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Effects of Exercise and Physical Activity on Prevention of


									Matsuda, M.
Review : Aging and Health Promotion

           Effects of Exercise and Physical Activity on
                  Prevention of Arteriosclerosis
          ― Special Reference to Arterial Distensibility ―
                                                        Mitsuo Matsuda*,**
                                         Tsukuba Advanced Research Alliance, University of Tsukuba
                                            1-1-1 Tennodai, Tsukuba-shi, Ibaraki 305-8577, Japan
                                    Tsukuba Indaustrial Liason and Cooperative Center, University of Tsukuba
                                           [Received May 20, 2005 ; Accepted November 7, 2005]

              Arterial distensibility, particularly central arterial distensibility, decreases with age-related
              changes in the arterial wall and, as a result, systolic blood pressure and/or pulse pressure
              (difference of systolic pressure and diastolic pressure) may increase in the elderly. Systolic
              hypertension, increased pulse pressure, and decreased central arterial distensibility are
              known to be independent risk factors for cardiovascular and cerebrovascular diseases.
              Decreased arterial distensibility may also cause the deterioration of physical ability in the
              elderly. Several previous studies, as well as the current investigation, have shown that daily
              physical activity is positively related to arterial distensibility in not only young but also
              elderly people and that relatively short-term and low-intensity aerobic exercise training could
              improve arterial distensibility even in the elderly. It has been shown, however, that the effect
              cannot be maintained without continued physical exercise. Some presumable biological
              mechanisms and the appropriate amount and/or intensity of physical activity and aerobic
              exercise for improving arterial distensibility have also been revealed. Thus, habitual physical
              activity and exercise may have the effect of retarding age-related changes to the arteries and
              establishing higher quality of life by preventing cardiovascular and cerebrovascular diseases
              and by improving physical ability in the elderly.

              Keywords: physical activity volume, exercise intensity, exercise training, systemic arterial compliance,
              pulse wave velocity, systolic blood pressure, pulse pressure
                                [International Journal of Sport and Health Science Vol.4, 316-324, 2006]

    1. Introduction                                                      in recent times, the top three causes of death for
                                                                         both males and females are cancer, cardiac diseases
       A statement released by the American Heart                        and cerebrovascular diseases. Among them, both
    Association (Thompson, et al., 2003) reported that                   ischemic heart diseases and cerebrovascular diseases
    aerobic exercise of moderate intensity performed                     are attributable to arteriosclerosis and combined they
    for 30 minutes or more per day (relevant to relative                 are the leading cause of death in Japan. In addition,
    intensity of 40-60 % of maximal oxygen uptake, or                    stroke due to cerebrovascular diseases is the major
    absolute intensity of 4-6 METs: correspondence                       event that causes elderly people to become bedridden.
    to relative intensity should vary according to age                   Thus, it is presumed that there would be a positive
    (physical fi tness)) should be conducted on most,                    influence on health maintenance and enhancement
    and preferably all, days of the week in order to                     for middle-aged and elderly people in Japan if the
    prevent arteriosclerotic cardiovascular diseases                     occurrence of arteriosclerotic cardiovascular and
    and that medical services and healthcare experts                     cerebrovascular diseases is restricted by actively
    should personally engage in an active lifestyles to                  pursuing the goals set out in the statement made by
    familiarize themselves with the issues involved in                   the American Heart Association.
    maintaining lifelong physical activity and to set a                     Arteriosclerosis is classifi ed as arteriolar
    ooitive example for patients and the public. In Japan                arteriosclerosis due to the degeneration of arteriole

    316                                                            International Journal of Sport and Health Science Vol.4, 316-324, 2006
                                                                                                       Prevention of Arteriosclerosis

walls caused by aging, hypertension and diabetes,                        2. The effects of exercise and physical
atherosclerosis due to subintimal deposition of                          activity on the age-related decrease of arterial
atheromas in large or medium-sized arteries and                          distensibility
medial arteriosclerosis that occurs mainly in large
artery media as age-related change. The effect of                        2.1. Age-related change in artery and systolic
aerobic exercise on the prevention of atherosclerotic                    hypertension
disease has been proved by many epidemiological
and experimental studies (Thompson, et al., 2003).                          Hypertension is the leading risk factor for stroke
In fact, a strong quantitative correlation is observed                   and ischemic heart disease caused by arteriosclerosis.
between habitual physical activity level and the                         In general, systolic blood pressure increases with age,
risk of several chronic diseases, including coronary                     while diastolic blood pressure decreases (Franklin,
artery disease and coronary risk factors, such as                        et al., 1997). Consequently, systolic hypertension
hypertension, and non-insulin-dependent diabetes                         with associated pulse pressure increase is frequently
mellitus, demonstrating a graded relationship of                         observed in middle-aged and elderly people. Systolic
increasing risks of the diseases with decreasing levels                  hypertension, which was at one time underestimated
of the physical activity. Several prospective studies                    as an aging phenomenon, is never innocent to the
suggested that a decline in physical activity level                      human body. An increase in systolic blood pressure
precedes the development of arteriosclerotic diseases                    and pulse pressure is known to be an independent risk
and that the decline is not induced by the disease.                      factor for stroke and ischemic heart disease (Beneton
Furthermore, the fact that regular exercise is effective                 A, et al., 1997). The occurrence rates of stroke and
in reducing the risk of developing arteriosclerotic                      ischemic heart disease rise more clearly in patients
diseases has been reported as well as the biological                     with even moderate systolic hypertension compared
mechanism (i.e. beneficial effects on atherosclerotic                    to normotensive people (Sagie A, et al., 1993), while
risk factor, myocardial function, coronary artery size                   it has been shown that a decline in systolic blood
and vasodilatory capacity, vascular tone, fibrinolysis,                  pressure lowers the occurrence rates of stroke and
platelet function, and vulnerability to ventricular                      ischemic heart disease considerably (Asia Pacifi c
fibrillation) in many intervention and experimental                      Cohort Studies Collaboration, 2003).
studies. A plausible and consistent relationship                            The major reason for the increase in systolic
between physical activity and its preventive effect on                   blood pressure and pulse pressure with aging is that
arteriosclerosis has been observed and consequently                      the buffering function of blood pressure and the
it is estimated that there should be a causal                            bloodstream declines due to the decrease in arterial
relationship between them.                                               compliance caused by lesser extensibility with
   This paper will discuss the effect of exercise                        age-related changes in the wall of the large artery
and physical activity on the decline in arterial                         (the central artery), such as the aorta (Nichols and
distensibility, which is closely related to medial                       O’Rourke, 1998). That is, when the total systemic
arteriosclerosis of large sized arteries, mainly                         arterial compliance decreases, as indicated in the
based on the results of our study, which targeted                        formula C =ΔV/ΔP, arterial inner pressure rises in
middle-aged and elderly people. The term ‘arterial                       a condition of a fixed cardiac output. In addition,
distensibility’ is used as a generic term for the                        since the function of collecting blood ejected from
physical value including arterial wall distensibility,                   the left ventricle by extending the artery wall is
volume distensibility of tubular structure arteries                      restricted, blood pressure drops causing a decrease
and arterial compliance. Arterial wall distensibility                    in bloodstream to peripheral vessels during the left
(D) is the physical volume corresponding to the                          ventricular diastole after a rapid rise occurs in blood
proportion between stress and strain per unit of length                  pressure during the left ventricular systole. The
or unit of area of the arterial wall. In contrast, arterial              contribution rate of the proximal aorta (ascending
compliance (C) corresponds to the proportion (ΔV/ΔP)                     aorta and aortic arch) in systemic arterial compliance
between the increase (ΔP) in intra-arterial pressure                     is about 60 % (Stergiopulos, et al., 1998) and the
(P) and the increase (ΔV) in arterial volume (V).                        contribution rate of the central artery may become
Therefore, there is the relation of D = C/V between                      larger than this as the descending, abdominal
the arterial distensibility and arterial compliance.                     and carotid arteries are included. In terms of the

International Journal of Sport and Health Science Vol.4, 316-324, 2006                                                           317
Matsuda, M.

                                    A                                                                              B
                                                                  n=413                                                                       n=413
     Systemic arterial compliance

                                    (ml/mmHg)                                                                      (mmHg)
                                                                  r=0.30                                                                      r=0.41
                                    3.0                                                                            220

                                                                                         Systolic blood pressure
                                                                  p<0.0001                                                                    p<0.0001


                                        0                                                                           60
                                            40   50   60     70   80       90 (years)                                    0       1.0       2.0           3.0 (ml/mmHg)
                                                       Age                                                               Systemic arterial compliance
                                                                                                                         (age adjusted value)

    Figure 1 The relationship between systemic arterial compliance and age (A), and the relationship between systemic arterial
    compliance (age adjusted value) and systolic blood pressure (B)

    relationship between systemic arterial compliance,                                                        people by Tanaka, et al. (2000). Moreover, Cameron,
    age and systolic blood pressure measured by us in                                                         et al. observed signifi cant positive correlation
    middle-aged and elderly people, it has been observed                                                      between systemic arterial compliance and duration
    that systemic arterial compliance decreases with                                                          of incremental exercise in middle-aged and elderly
    aging (Figure 1 A), and that a decrease in systemic                                                       people. However, all of these studies investigated the
    arterial compliance raises systolic blood pressure                                                        relationship between maximum exercise capability and
    (Figure 1 B). In some recent studies, it has been                                                         arterial distensibility. It is presumed that whole body
    elucidated that the decline itself in central artery                                                      endurance (aerobic) capacity in submaximal exercise
    distensibility can be an independent risk factor for                                                      is more meaningful than maximal physical capacity
    cardiovascular diseases in hypertension patients as                                                       to daily vital functions in the majority of middle-aged
    well as systolic hypertension (Blacher, et al., 1999,                                                     and elderly people. Thus we have examined the
    Laurent, et al., 2001).                                                                                   relationship between aerobic capacity and systemic
                                                                                                              arterial compliance in middle-aged and elderly people
    2.2. Arterial distensibility and aerobic exercise                                                         during submaximal exercise, and clarified that aerobic
    capacity                                                                                                  capacity (oxygen uptake at the ventilatory threshold
                                                                                                              level) is low in middle-aged and elderly people as
       Since an increase in systolic blood pressure due                                                       the value of systemic arterial compliance declines
    to the decline in arterial distensibility augments                                                        (Figure 2: Otsuki, et al., 2003), which means that the
    the burden on heart (afterload), and the decline in                                                       decline in distensibility of the central artery is one of
    diastolic blood pressure lessens the amount of blood                                                      the factors to restrict vital function in the every day
    flowing into the cardiac muscle, cardiac functions                                                        lives of middle-aged and elderly people.
    are suppressed (Urshel, et al., 1968). The decline in
    arterial distensibility with aging lessens the cardiac                                                    2. 3. Arterial distensibility, exercise and
    function during exercise in particular, which might                                                       physical activity
    cause a decline in physical fitness (aerobic exercise
    capacity) (Nichols and O’Rourke, 1998). In fact, it has                                                      Arterial distensibility is higher in athletes who
    been suggested that there exists significant correlation                                                  continue high-aerobic exercise (Mohiaddin, et al.,
    between the peak oxygen uptake or maximal oxygen                                                          1989, Vaikevicius, et al., 1993, Kakiyama, et al.,
    uptake and arterial distensibility in a wide range of age                                                 1998a) and active people in general (Kakiyama,
    groups from youth to middle-aged and elderly people                                                       et al., 1998a, 1998b, Tanaka, et al., 2000, Tanabe,
    by Vaitkevicius, et al. (1993), in youth by Cameron                                                       et al., 2003a, 2004). The effect observed in
    and Dart (1994) and in middle-aged and elderly                                                            cross-sectional data does not necessarily indicate

    318                                                                                 International Journal of Sport and Health Science Vol.4, 316-324, 2006
                                                                                              Prevention of Arteriosclerosis

                                                                           Tanabe, et al., 2003a, 2004), it is indicated
                               Aerobic exercise capacity (VO2@VT)    24    that physical activity volume can have the
                                         n=46                              effect of decreasing systolic blood pressure
                                         r=0.4                             signifi cantly by restricting the decline in
               20                        p<0.005
                                                                           artery distensibility with aging. In addition,
                                                                           when examining the relationship between
                                                                           physical activity volume and systemic
                                                                           arterial compliance in middle-aged and
               12                                                          elderly people, including those with a
                                                                           higher level of daily physical activity (such
                8                                                          as belonging to a "walking circle"), it is
                   0.2 0.6 1.0 1.4 1.8 2.2
                                                                           suggested that systemic arterial compliance
                                               ml/mmHg/m�                  is higher for those for whom the amount
              Systemic arterial compliance                                 of physical activity is larger (Figure 3, in
                                                                           submitting). In Figure 3, the relationship
                                                                           between physical activity volume and
Figure 2 The relationship between systemic arterial compliance and
aerobic exercise capacity                                                  systemic arterial compliance is shown by
                                                                           a logarithm regression curve, as the effect
                                                                           of physical activity volume seems to be
                                                                           nonlinear and has an upper threshold. That
                                                                           is, although systemic arterial compliance
         3.0                                                               increases linearly when the amount of
Systemic arterial compliance

                                                                           physical activity is low, the effect plateaus
    (age adjusted value)

        2.0                                                                when the amount of physical activity
                                                                           exceeds 200-300 kcal per day and appears
                                                                           not to increase any more. The American
        1.0                                             n = 413            College of Sports Medicine (Pate, et al.,
                                                        r = 0.35
                                                                           1995) recommends a physical activity level
                                                                           of 200 kcal per day in order to improve
           0                                                               physical fitness and to prevent disease. In
             0          200     400     600       800      1000
                                                                           the studies of Paffenbarger, et al. (1978,
                           Daily physical activity                         1986), it was indicated that although people
                                                                           with a physical activity level of more than
Figure 3 The relationship between systemic arterial compliance and
daily physical activity
                                                                           2000 kcal per week live longer than those
                                                                           whose level was under 500 kcal per week,
                                                                           the heart attack occurrence rate is the lowest
a causal correlation. However, it is known that                  for those with a physical activity level of 2000-3000
arterial distensibility increases through aerobic                kcal per week. It was also indicated that the rate of
exercise training, according to some longitudinal                risk becomes rather higher when the physical activity
studies (Cameron and Dart, 1994, Tanaka, et al,                  level is more than 4000 kcal per week. Therefore, it
2000, Kakiyama, et al., 2001, Ohtsuki, et al., 2003,             is not necessarily true that more physical activity will
Kakiyama, et al., 2005). In contrast, carotid artery             lead to health benefits. Aerobic exercise of around
distensibility decreases in people who continue                  200-300 kcal per day is enough for middle-aged and
high-resistance training (Miyachi, et al., 2003) and is          elderly people. Even if they do more than that, an
reported to decrease due to high-resistance training             effect matching the amount of increase cannot be
(Miyachi, et al., 2004).                                         expected.
   In our examination using multivariate analysis                   Exercise intensity (energy consumption per unit
with arterial distensibility, age, daily physical activity       of time) can influence the effects of exercise, as well
level, or risk factors for arteriosclerosis including            as total energy consumption. It has been elucidated
hyperlipemia as variables (Kakiyama, et al., 1998b,              that aerobic exercise training with above moderate

International Journal of Sport and Health Science Vol.4, 316-324, 2006                                                  319
Matsuda, M.

                                                       p < 0.05                                                  24
                                   ml/mmHg                                                                                                          60 - 69 yrs (n= 9)
                                                                                                                                                     ● pre-training
                                                                                                                                                     ○ post-training
    Systemic arterial compliance

                                   2.0                                                                                                              70 - 77 yrs (n= 7)
                                                                                                                 20                                  ◆ pre-training
                                                                                                                                                     ◇ post-training

                                                                                           VO2VT (ml / kg/min)

                                                                                                                                                                mean ±SD

                                                                                                                                                Aerobic exercise capacity: p < 0.05
                                                                                                                                                Systemic arterial compliance: p < 0.05

                                                                          mean + SD
                                                                                                                      0.2         0.6         1.0                 1.4
                                              < 30 min         30 min ≦
                                              n=69             n=166
                                                                                                                      Systemic arterial compliance (ml / mmHg/m2)
                                         Moderate-intensity physical activity time
        Figure 4 Effect of moderate-intensity (3-4 METs) physical                          Figure 5 Effect of aerobic training on systemic arterial
        activity on systemic arterial compliance in the elderly (65 yrs <)                 compliance in the elderly

        intensity increases arterial distensibility (Cameron                               physical fitness. Thus, it is presumed that exercise
        and Dart, 1994, Tanaka, et al., 2000). The American                                for the improvement of health should not necessarily
        Heart Association suggests exercise of 4-6 METs for                                be performed at high intensity.
        30 minutes per day as moderate intensity exercise                                     In our longitudinal examination, the effect of
        (Thompson, et al., 2003). The American College                                     comparatively light intensity exercise on arterial
        of Sports Medicine recommends a similar fi gure                                    distensibility was also acknowledged. Central arterial
        (exercise of 3-6 METs) as moderate intensity exercise                              distensibility and aerobic capacity increased and
        (Pate, et al., 1995). It is desirable for middle-aged                              systolic blood pressure declined in middle-aged and
        and elderly people to do effective lower intensity                                 elderly people six months after starting twice-weekly
        exercise that can be performed safely and easily.                                  sports lessons that involved light intensity aerobic
        Thus, we defined moderate intensity exercise that                                  training and muscular strength training (Kakiyama,
        can be performed safely and easily by middle-aged                                  et al., 2001). Moreover, both systemic arterial
        and elderly people as 3-5 METs and compared the                                    compliance and aerobic capacity (the amount of
        effects of different durations of low intensity (under                             oxygen consumption at the ventilatory threshold)
        3 METs), moderate intensity and high intensity                                     increased significantly and systolic blood pressure
        (above 6 METs) exercise on arterial distensibility                                 declined in middle-aged and elderly people who
        through multivariate analysis by using cross-sectoral                              performed aerobic exercise (30 minutes per day, 5
        data. A significant effect on arterial distensibility                              times per week) at 80 % of the ventilatory threshold
        was not observed in lower intensity exercise, while                                using a bicycle ergometer, 12 weeks after starting the
        a significant effect was observed in middle intensity                              exercise (Otsuki, et al., 2003).Thus, it was indicated
        exercise and it has been suggested that the effect is                              that aerobic training of light-to-middle intensity
        independent of the total amount of activity and the                                improves arterial distensibility and aerobic capacity
        amount of high intensity activity. A significant effect                            in a relatively short time. In contrast, significant
        was observed even during exercise of 3-4 METs                                      alteration was not observed in arterial compliance
        intensity, particularly in elderly people (Figure 4).                              and ventilatory threshold in a study targeting elderly
        Blair, et al. (1989) studied the relationship between                              people 70 years of age and older (Otsuki, et al.,
        aerobic capacity and death rate and indicated that                                 2005). Therefore, it is assumed that the effect of
        there is an upper threshold in the effect of physical                              exercise on arterial distensibility becomes less with
        activity on the decline in death rate and that                                     aging. However, as shown in Figure 5 (which covers
        continuous moderate intensity exercise for about                                   subjects from 60 to 77 years of age collectively),
        30 minutes per day is enough to maintain necessary                                 systemic arterial compliance and ventilatory threshold

        320                                                                           International Journal of Sport and Health Science Vol.4, 316-324, 2006
                                                                                                        Prevention of Arteriosclerosis

    ml/mmHg        Systemic arterial compliance                          arterial compliance and systolic blood pressure
     2.5                                                                 returned to the previous level one year later following
                                                                         a decrease in physical activity volume (Figure 6).
                                                                         Moreover, arterial distensibility that increased during
     1.5                                                                 an eight-week aerobic training programme returned
                                                                         to the former level in the fourth week after stopping
     1.0                                                                 training in an intervention experiment for younger
                                                                         people (Kakiyama, et al., 2005). This means that it
                                                                         is necessary to build up a habit of physical activity or
   mmHg             Systolic blood pressure                              continue aerobic exercise training in order to maintain
                                                                         the improved arterial distensibility level. The fact that
                                                                         a positive effect on health can be achieved by adopting
     120                                                                 a more active lifestyle, even after reaching middle
                                                                         or elderly age, has been reported as in the study of
     100                                                                 Paffenbarger, et al. (1993).

                                                                         2.4. Presumptive mechanism of effects of
                                                                         aerobic exercise on arterial distensibility
   kcal / day       Daily physical activity
                                                                            The decline in arterial distensibility with aging is
                                                                         considered to be caused by the age-related progress
     150                                                                 of organic change, including the alteration and
                                                                         decrease in elastic fibers that are the main elastic
                                                                         component of arterial wall media and the increase in
                                                                         collagen fibers (Nichols and O’Rourke, 1998). The
                Before   After 6 mths     After 1 yrs
                                                                         decline in aorta distensibility was restrained as the
                                              n = 32
Figure 6 Transition of systemic arterial compliance, systolic
                                                                         age-related alteration of elastic fibers was restrained
blood pressure, and daily physical activity in the elderly               due to exercise in an experiment using young rats
                                                                         (Matsuda, et al., 1988, 1989, 1993). However, the
                                                                         effect of exercise on the alteration of elastic fibers
increased in several subjects 70 years of age and older.                 was not apparent in older rats (Nasaka, et al., 2003)
In addition, the cross-sectoral data demonstrates that                   and for humans that live longer and whose degree
systemic arterial compliance improves as the amount                      of age-related organic change is large there seems to
of physical activity increases in very elderly people                    be less possibility of restoring elastic fibers through
(Figure 3). Given this, it is undeniable that exercise                   exercise training over a comparatively short term,
training can have an effect on elderly people over 70                    from several months to half a year. As mentioned
years of age. It is possible that an absolute exercise                   above, the increase in arterial distensibility
intensity of under 3 METs for a majority of people in                    disappeared after a short period due to cessation of
this study might make the result ambiguous. Studies                      exercise training in our study of middle-aged/elderly
involving higher intensity exercise are expected to be                   people and young people (Kakiyama, et al., 2005).
performed in the future, as well as studies with more                    Therefore, it is assumed that some different factors,
subjects and of prolonged duration.                                      apart from organic changes to the arterial wall, may
   The effect of exercise on arterial distensibility                     be related to the effect emerging in the short-term
emerges after a short period both in middle-aged/elderly                 exercise. Smooth muscle in arterial wall media
people and younger people but does not last long.                        controls artery diameter by changing tension,
Systemic arterial compliance and systolic blood                          through contraction and relaxation, and the tension
pressure declined in middle-aged and elderly people                      of smooth muscle also affects the hardness of the
who participated in aerobic exercise training twice a                    arterial wall. Smooth muscle tension is controlled
week, with an increase in physical activity volume                       by autonomic nervous activity and by a vasoactive
six months after starting exercise. However, systemic                    substance (e.g.nitric oxide and endothelin-1)

International Journal of Sport and Health Science Vol.4, 316-324, 2006                                                            321
Matsuda, M.

                       A                                                      B
                                    p < 0.01
                                                                     arbitrary unit                        n.s.
     arbitrary unit          p < 0.01    p < 0.05
            0.25                                                                       60          p < 0.05    p < 0.05


                                                                              eNOS protein
    eNOS mRNA



                                                         mean + SE                                                              mean + SE
                   0                                                                         0
                           Young    Aged             Aged                                        Young        Aged           Aged
                           n=7          n=7           n=7                                        n=7          n=7             n=7
                            Sedentary               Training                                      Sedentary                Training
    Figure 7 Expression of endothelial nitric oxide synthase (eNOS) mRNA (A) and eNOS protein (B) in the rat aorta

    produced by endothelial cells. The increase in                        function improved during 8 weeks of aerobic training
    sympathetic activity mainly causes contraction of                     (Tanabe, et al., 2003b). In addition, nitrite/nitrate
    smooth muscle, while nitric oxide causes it to relax                  concentration in the blood increased in middle-aged
    and endothelin-1 to contract. Since endurance                         and elderly people after 12 weeks of aerobic training
    exercise training suppress sympathetic nervous                        (Maeda, et al., 2004) and endothelin-1 concentration
    system activity at rest (Jennings, et al., 1997), it is               in the blood declined (Maeda, et al., 2003).
    undeniable that there is a possibility for central artery             Nitrite/nitrate in the blood returned to the level it
    sympathetic activity to suppress as well. Exercise                    had been before training was begun when exercise
    training is also known to affect arterial endothelial                 was intermitted (Maeda, et al., 2004). These results
    function (Walther, et al., 2004) so that it is possible               elucidate a part of an exercise effect mechanism and
    for these functional factors to be involved in the                    show the basis for improving the effect of exercise on
    alteration mechanism of arterial wall distensibility                  the age-related decrease in arterial wall distensibility
    during short-term exercise. It has been reported that                 at the same time. It is also undeniable that there are
    endothelium-dependent or -independent vasodilation                    possibilities for the stimulus of short-term exercise
    of the brachial artery increases in middle-aged and                   to affect cross-links of collagen fibers which are a
    elderly people who continue aerobic exercise of                       strong limiting factor of arterial wall distensibility
    high intensity (Rywik, et al., 1999), and a significant               along with elastic fibers (Tanaka, et al., 2000) and to
    correlation is observed between physical activity                     increase arterial wall distensibility by promoting the
    volume and endothelin-dependent vasodilation                          new formation of elastic fibers rich in elasticity.
    of the brachial artery in middle-aged and elderly
    postmenopausal women (McKechie, et al., 2001). In                     3. Conclusion
    an animal experiment, mRNA of nitric oxide synthase
    and protein expression was observed to advance in                        Both the results of previous studies and of our
    aortic tissues due to aerobic exercise training (Delp                 own study lead to the following conclusion. That is,
    and Laughlin, 1997). The result of our experiment,                    in order to prevent further hardening of arteries, to
    where older rats were made to exercise (Figure 7),                    decrease the risk of lifestyle related diseases and to
    indicates age-related decrease in nitric oxide synthane               maintain and enhance vital functions in middle-aged
    function, as nitric oxide synthase gene and protein                   and elderly people, it is desirable: 1) to increase
    expression in aortic endothelium was less in older                    the activity mass (energy consumption) of aerobic
    rats compared to young rats, while the synthane                       exercise, aiming for 200-300 kcal per day; 2) to do

    322                                                              International Journal of Sport and Health Science Vol.4, 316-324, 2006
                                                                                                             Prevention of Arteriosclerosis

more than 30 minutes of middle intensity exercise                        Kakiyama, T., Sugawara, J., Murakami, H., Maeda, S., Kuno,
per day as part of that exercise; and 3) to ensure                          S., and Matsuda, M (2005). Effects of short-term endurance
                                                                            training and detraining on aortic distensibility in young
continuation of this appropriate amount of physical                         males. Med. Sci. Sports Exerc. 37: 267-271.
activity and exercise.                                                   Laurent, S., Boutouyrie, P, Asmar, R, Gautier, I., Laloux, B.,
                                                                            Guize, L., Ducimetier P, Benetos, A. (2001). Aortic stiffness
Acknowledgement                                                             is an independent predictor of all-cause and cardiovascular
                                                                            mor tality in hyper tensive patients. Hyper tension, 37:
   This work was supported by grants-in-aid for scientific research
(14380008) and special coordination funds of the Japanese
                                                                         Maeda, S., Tanabe, T., Miyauchi, T., Otsuki,T., Sugawara, J.,
Ministry of Education, Culture, Sports, Science and Technology.
                                                                            Iemitsu, M., Kuno, S., Ajisaka, R., Yamaguchi, I., Matsuda,
                                                                            M. (20 03) Aerobic exercise t rai ni ng reduces plasma
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International Journal of Sport and Health Science Vol.4, 316-324, 2006                                                                 323
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       elderly people over 70. Jap. J. Clin. Sports Med., 13: 105-109.        on performance of the left ventricle. Am J Physiol 214:
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       Bouchard, C., Buchner, D., Ettinger, W., Heath, G.W., King,                                 Name:
       A.C., Kriska, A., Leon, A.S., Marcus, B.H., Morris, J.,                                     Mitsuo Matsuda
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       Sallis, J., Wilmore, J.H. (1995) Physical activity and public                               Affiliation:
       health. A recommendation from the Centers for Disease                                       Emeritus professor: University of Tsukuba
       Control and Prevention and the American College of Sports                                   Visiting fellow:
       Medicine J, JAMA, 273: 402-407.                                                             Tsukuba Advanced Research Alliance,
    Rywik, T.M., Blackman, M.R., Yataco, A.L., Vaitkevicius ,P.V.,                                 University of Tsukuba
       Zink, R.C., Cottrell, E.H., Wright, J.G., Katzel, L.I., and                                 Ts u k u b a I n d a u s t r i a l L i a s o n a n d
       Fleg, J.L. (1999) Enhanced endothelial vasoreactivity in                                    Cooperative Center, University of Tsukuba
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    Sagie, A., Larson, M.G., Levy, D. (1993) The natural history of         1-1-1 Tennodai, Tsukuba-shi, Ibaraki 305-8577 Japan
       borderline isolated systolic hypertension. N Engl J Med 329:         Brief Biographical History:
       1913-1917.                                                           Education:
    Stergiopulos, N., Westerhof, B. E., and Westerhof, N. (1998)            1963 Faculty of Science, Tokyo University
       Physical basis of pressure transfer from periphery to aorta: a       1967 Faculty of Medicine, Tokyo University
       model-based study. Am. J. Physiol. 274: H1386-H1392.                 1976 Doctor of Medical Science (Tokyo University )
    Tanabe, T., Maeda, S., Sugawara, j., Otsuki, T., Miyauchi, T.,          Work History:
       Kuno, S., Ajisaka, R., Matsuda, M. (2003a) Effect of physical        1968-1970 Kawakita Hospital, Medical Service
       activuty on systemic blood pressure in elderly humans –              1970-1971 Mitsui Memorial Hospital, Medical Service
       Special reference to systemic arterial compliance-. Jpn. J.          1970-1976 Tokyo University Hospirtal, Medical Service
       Fitness Sports Med. 52 suppl: 167-176.                               1977 Tokyo University, Assistant
    Tanabe, T., Maeda, S., Miyauchi, T., Iemitsu, M., Takanashi, M.,        1977-1983 the University of Tsukuba, Lecturer
       Irukayama-Tomobe, Y., Yokota, T., Ohmori, H., Matsuda, M.            1984-1989 the University of Tsukuba, Associate professor
       (2003b) Exercise training improves aging-induced decrease            1989-2004 the University of Tsukuba, Professor
       in eNOS expression of the aorta. Acta Physiol. Scand., 178,          2004-Present the University of Tsukuba, Emeritus professor
       3-10.                                                                2004-Present the University of Tsukuba, Visiting fellow
    Tanabe, T., Maeda, S., Sugawara, J., Otsuki, T., Kakiyama, T.,          Main Works:
       Yokoyama, N., Miyauchi, T., Kuno, S., Ajisaka, A., Matsuda,          • Maeda, S., Tanabe, T., Miyauchi, T., Otsuki,T., Sugawara, J.,
       M. (2004) Effect of physical activity on central arterial              Iemitsu, M., Kuno, S., Ajisaka, R., Yamaguchi, I., Matsuda, M.
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       2004.                                                                • Tanabe, T., Maeda, S., Miyauchi, T., Iemitsu, M., Takanashi,
    Tanaka, H., Dinenno, F.A., Monahan, K.D., Clevenger, C.M.,                M., Irukayama-Tomobe, Y., Yokota, T., Ohmori, H., Matsuda,
       DeSouza, C.A., Seals, D.R. (2000) Aging, habitual exercise,            M. (2003) Exercise training improves aging-induced decrease
       and dy namic a r ter ial compliance. Ci rculat ion, 102:               in eNOS expression of the aorta. Acta Physiol. Scand., 178,
       1270-1275.                                                             3-10.
    T hompson, P.D., Buch ner, D., Pi na, I.L., Balady, G. J.,              • Maeda, S., Tanabe, T., Otsuki, T., Sugawara, J., Iemitsu,
       Williams, M.A., Marcus, B.H., Berra K., Blair, SN, Costa               M., Miyauchi, T., Kuno, S., Ajisaka, R., Matsud, M. (2004)
       F., Franclin B, Fletcher G.F., Gordon N.F., Pate R.R.,                 Moderate regular exercise increases basal production of nitric
       Rodriguez B.L., Yancey, A.K., Wenger, N.K. (2003) AHA                  oxide in elderly women. Hypertens. Res., 27: 947-953.
       Scientific Statement. Exercise and physical activity in the          • Sugawara, J., Maeda, S., Otsuki, T., Tanabe, T., Ajisaka, R.,,
       prevention and treatment of atherosclerotic cardiovascular             Matsuda, M.. (2004) Effects of nitric oxide synthase inhibitor
       disease. A statement from the council on clinical cardiology           on decrease in peripheral arterial stiffness with acute low
       (subcomimttee on exercise, rehabilitation, and prevention)             intensity aerobic exercise. Am. J. Physiol. Heart Circ. Physiol.
       a nd t he cou ncil on nut r it ion, physical act iv ut y, a nd         287: H2666-2669.
       metabolism (subcomittee on physical activuty). Circulation           • Kakiyama, T., Sugawara, J., Murakami, H., Maeda, S., Kuno,
       107: 3109-3116.                                                        S., and Matsuda, M. (2005). Effects of short-term endurance
    Urschel, C.W., Covell, J.W., Sonnenblic, E.H., Ross, j. Jr.,              training and detraining on aortic distensibility in young males.
       Braunwald, E. (1968) Effects of decreased aortic compliance            Med. Sci. Sports Exerc. 37: 267-271.

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