Treinamento e complacência arterial

Prévia do material em texto

Copyrig
Resistance training and arterial compliance: keeping the
bene e
Hiros o
Objecti
modera
resistan
arterial
Backgr
mode o
stiffen c
Method
either to
the com
(COMBO
Participa
session
months
Results
all the m scle groups tested (P < 0.05). Carotid arterial
complia
applana
MODE t
mmHg,
complia
0.23 W 0
0.20 W 0
d, c
Pe
y g
lus
ic
id a
hy
ms
l of
rds
train
n o
n, T
zaw
ity o
and Health Education, University of Texas, Austin, Texas, USA
u, T
1 3
orsh
and
e (1
ed
Introd
The aor
cardiova
periphe
changes
of bloo
systole a
blood fl
load. Th
reductio
stiffness
sure, lef
[1,2]. In
greater
failure a
interven
ance sh
Resistance training has become a popular modality of
exercise
an inte
endorse
]. R
ulo
ten
rco
tra
ell
int
ced
lly
gth
late
al
ide
fits
an
rit
ing
ial
plausible. First, the intensity and volume of the resist-
Original article 1753
0263-6352
 � 2006 Lippincott Williams & Wilkins
performed by most populations, and has become
gral component of exercise recommendations
d by a number of national health organizations
ance training used in the previous studies [8,9] were more
strenuous and vigorous than those recommended for the
comprehensive health programs [5–7]. It is not currently
tion tonometry) decreased approximately 20% after
raining (from 0.20 W 0.01 to 0.16 W 0.01 mm2/
P < 0.01). No significant changes in carotid arterial
nce were observed in the COMBO (0.20 W 0.01 to
.01 mm2/mmHg) and CONTROL (0.20 W 0.01 to
.01 mm2/mmHg) groups. Following the detraining
Health
Shinjuk
Tel: +8
Spons
Labor
Scienc
Receiv
uction
ta and large arteries play an important role in the
scular system not only as blood conduits to the
ral tissues, but also as a buffer for pressure
resulting from intermittent ventricular ejection
d. By absorbing a proportion of the energy in
nd releasing it in diastole, they maintain coronary
ow and avoid an increase in left ventricular after-
rough the impairment of this buffering function,
ns in arterial compliance or increases in arterial
contribute to elevations in systolic blood pres-
t ventricular hypertrophy, and coronary ischemia
deed, higher arterial stiffness is associated with a
rate of mortality in patients with end-stage renal
nd essential hypertension [3,4]. Accordingly, any
tions that could act to decrease arterial compli-
ould be cautiously performed or even avoided.
[5–7
musc
main
of sa
ance
not w
high-
redu
initia
stren
and
sever
Cons
bene
resist
ing c
train
arter
ht © Lippincott Williams & Wilkins. Unauthorized
motion and Exercise, National Institute of Health and Nutrition,
okyo 162-8636, Japan
3 203 8061; fax: +81 33 203 1731; e-mail: miyachi@nih.go.jp
ip: This study was supported by grants from the Ministry of Health,
Welfare (H18-J-W-002), the Japan Society for the Promotion of
7300226), and the National Institutes of Health in the US (AG20966).
13 February 2006 Accepted 4 April 2006
esistance training has profound effects on the
skeletal system, thereby contributing to the
ance of functional capacity and the prevention
penia and osteoporosis [7]. The effects of resist-
ining on the cardiovascular system, however, are
understood. We have recently demonstrated that
ensity resistance training is associated with
arterial compliance [8,9]. This finding was
observed in cross-sectional studies comparing
-trained individuals and sedentary controls [8]
r confirmed by interventional studies involving
months of resistance training interventions [9].
ring a number of functional and physiological
that resistance training induces, practice of
ce training should not be discouraged. A remain-
ical question is whether any type of resistance
could be performed regularly without inducing
stiffening. In this context, two strategies appear
nce (via simultaneous carotid ultrasound and Correspondence and requests for reprints to Motohiko Miyachi, PhD, Division of
Pro
A
u
fits while minimizing the stiff
hi Kawanoa,b,c, Hirofumi Tanakad and M
ves This study aimed to determine the effects of
te resistance training as well as the combined
ce and aerobic training intervention on carotid
compliance.
ound Resistance training has become a popular
f exercise, but intense weight training is shown to
arotid arteries.
s Thirty-nine young healthy men were assigned
the moderate-intensity resistance training (MODE),
bined resistance training and endurance training
) or the sedentary control (CONTROL) groups.
nts in the training groups underwent three training
s per week for 4 months followed by four additional
of detraining.
ll training groups increased maximal strength in
perio
level.
in an
Conc
aerob
carot
healt
Willia
Journa
Keywo
cross-
aDivisio
Nutritio
Tokoro
Univers
 reproduction of this article is prohibited.
ning
tohiko Miyachia
arotid arterial compliance returned to the baseline
ripheral (femoral) artery compliance did not change
roups.
ions We concluded that simultaneously performed
exercise training could prevent the stiffening of
rteries caused by resistance training in young
men. J Hypertens 24:1753–1759 Q 2006 Lippincott
& Wilkins.
Hypertension 2006, 24:1753–1759
: arterial structure and compliance, exercise, imaging,
ing, ultrasonics
f Health Promotion and Exercise, National Institute of Health and
okyo, bGraduate School of Human Sciences, Waseda University,
a, Saitama, cDepartment of Health and Sports Sciences, Kawasaki
f Medical Welfare, Okayama, Japan and dDepartment of Kinesiology
Copyrigh
known whether moderate resistance training would
induce s
aerobic
complia
ance tra
ing, the
Neither
Accordi
determi
training
training
hypothe
would n
ance tra
training
period,
reasone
pliance
values
stimuli
Metho
Particip
A total
the men
training
tensive
< 30 kg
assessed
a comp
ation. C
taking
steroids
plaque
sclerosis
All sub
particip
approve
were ra
sity resi
bined h
intensit
n ¼ 11),
n ¼ 16).
because
resistan
were no
between
Measur
The exe
before
exercise
training
8 month
control
nth
al
y t
to
d f
ig
ed
oid
sti
isi
me
em
ea
me
m
m
gt
ma
sed
in
url
itio
ne
coe
ato
e c
est
composition
body composition was determined using the bio-
ric impedance method (coefficient of variance,
%) [14].
ial blood pressure at rest
nic levels of arterial blood pressure at rest were meas-
with a semi-automated oscillometric device (Form
/ABI; Colin Medical, Komaki, Aichi, Japan) over
rachial and dorsalis pedis artery. Recordings were
in triplicate with participants in the supine position.
1754 Journal of Hypertension 2006, Vol 24 No 9
Table 1 Selected subject characteristics at baseline
e
ears
(cm
eig
ass
at (%
ody
xyge
g p
rese
te-i
nce
imilar arterial stiffening. Second, because regular
exercise has been shown to increase arterial
nce [10,11], simultaneously performed endur-
ining may negate the effects of resistance train-
reby attenuating or preventing arterial stiffening.
of these possibilities has been tested, however.
ngly, the primary aim of the present study was to
ne the effects of moderate-intensity resistance
as well as the combined strength and endurance
intervention on carotid arterial compliance. We
sized that the compliance of carotid arteries
ot change following moderate-intensity resist-
ining as well as combined resistance and aerobic
. At the completion of the exercise intervention
we implemented a period of detraining. We
d that if the observed changes in arterial com-
were induced by the prescribed exercise training,
should return to the baseline levels when the
of exercise training were removed.ds
ants
of 39 young healthy men were studied. None of
had participated in any resistance or endurance
on the regular basis. All subjects were normo-
(< 140/90 mm Hg), non-obese (body mass index
/m2), and free of overt chronic diseases as
by medical history, physical examination, and
lete blood chemistry and hematological evalu-
andidates who smoked in the past 4 years were
cardiovascular-acting medications or anabolic
, or had significant intima–media thickening,
formation, and/or other characteristics of athero-
(e.g. ankle–brachial index< 0.9) were excluded.
jects gave their written informed consent to
ate, and all procedures were reviewed and
d by the Institutional Review Board. Subjects
ndomly assigned into either the moderate-inten-
stance training group (MODE, n ¼ 12), the com-
igh-intensity resistance training and moderate-
y aerobic exercise training group (COMBO,
or sedentary control group (CONTROL,
No endurance-training group was included
the primary focus of the present study was on
ce training. Before the intervention period, there
significant differences in any of the variables
the groups (Table 1).
ements
rcise intervention groups were studied five times:
training (baseline), at 2 months (midpoint of
training), at 4 months (completion of exercise
), at 6 months (midpoint of detraining), and at
s (completion of detraining). The non-exercising
group was studied three times: baseline, at
4 mo
diurn
of da
prior
faste
overn
studi
to av
were
exerc
Incre
To d
we m
incre
consu
were
Stren
Maxi
asses
follow
leg c
repet
obtai
day
labor
in th
the t
Body
The
elect
4 � 2
Arter
Chro
ured
PWV
the b
made
Variabl
N
Age (y
Height
Body w
Body m
Body f
Lean b
Peak o
(ml/k
Data p
modera
resista
t © Lippincott Williams & Wilkins. Unauthorized 
s, and at 8 months. In order to avoid potential
variations, subjects were tested at the same time
hroughout the study period [9,10]. Furthermore,
each testing, subjects abstained from caffeine and
or at least 4 h; most subjects were studied after
ht fast. Subjects in the intervention groups were
20–24 h after their last exercise training session
the acute effects of exercise [12], but while they
ll considered to be in their normal (i.e. habitually
ng) physiological state.
ntal exercise
onstrate that the participants had been sedentary,
sured the maximal oxygen consumption during an
ntal cycle ergometer exercise [13]. The oxygen
ption, heart rate, and ratings of perceived exertion
easured throughout the protocol.
h testing
l muscular strength in the intervention groups was
before and after resistance training using the
g exercises: half squat, bench press, leg extension,
s, lat row, and abdominal bend. After 10 warm-up
ns, one-repetition maximum (1 RM) values were
d according to established guidelines. The day-to-
fficient of variation for 1 RM strength in our
ry is 4 � 2%. The 1 RM test was not performed
ontrol group due to the potential risks involved in
ing.
CONTROL
group
MODE
group
COMBO
group
16 12 11
) 22 � 1 20 � 1 21 � 1
) 172 � 1 169 � 2 171 � 2
ht (kg) 68 � 2 65 � 2 66 � 2
index (kg/m2) 22 � 1 23 � 1 23 � 1
) 21 � 1 18 � 2 21 � 1
mass (kg) 55 � 2 51 � 1 53 � 1
n consumption
er min)
49 � 3 52 � 2 49 � 2
nted as the mean � SEM. CONTROL, sedentary control group; MODE,
ntensity resistance training group; COMBO, combined high-intensity
training and moderate-intensity aerobic exercise training group.
reproduction of this article is prohibited.
Copyrig
Carotid artery intima–media thickness
The ca
measure
machine
broad-b
sound i
image a
IMT w
were us
to-day r
for the
Carotid
A comb
commo
of tono
contrala
minatio
artery d
from an
resoluti
of the
was acq
assess t
same p
artery.
same in
ments.
Pressure
the com
incorpo
(SPT-30
[10,16].
subjecte
obtaine
carotid
brachial
pliance
which p
for diste
b-stiffn
[(D1�D
[(D1�D
minimu
lowest b
the ank
calculat
coefficie
the caro
complia
femoral
Left ven
Echocar
cular d
accordin
described [8]. The left ventricular mass and stroke
e
rat
e le
as
cis
e fi
ing
ing
cip
12
E
of
d c
Th
ive
ery
int
xi
rm
or
on.
an
ise
an
d.
ct
gh
stic
ge
p �
fica
od
g m
ter
en
ian
iat
p
ble
ult
re t
ren
le
ht,
he
he
gth
0.0
gth
for
ua
, a
Combined training and arterial compliance Kawano et al. 1755
rotid artery intima–media thickness (IMT) was
d from the images derived from an ultrasound
equipped with a high-resolution linear-array
and transducer as previously described [8]. Ultra-
mages were analyzed by use of computerized
nalysis software. At least 10 measurements of
ere taken at each segment, and the mean values
ed for analysis. This technique has excellent day-
eproducibility (coefficient of variance, 3 � 1%)
carotid IMT.
artery stiffness and compliance
ination of ultrasound imaging of the pulsatile
n carotid artery with simultaneous applanation
metrically obtained arterial pressure from the
teral carotid artery permits non-invasive deter-
n of arterial compliance [10,15]. The carotid
iameter was measured from images derived
ultrasound machine equipped with a high-
on linear-array transducer. A longitudinal image
cephalic portion of the common carotid artery
uired 1–2 cm distal to the carotid bulb. To
he effects of peripheral artery compliance, the
rocedure was repeated on the common femoral
All image analyses were performed by the
vestigator who was blinded to the group assign-
waveforms and amplitudes were obtained from
mon carotid artery with a pencil-type probe
rating a high-fidelity strain-gauge transducer
1; Millar Instruments, Houston, Texas, USA)
Because baseline levels of blood pressure are
d to hold-down force, the pressure signal
d by tonometry was calibrated by equating the
mean arterial and diastolic blood pressure to the
artery value [9,10]. In addition to arterial com-
[17], we also calculated the b-stiffness index,
rovides an index of arterial compliance adjusted
nding pressure [18]. Arterial compliance and the
ess index were calculated using the equations
0)/D0]/[2(P1�P0)] � p � (D0)2 and [ln(P1/P0)]/
0)/D0], where D1 and D0 are the maximal and
m diameters, and P1 and P0 are the highest and
lood pressures. The blood pressure obtained at
le (Form PWV/ABI; Colin Medical) was used to
e the femoral artery compliance. The day-to-day
nts of variation were 2 � 1, 7 � 3, and 5 � 2 for
tid artery diameter, pulse pressure, and arterial
nce, respectively. The coefficient of variance for
arterial compliance was 7 � 4%.
tricular dimensions, mass and function
diography was used to measure the left ventri-
imensions, wall thickness, and stroke volume
g to established guidelines [19] as previously
volum
The
to th
used
Exer
In th
train
train
parti
of 8–
MOD
50%
seate
ups.
gress
recov
min
appro
perfo
rate f
sessi
jects
exerc
from
perio
instru
throu
Stati
Chan
(grou
signi
meth
amon
in ar
indep
covar
covar
were
varia
Res
Befo
diffe
(Tab
weig
out t
All t
stren
(P <
stren
25%
for sq
press
ht © Lippincott Williams & Wilkins. Unauthorized
were normalized for the body surface area.
io of the average left ventricular wall thickness
ft ventricular internal end-diastolic diameter was
an index of relative wall thickness [8].
e training intervention
rst 4 months of study period, participants in all
groups underwent three supervised resistance
sessions per week. During each training session,
ants in the COMBO group completed three sets
exercises at 80% of 1 RM and subjects in the
group completed three sets of 14–16 exercises at
1 RM, in the following order: leg extension,
hest press, leg curls, lateral row, squat, and sit-
e resistance of each exercise was increased pro-
lythroughout the resistance training period. The
time between exercise bouts was controlled at 2-
ervals. Each resistance training session lasted
mately 45 min. Subjects in the COMBO group
ed a cycle exercise at 60% of the maximal heart
30 min immediately after each resistance training
Training assistants verbally encouraged the sub-
d ensured proper form and technique at each
session. Participants were instructed to refrain
y other regular exercise during the entire study
Participants in the sedentary control group were
ed not to alter their normal activity levels
out the study period.
al analyses
s were assessed by two-way analysis of variance
time) with repeated measures. In the case of
nt F-values, a post-hoc test (Newman–Keuls
) was used to identify significant differences
ean values. To determine whether the changes
ial compliance and the b-stiffness index were
dent of changes in stroke volume, analysis of
ce was performed with stroke volume as the
e. Pearson’s correlation and regression analyses
erformed to determine the relation between
s of interest.
s
he intervention period, there were no significant
ces in any of the variables between the groups
1). In all groups, there were no changes in height,
body mass index, and body surface area through-
intervention periods.
exercise intervention groups increased 1 RM
significantly in all muscle groups tested
5 to P < 0.0001). Percentage increases in 1 RM
for the MODE and COMBO groups were 6 and
leg extension, 13 and 14% for leg curl, 10 and 25%
t, 8 and 17% for lateral row, 6 and 21% for bench
nd 12 and 21% for abdominal bend, respectively.
 reproduction of this article is prohibited.
Copyrigh
The ma
COMBO
except
There w
complia
(Fig. 1
4 month
arterial
increase
vention
pliance
in arteri
arterial
unchang
results (
1756 Journal of Hypertension 2006, Vol 24 No 9
Fig. 1
A
rt
er
ia
l c
o
m
p
lia
n
ce
 (
m
m
2 /
m
m
H
g
)
0
0
0
0
0
0
(a)
(b)
Changes
the seden
strength t
strength t
mean � S
Table 2 Hemodynamic and vascular indices
e Baseline After training After detraining Interaction
al sy
TR
E g
BO
al di
TR
E g
BO
al pu
TR
E g
BO
sys
TR
E g
BO
pu
TR
E g
BO
lum
†
†
CONTROL
MODE
COMBO
.14
.16
.18
.20
.22
.24
Variabl
Brachi
CON
MOD
COM
Brachi
CON
MOD
COM
Brachi
CON
MOD
COM
Carotid
CON
MOD
COM
Carotid
CON
MOD
COM
Carotid
t © Lippincott Williams & Wilkins. Unauthorized 
gnitude of increases was larger (P < 0.05) in the
group than in the MODE group in all exercises
for the leg curl.
ere no significant differences in baseline arterial
nce and b-stiffness index between all four groups
). Carotid arterial compliance decreased after
s of MODE interventions (P < 0.01). In contrast,
compliance did not decrease, but rather tended to
(P ¼ 0.06), after 4 months of the COMBO inter-
. Following the detraining period, arterial com-
values returned to the baseline level. Alterations
al compliance were primarily due to changes in
distension as the carotid pulse pressure remained
ed (Table 2). In general, qualitatively similar
although inverse in direction) were obtained by
use of
arterial
pheral (
all grou
and car
carotid
In all gr
rate at
the resi
ventricu
(P < 0.0
index t
(P ¼ 0.0
stroke
the detr
tional in
significa
changes
study p
volume
found t
formed
DetrainingTraining
8 months4 months0 months
2.5
3.0
3.5
4.0
4.5
5.0
†
†
in (a) carotid arterial compliance and (b) b-stiffness index for
tary control group (CONTROL), the moderate-intensity
raining group (MODE), and the combined aerobic and
raining group (COMBO). Data presented as the
EM. �P < 0.05 versus baseline; yP < 0.05 versus 4 months.
CONTR
MODE g
COMBO
D Carotid
CONTR
MODE g
COMBO
Carotid int
CONTR
MODE g
COMBO
Femoral co
CONTR
MODE g
COMBO
Data prese
moderate-i
resistance
�P < 0.05
stolic blood pressure (mmHg)
OL group 118 � 2 119 � 1 120 � 2 F ¼ 2.130
roup 120 � 3 117 � 3 115 � 2 P ¼ 0.086
group 115 � 2 116 � 2 115 � 2
astolic blood pressure (mmHg)
OL group 68 � 2 73 � 2� 73 � 1 F ¼ 5.475
roup 71 � 2 66 � 2� 68 � 2 P > 0.001
group 67 � 1 67 � 2 67 � 2
lse pressure (mmHg)
OL group 49 � 2 47 � 1 47 � 1 F ¼ 2.407
roup 49 � 2 52 � 2 47 � 2 P ¼ 0.057
group 48 � 2 49 � 1 48 � 1
tolic blood pressure (mmHg)
OL group 101 � 2 104 � 2 104 � 1 F ¼ 1.653
roup 105 � 3 105 � 4 104 � 3 P ¼ 0.170
group 99 � 2 97 � 2 98 � 2
lse pressure (mmHg)
OL group 33 � 2 32 � 1 32 � 1 F ¼ 2.383
roup 36 � 2 39 � 3 36 � 2y P ¼ 0.059
group 31 � 1 30 � 1 32 � 1
en diameter (mm)
OL group 5.91 � 0.11 5.94 � 0.14 6.06 � 0.11 F ¼ 1.839
roup 6.03 � 0.13 6.02 � 0.10 6.02 � 0.11 P ¼ 0.131
group 5.79 � 0.09 5.91 � 0.07 5.81 � 0.09
lumen diameter (mm)
OL group 0.66 � 0.03 0.66 � 0.04 0.63 � 0.03 F ¼ 3.460
roup 0.74 � 0.02 0.66 � 0.04� 0.76 � 0.04y P ¼ 0.012
group 0.71 � 0.04 0.72 � 0.03 0.69 � 0.04
ima–media thickness (mm)
OL group 0.50 � 0.01 0.52 � 0.02 0.50 � 0.02 F ¼ 1.803
roup 0.46 � 0.01 0.45 � 0.02 0.46 � 0.01 P ¼ 0.138
reproduction of this article is prohibited.
the b-stiffness index (P < 0.01). The femoral
compliance, an index of the compliance of peri-
muscular) artery, did not change in any groups. In
ps, there were no significant changes in brachial
otid systolic blood pressures, carotid IMT, and
lumen diameter (Table 2).
oups, there were no significant changes in heart
rest throughout the study period (Table 3). All
stance training interventions increased the left
lar mass index and the relative wall thickness
01). In the COMBO group, the stroke volume
ended to increase during the training period
7). There were no significant changes in the
volume index in any other groups. Following
aining period, left ventricular structural and func-
dices returned to baseline and were no longer
ntly different from baseline. There were no such
in the sedentary control group throughout the
eriod. To determine whether changes in stroke
, a determinant of arterial compliance, could con-
he interpretation of the present results, we per-
several different analyses. When we performed a
group 0.47 � 0.01 0.52 � 0.01 0.51 � 0.02
mpliance (mm2/mmHg)
OL group 0.10 � 0.01 0.09 � 0.01 0.08 � 0.01 F ¼ 0.950
roup 0.08 � 0.01 0.09 � 0.01 0.08 � 0.01 P ¼ 0.441
group 0.09 � 0.01 0.07 � 0.01 0.07 � 0.01
nted as the mean � SEM. CONTROL, sedentary control group; MODE,
ntensity resistance training group; COMBO, combined high-intensity
training and moderate-intensity aerobic exercise training group.
versus baseline. yP < 0.05 versus after the training period.
Copyrig
univaria
index a
lation, t
P ¼ 0.9
complia
volume
P ¼ 0.2
perform
overall r
tially th
Discus
The ma
First, re
sity prod
high-int
Second,
minimiz
high-int
that a s
negate
caused
Historic
unsafe
events b
and my
resistan
ial bloo
thought
[8]. The
mented
and via
increase
modera
reasons,
formed
decreas
hypothesis, moderate resistance training significantly
as
� 0
ctio
ou
0.
th
ine
con
ce
an
ter
ase
ne
Ev
pp
re
an
gen
cial
rta
the
an
er
he
ise
de
ing
ctio
ntr
ow
ial
d t
tra
ing
d c
nt
rm
ter
Combined training and arterial compliance Kawano et al. 1757
Table 3 Cardiac indices
Variable
Heart rate
CONTR
MODE g
COMBO
Left ventric
CONTR
MODE g
COMBO
Relative wa
CONTR
MODE g
COMBO
Stroke volu
CONTR
MODE g
COMBO
Data prese
moderate-i
resistance
�P < 0.05
te correlation analysis between the stroke volume
nd carotid arterial compliance in a pooled popu-
hese two functions were not correlated (r ¼ 0.05,
3). Additionally, changes in carotid arterial
nce were not associated with changes in stroke
index in the combined exercise group (r ¼0.19,
6). Moreover, when analysis of covariance was
ed with the stroke volume as the covariate, the
esults on carotid arterial compliance were essen-
e same.
sion
jor findings of the present study are as follows.
sistance training performed at a moderate inten-
uced a magnitude of arterial stiffening similar to
ensity resistance training previously reported [9].
concurrently performed endurance training
ed arterial stiffening that was accompanied by
ensity resistance training. These results suggest
imultaneously performed aerobic training could
and prevent the stiffening of carotid arteries
decre
0.16
redu
previ
(from
over,
basel
ing,
plian
resist
in ar
incre
thick
ing.
fore a
Our p
resist
the
espe
impo
that
resist
great
sive
exerc
exclu
train
redu
In co
is sh
arter
esize
ance
train
woul
prese
perfo
in ar
Baseline 4 months 8 months Interaction
at rest (beats/min)
OL group 58 � 3 56 � 2 57 � 2 F ¼ 0.254
roup 55 � 3 54 � 2 53 � 2 P ¼ 0.906
group 52 � 3 48 � 1 50 � 1
ular mass index (g/m2)
OL group 131 � 7 132 � 7 131 � 7 F ¼ 11.940
roup 139 � 4 151 � 4� 137 � 4y P < 0.001
group 125 � 5 143 � 6� 127 � 6y
ll thickness (%)
OL group 19.5 � 0.4 19.7 � 0.4 19.8 � 0.4 F ¼ 15.793
roup 19.0 � 0.5 20.7 � 0.5� 19.3 � 0.5y P < 0.001
group 19.0 � 1.0 20.2 � 0.9� 18.9 � 0.9y
me index (ml/m2)
OL group 47 � 2 47 � 2 46 � 2 F ¼ 1.861
roup 51 � 1 50 � 1 50 � 1 P ¼ 0.130
group 48 � 2 50 � 2 48 � 2
nted as the mean � SEM. CONTROL, sedentary control group; MODE,
ntensity resistance training group; COMBO, combined high-intensity
training and moderate-intensity aerobic exercise training group.
versus baseline. yP < 0.05 versus 4 months.
ht © Lippincott Williams & Wilkins. Unauthorized
by resistance training.
ally, resistance training had been regarded as
for individuals at high risk for future cardiac
ecause of the abrupt increases in blood pressure
ocardial oxygen demand during high-intensity
ce training [20]. These marked increases in arter-
d pressure during resistance exercise were
to be initiating factors for arterial stiffening
majority of recent studies, however, have docu-
that low to moderate resistance training is a safe
ble form of exercise training as blood pressure
s are within the clinically acceptable range during
te-intensity resistance training [21]. For these
we hypothesized that resistance training per-
at a moderate intensity would not result in a
e in arterial compliance. In contrast to our working
intensit
tendenc
bined e
point of
‘cross-tr
and bre
particip
togethe
ance an
measure
training
It is no
the effe
Chronic
on endo
sion of
ed arterial compliance (from 0.20 � 0.01 to
.01 mm2/mmHg), and the magnitude of the
n in arterial compliance was similar to that we
sly observed in high-intensity resistance training
20 � 0.02 to 0.16 � 0.01 mm2/mmHg) [9]. More-
ese changes in arterial compliance returned to the
levels a few months after the cessation of train-
firming that the change in carotid arterial com-
was indeed due to the effect of the moderate
ce training intervention. Furthermore, reductions
ial compliance were accompanied by significant
s in left ventricular mass index and relative wall
ss, important clinical correlates of arterial stiffen-
en moderate-intensity resistance training there-
ears to stiffen or harden the large elastic arteries.
sent study provides a warning that even moderate
ce training, which is typically recommended to
eral public, should be prescribed cautiously,
ly for high-risk populations. However, one
nt consideration that should be emphasized is
volume (i.e. three sets) of moderate-intensity
ce training used in the present study was still
than that typically recommended for comprehen-
alth programs, where only one set of resistance
s is recommended [6,7]. We therefore cannot
the possibility that moderate-intensity resistance
performed with fewer sets may not result in a
n in arterial compliance.
ast to resistance training, regular aerobic exercise
n to be efficacious in preventing and reversing
stiffening in healthy adults [10,11]. We hypoth-
hat by combining the stiffening effects of resist-
ining and the destiffening effects of endurance
, both interventions would negate each other and
ause no changes in arterial compliance. In the
study, we demonstrated that simultaneously
ed endurance training prevented the reduction
ial compliance that was accompanied by high-
y resistance training. Additionally, there was a
y for arterial compliance to increase with com-
ndurance and resistance training. From the stand-
exercise adherence and compliance, this type of
aining’ is highly beneficial as it is more enjoyable
aks the boredom that often results from long-term
ation in a single exercise mode [22,23]. Taken
r, these findings suggest that combined resist-
d aerobic training may be an effective counter-
for the unfavorable effects of strenuous resistance
.
t clear what physiological mechanisms explain
cts of combined training on arterial compliance.
or repeated increases in flow exert their effects
thelial vasodilatation by modulating the expres-
nitric oxide synthase [24]. Carotid arteries
 reproduction of this article is prohibited.
Copyrigh
experience increases in blood flow and shear stress
during
blood fl
exercise
function
[29,30]
training
appears
tion [33
aerobic
nitric o
negated
the art
determi
the infl
carotid
Althoug
with res
otid arte
combin
training
strength
training
high-int
in the l
the sam
to both
number
who pe
training
forming
fore be n
training
ate opt
minimiz
on stren
enduran
smaller
might c
modera
much s
similar m
sity trai
arterial
depend
There a
should b
that per
not incl
ously pe
of ‘high
reasona
‘modera
as well.
pressure
changes in arterial compliance were not associated with the
sponding changes in blood pressure in the present
. B
ar
ssi
ha
ve
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ly)
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], t
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tra
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edu
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10:2
1758 Journal of Hypertension 2006, Vol 24 No 9
aerobic exercise bouts [25,26], whereas carotid
ow does not appear to change during resistance
s [27,28]. Consistent with this, endothelial
is improved with regular aerobic exercise
as well as with combined resistance and aerobic
[31,32]. Resistance training alone, however,
to have no effects on flow-mediated vasodila-
]. One possibility is therefore that the combined
and resistance training may have increased
xide bioavailability, which in turn may have
the opposing effects of resistance training on
erial wall. Future studies will be needed to
ne the physiological mechanisms underlying
uence of resistance and aerobic training on
arterial compliance.
h endurance training performed concurrently
istance training prevented the stiffening of car-
ries, the magnitude of increases was larger in the
ed training group than in the moderate-intensity
group in all exercises except for the leg curl. The
gains were consistently smaller in the combined
group compared with the previously studied
ensity resistance training alone [9], especially
ower limbs. This occurred despite the fact that
e training intensity and volume were prescribed
groups. These results are consistent with a
of previous studies demonstrating that subjects
rform a combination of endurance and strength
achieve lower strength gains than subjects per-
weight training alone [34–36]. It should there-
oted that simultaneous endurance and resistance
may prevent arterial stiffening, but could attenu-
imum gains in muscular strength. In order to
ethe antagonistic effects of endurance training
gth gains, it is recommended that strength and
ce training be performed on alternate days [36]. A
strength gain in the combined training group
onfound the interpretation of our findings. The
te-intensity resistance training that achieved
maller strength gains, however, experienced a
agnitude of arterial stiffening to the high-inten-
ning group. The effect of resistance training on
compliance therefore does not appear to be
ent upon the training intensity or strength gains.
re several limitations of the present study that
e emphasized. First, the combined training group
formed moderate-intensity resistance training was
uded in the present study. Because simultane-
rformed endurance training negated the effects
-intensity’ resistance training, however, it is fairly
ble to assume that it would negate the effects of
te-intensity’ (i.e. lesser stimuli) resistance training
Second, although arterial compliance and blood
often change simultaneously with interventions,
corre
study
appe
is po
may
relati
(n ¼
Futu
elder
In lig
train
[5–7
elast
two s
assoc
mode
cant
bined
decre
sugg
of ca
train
ance
Ack
The
Yuzu
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Refe
1 R
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hy
1
2 P
b
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3 B
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1
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1
5 D
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6 A
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9
7 P
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en
1
8 M
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9 M
et
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1
t © Lippincott Williams & Wilkins. Unauthorized 
Dr Mitsuru Higuchi, and Dr Izumi Tabata for
lpful comments.
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37
ht © Lippincott Williams & Wilkins. Unauthorized
 reproduction of this article is prohibited.
	Resistance training and arterial compliance: keeping the benefits while minimizing the stiffening
	Introduction
	Methods
	Participants
	Measurements
	Incremental™exercise
	Strength™testing
	Body™composition
	Arterial blood pressure at™rest
	Carotid artery intima-media thickness
	Carotid artery stiffness and™compliance
	Left ventricular dimensions, mass and™function
	Exercise training™intervention
	Statistical™analyses
	Results
	Discussion
	Acknowledgements
	References