and flow-mediated dilation: a study on obese postmenopausal women with prehypertension. Menopause 2017;24:269–277. doi: 10.1097/GME.0000000000000762
doi: 10.1097/GME.0000000000000762
Bailey TG, Cable NT, Aziz N, et al. Exercise training reduces the acute physiological severity of post-menopausal hot flushes. J Physiol 2016;594:657–667. doi: 10.1113/JP271456
doi: 10.1113/JP271456
Jo EA, Wu SS, Han HR, Park JJ, Park S, Cho KI. Effects of exergaming in postmenopausal women with high cardiovascular risk: a randomized controlled trial. Clin Cardiol 2020;43:363–370:clc.23324. doi: 10.1002/clc.23324
doi: 10.1002/clc.23324
Klonizakis M, Moss J, Gilbert S, Broom D, Foster J, Tew GA. Low-volume high-intensity interval training rapidly improves cardiopulmonary function in postmenopausal women. Menopause 2014;21:1099–1105. doi: 10.1097/GME.0000000000000208
doi: 10.1097/GME.0000000000000208
Pierce GL, Eskurza I, Walker AE, Fay TN, Seals DR. Sex-specific effects of habitual aerobic exercise on brachial artery flow-mediated dilation in middle-aged and older adults. Clin Sci 2011;120:13–23. doi: 10.1042/CS20100174
doi: 10.1042/CS20100174
Higgins JPT, Thomas J, Chandler J, et al. Cochrane Handbook for Systematic Reviews of Interventions. Oxford, UK: John Wiley & Sons; 2019.
Garber CE, Blissmer B, Deschenes MR, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc . 2011;43:1334–1359. doi: 10.1249/MSS.0b013e318213fefb
doi: 10.1249/MSS.0b013e318213fefb
Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315:629–634. doi: 10.1136/bmj.315.7109.629
doi: 10.1136/bmj.315.7109.629
Yoshizawa M, Maeda S, Miyaki A, et al. Additive beneficial effects of lactotripeptides intake with regular exercise on endothelium-dependent dilatation in postmenopausal women. Am J Hypertens 2010;23:368–372. doi: 10.1038/ajh.2009.270
doi: 10.1038/ajh.2009.270
National Heart, Lung, and Blood Institute. Study Quality Assessment Tools. 2019. Available at: https://www.nhlbi . nih. gov/health-topics/study-quality-assessment-tools. Accessed November 1, 2021.
Vitale C, Mercuro G, Cerquetani E, et al. Time since menopause influences the acute and chronic effect of estrogens on endothelial function. Arterioscler Thromb Vasc Biol 2008;28:348–352. doi: 10.1161/ATVBAHA.107.158634
doi: 10.1161/ATVBAHA.107.158634
Guetta V, Cannon RO 3rd. Cardiovascular effects of estrogen and lipid-lowering therapies in postmenopausal women. Circulation 1996;93:1928–1937. doi: 10.1161/01.cir.93.10.1928
doi: 10.1161/01.cir.93.10.1928
Magnusson C, Baron JA, Correia N, Bergström R, Adami HO, Persson I. Breast-cancer risk following long-term oestrogen- and oestrogen-progestin-replacement therapy. Int J Cancer 1999;81:339–344. doi: 10.1002/(SICI)1097-0215(19990505)81:3%3C339:AID-IJC5%3E3.0.CO;2-6
doi: 10.1002/(SICI)1097-0215(19990505)81:3%3C339:AID-IJC5%3E3.0.CO;2-6
Howley ET. Type of activity: resistance, aerobic and leisure versus occupational physical activity. Med Sci Sports Exerc 2001;33:S364–S369. doi: 10.1097/00005768-200106001-00005
doi: 10.1097/00005768-200106001-00005
Hoier B, Olsen LN, Leinum M, et al. Aerobic high-intensity exercise training improves cardiovascular health in older post-menopausal women. Front Aging 2021;2:8. doi: 10.3389/fragi.2021.667519
doi: 10.3389/fragi.2021.667519
Nishiwaki M, Kawakami R, Saito K, Tamaki H, Takekura H, Ogita F. Vascular adaptations to hypobaric hypoxic training in postmenopausal women. J Physiol Sci 2011;61:8391. doi: 10.1007/s12576-010-0126-7
doi: 10.1007/s12576-010-0126-7
Burt VL, Whelton P, Roccella EJ, et al. Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988–1991. Hypertension 1995;25:305–313. doi:10.1161/01.HYP.25.3.305
doi: 10.1161/01.HYP.25.3.305
Nyberg M, Seidelin K, Andersen TR, Overby NN, Hellsten Y, Bangsbo J. Biomarkers of vascular function in premenopausal and recent postmenopausal women of similar age: effect of exercise training. Am J Physiol Regul Integr Comp Physiol 2014;306:R510–R517. doi: 10.1152/ajpregu.00539.2013
doi: 10.1152/ajpregu.00539.2013
Lewington S, Clarke R, Qizilbash N, et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002;360:1903–1913. doi: 10.1016/S0140-6736(02)11911-8
doi: 10.1016/S0140-6736(02)11911-8
American Heart Association. Heart and Stroke Statistical Update—2000 . Dallas, TX, American Heart Association. 2004.
Moriguchi J, Itoh H, Harada S, et al. Low frequency regular exercise improves flow-mediated dilatation of subjects with mild hypertension. Hypertens Res 2005;28:315–321. doi: 10.1291/hypres.28.315
doi: 10.1291/hypres.28.315
Kaplon RE, Walker AE, Seals DR. Plasma norepinephrine is an independent predictor of vascular endothelial function with aging in healthy women. J Appl Physiol 2011;111:1416–1421. doi: 10.1152/japplphysiol.00721.2011
doi: 10.1152/japplphysiol.00721.2011
Sverrisdóttir YB, Jansson LM, Hägg U, Gan L-M. Muscle sympathetic nerve activity is related to a surrogate marker of endothelial function in healthy individuals. PLoS One 2010;5:e9257. doi: 10.1371/journal.pone.0009257
doi: 10.1371/journal.pone.0009257
Parthasarathy S, Barnett J, Fong LG. High-density lipoprotein inhibits the oxidative modification of low-density lipoprotein. Biochim Biophys Acta 1990;1044:275–283. doi: 10.1016/0005-2760(90)90314-N
doi: 10.1016/0005-2760(90)90314-N
Simons LA, Sullivan D, Simons J, Celermajer DS. Effects of atorvastatin monotherapy and simvastatin plus cholestyramine on arterial endothelial function in patients with severe primary hypercholesterolaemia. Atherosclerosis 1998;137:197–203. doi: 10.1016/S0021-9150(97)00252-9
doi: 10.1016/S0021-9150(97)00252-9
Lewis TV, Dart AM, Chin-Dusting JP, Kingwell BA. Exercise training increases basal nitric oxide production from the forearm in hypercholesterolemic patients. Arterioscler Thromb Vasc Biol 1999;19:2782–2787. doi: 10.1161/01.ATV.19.11.2782
doi: 10.1161/01.ATV.19.11.2782
Sisson SB, Katzmarzyk PT, Earnest CP, Bouchard C, Blair SN, Church TS. Volume of exercise and fitness non-response in sedentary, post-menopausal women. Med Sci Sports Exerc 2009;41:539–545. doi: 10.1249%2FMSS.0b013e3181896c4e
doi: doi: 10.1249%2FMSS.0b013e3181896c4e
Mandrup CM, Egelund J, Nyberg M, et al. Effects of high-intensity training on cardiovascular risk factors in premenopausal and postmenopausal women. Am J Obstet Gynecol 2017;216:384.e1–384.e11. doi: 10.1016/j.ajog.2016.12.017
doi: 10.1016/j.ajog.2016.12.017
Corretti MC, Anderson TJ, Benjamin EJ, et al. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol 2002;39:257–265. doi: 10.1016/S0735-1097(01)01746-6
doi: 10.1016/S0735-1097(01)01746-6
Kawano N, Emoto M, Mori K, et al. Association of endothelial and vascular smooth muscle dysfunction with cardiovascular risk factors, vascular complications, and subclinical carotid atherosclerosis in type 2 diabetic patients. J Atheroscler Thromb 2012;19:276–284. doi: 10.5551/jat.10629
doi: 10.5551/jat.10629
Thijssen DHJJ, Black MA, Pyke KE, et al. Assessment of flow-mediated dilation in humans: a methodological and physiological guideline. Am J Physiol Hear Circ Physiol 2011;300:H2–12. doi: 10.1152/ajpheart.00471.2010
doi: 10.1152/ajpheart.00471.2010
Black MA, Cable NT, Thijssen DHJ, Green DJ. Importance of measuring the time course of flow-mediated dilatation in humans. Hypertension 2008;51:203–210. doi: 10.1161/HYPERTENSIONAHA.107.101014
doi: 10.1161/HYPERTENSIONAHA.107.101014
Woodman RJ, Playford DA, Watts GF, et al. Improved analysis of brachial artery ultrasound using a novel edge-detection software system. J Appl Physiol 2001;91:929–937. doi: 10.1152/jappl.2001.91.2.929
doi: 10.1152/jappl.2001.91.2.929
Harris RA, Nishiyama SK, Wray DW, Richardson RS. Ultrasound assessment of flow-mediated dilation. Hypertension 2010;55:1075–1085. doi: 10.1161/HYPERTENSIONAHA.110.150821
doi: 10.1161/HYPERTENSIONAHA.110.150821
Donald AE, Halcox JP, Charakida M, et al. Methodological approaches to optimize reproducibility and power in clinical studies of flow-mediated dilation. J Am Coll Cardiol 2008;51:1959–1964. doi: 10.1016/j.jacc.2008.02.044
doi: 10.1016/j.jacc.2008.02.044