Benefits of Regular Exercise on the Endothelium

Engaging in regular exercise is absolutely one of the best things you can do for your cardiovascular health, and the function of your endothelium. Even though most people know about the benefits of exercise on their overall health, the majority still do not incorporate physical activity into their lives. It is true that there are fewer opportunities to be active with regards to occupational choices, and the many advancements in technology allow us to perform tasks that used to require more physical exertion in much easier ways. However, there are also many more ways to get the necessary levels of exercise we need through our leisure and recreational activities. Also, there is more accessibility to health clubs and fitness centers than ever before. If joining a workout facility does not suit you or your finances, there are more types of home workout equipment than ever before.

According to the American Council on Exercise (ACE), approximately 88 million Americans are inactive. In 1997, only 22 percent of americans engaged in enough physical activity to see some benefit. The Centers for Disease Control (CDC) was so concerned about the 34 percent of population over 50 that was sedentary, that in 2001 they published the National Blueprint: Increasing Physical Activity Among Adults Aged 50 and older, a report that strongly recommends that this group of people boost its amount of exercise. People who are physically active have less risk for breast, prostate, and colon cancer. They also experience an increase in insulin sensitivity and improved carbohydrate metabolism.

The problem of inactivity is extending to our children, who are more overweight than any generation. In 1999, researchers found that 60 percent of children between the age of 5 and 10 had at least one risk for heart disease. This rise in children at risk is largely due to less physical activity and increased body weight.

Regular exercise improves overall health, and aerobic exercise in particular, is the best way to improve your cardiovascular health. Brisk walking, jogging, jumping rope, cross-country skiing, swimming, biking are all examples of aerobic exercise. All these activities require vigorous and sustained use of your large muscle groups.

The following guidelines are helpful in determining the intensity and length of your aerobic sessions.

Your maximum heart rate is determined as follows:

220 - your age = maxium heart rate

This number represents your approximate heart rate if you were exercising at your highest level. This is an important number for determining a safe, yet challenging, Target Heart Rate for your particular fitness level. Your Target Heart Rate is the heart rate you should try to reach during aerobic exercise for at least 20 minutes.

For individuals who are already active, determine your maximum heart rate and then multiply that number by 75 percent. This is your Target Heart Rate. This range will provide the most benefit for your heart, lungs, and circulatory system.

If you have been sedentary, but feel good otherwise, multiply your maximum heart rate by 60 percent for your Target Heart Rate. Once you have been exercising at this level for a few weeks, gradually increase your heart rate until you are up to 75 percent of your maximum heart rate.

If you are over 65, there are a few other considerations to follow. If you have been sedentary, a heart rate of 100 would be a good target to aim for. As you become more fit, increase your heart rate to around 115. If you are fit and over 65, you may be able to exercise at a higher heart rate than this level.

If you are at risk for cardiovascular disease, or already have symtpoms, you should consult with a physician before starting an exercise program. An EKG-monitored treadmill test may be necessary to determine a safe level of exercise.

If you are already physically fit, performing vigorous aerobic exercise for at least 30 minutes three to four times per week is advised, with a Target Heart Rate of 75 percent of your maximum. You can also receive some benefit from more moderate activity for 30 minutes, but not to as great an extent. If you have been sedentary or are unable to perform vigorous exercise, you should just try to do as much moderate level exercise as possible. Even small amounts can help lower the risk of cardiovascular disease. If possible, try to walk at least 30 minutes per day.

Aerobic exercise has metabolic benefits that help prevent heart disease. It reduces LDL (bad) cholesterol and increases HDL (bad) cholesterol. It also lowers your blood sugar to healthy levels, and lowers blood pressure and heart rate. Aerobic exercise is one of the best methods for burning calories, and in so doing, lowering your body fat percentage. This is especially important because being overweight is a risk factor for several types of disease, including heart disease, high blood pressure, stroke, and diabetes.

The two other types of exercise are strength training and stretching to improve flexibility. While the best type of exercise to improve your cardiovascular health is aerobic exercise, both strength training and stretching for flexibility are very important for your overall health and well-being. Strength training is important for maintaining and building muscle mass and muscle tone. Weight training also strengthens your bones and decreases the chances of osteoporosis. It also decreases your chances of developing adult-onset diabetes (type II diabetes), and like aerobic exercise, increases your HDL cholesterol level. Stretching to improve flexibility is also very important for your overall health and fitness. As you get older, muscles begin to tighten and range of motion is decreased. Stretching will help lengthen your muscles, helping make day-to-day activities much easier. Increased flexibility also improves circulation, which can provide many benefits for all body systems. Increased range of motion also decreases injuries by allowing your joints to move further before an injury occurs.

Like all other muscles, the heart needs to be exercised for maximum performance. If your heart is stronger, it does not have to work as hard to pump blood and oxygen throughout your body. The reduced chance of heart attack by people who exercise regularly has been well documented in a number of studies. The Honolulu Heart Program, begun in 1965 by the National Heart, Lung, and Blood Institute, carefully monitored 8,000 Hawaiian men of Japanese ancestry for 30 years. The researchers found that retired men who walked two miles per day had half the risk for serious heart disease than those who were sedentary.

Aerobic exercise improves your heart and blood vessel health by directly benefitting the endothelium. Being active is one of the best ways to restore the health of the endothelium. Exercise improves blood flow through your vessels. The endothelium senses the increased flow and responds by producing more of the enzyme NO synthase, which in turn produces more nitric oxide. When your endothelial cells are exposed to long-term increases in blood flow, they become more like Teflon and less like Velcro. This makes white blood cells and platelets less likely to stick to blood vessel walls, and reduces the chance of plaque build-up.

Exercise also increases the diameter of your blood vessels. The first to notice this benefit was the great cardiac pathologist Paul Wood about 60 years ago when he performed an autopsy on an old marathon runner who had died of cancer. Dr. Wood noticed that the marathon runner's coronary arteries were two to three times the size of a normal man.

A paper published in the journal Circulation in 2000, Italian researchers examined whether the impairment of the endothelium - which had been described as part of the aging process - can be minimized by regular physical activity. The health of the endothelial cells was evaluated in older people (average age 64) who exercised, compared to much younger individuals (average age 28). The older people had blood vessels that were as healthy as those of the younger group. Researchers concluded that "regular physical training protects the vascular endothelium from aging-related alterations." They added that this positive effect of exercise is "related to preservation of NO availability."

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