Effect of aerobic exercise training on cGMP levels and blood pressure in treated hypertensive postmenopausal women

Abstract The second messenger cGMP has been largely studied as a therapeutic target in a variety of disorders such as erectile dysfunction, arterial hypertension and heart failure. Evidence has shown thatcGMP activators are less efficient in estrogen-deficiency animals, but no studies exist involving non-pharmacological approacheson NO/cGMP signaling pathway in hypertensive postmenopausal women. The aim of this study is to examine NO/cGMP pathway, redox state and blood pressure in trained treatedhypertensive (HT) postmenopausal women comparing with normotensive (NT) group. The rationale for that is most of HT patients is encouraged by physician to perform exercise associated with pharmacological treatments.Aerobic exercise training (AET) consisted of 24 sessions, 3 times/week.Parameters were evaluated at baseline and after AET for both groups (HT=28; NT=33).In treatedHT group, AET was significantly effective in increasing cGMP concentrations (28%) accompanied by an up-regulation of SOD (97%) and catalase activity (37%). In NT group, we found an increasein SOD activity (58%). TreatedHT postmenopausal women were still responsive to AET increasing cGMP levels and up-regulating antioxidant system. It should also be emphasized that these findings provide information on the circulating biomarkers that might delay the developing of cardiovascular events in this particular population.(AU)

Assessment of endothelial function by flow-mediated dilation in diabetic patients: effects of physical exercise

The endothelium is now recognized as an endocrine organ that acts to maintain vascular homeostasis regulating the vascular tone and structure. The endothelial cells synthetize a variety of mediators among them, the main agent is the nitric oxide (NO), a potent vasodilator. NO exerts its protective role preventing leukocyte adhesion and migration, expression of adhesion molecules, platelet aggregation, cell proliferation, and promoting the relaxation of smooth muscle cells. On the other hand, endothelial dysfunction present in many chronic diseases such as atherosclerosis, coronary artery disease, peripheral artery disease, hypertension and diabetes mellitus, is characterized by reduced NO bioavailability. Thus, a few decades ago, measurement of endothelial function has emerged as valuable tool that provides insights in the pathophysiological mechanisms, opportunity to identify early disease and cardiovascular risk, preventing future events or avoiding the progression of the disease. Diabetic patients, particularly, have been a target to apply this technique, mainly because this condition has been related with an impairment of endothelium-dependent dilation and it is believed that the endothelium dysfunction is the basis of diabetes complications such as coronary artery disease and accelerated atherosclerosis. In addition, cardiovascular complications represent the leading cause of morbidity and death in diabetes mellitus. Besides pharmacological therapy, lifestyle modifications have been recommended by specific organizations as a strategy to improve the endothelial function or even prevent the development of diabetes. The aim of this mini eview is to give an update about the importance of endothelium, most common non-invasive technique to evaluate its function, and to summarize some mechanisms involved in endothelial dysfunction and the beneficial effects of exercise in diabetes mellitus.