Vascular healing through exercise

Photo credits: Barbara A. Brehm, Healthy Learning

Photo credits: Barbara A. Brehm, Healthy Learning

Exercise has been deemed a top means to improve physical health, and a Eurasian recent study conglomerates evidence linking exercise to improved health in specific disease populations due to increased endothelial progenitor cells (EPCs). EPCs are precursors to the cells that make up a blood vessel’s lining. These cells participate in angiogenesis and vasculogenesis, two processes that result in the growth of new blood vessels.  Exercise is said to increase EPCs and blood vessel growth, which helps to fight certain diseases.

In this review, coronary heart disease, chronic heart failure, chronic obstructive pulmonary disease, obstructive sleep apnea, diabetes, cerebrovascular disease, peripheral arterial disease, arterial hypertension, and obesity were looked at in relation to EPC levels. Specifically,

– A decreased level of EPCs was seen in coronary heart disease, diabetes (I and II), and obesity patients. Also, EPC function was impaired in obese patients.

– Biphasic levels of EPCs were seen in chronic heart failure (CHF) and peripheral arterial disease (PAD) patients as increased in moderate stages of the disease and decreased in the advanced stage. Conversely biphasic levels were seen in cerebrovascular disease (ischemic stroke) sufferers as decreased until after the stroke. It is thought that this post-stroke EPC increase occurs to aid in neurorepair.

– Unchanged levels of EPCs were seen in arterial hypertension patients, however, these EPCs were impaired in function.

– Inconclusive levels of EPCs were seen in chronic obstructive pulmonary disease and obstructive sleep apnea patients as studies did not show agreeing levels of EPCs for patients. This may suggest a non-link between EPCs and these diseases.

Regarding exercise, an up to three fold  increase of circulating EPCs was seen after sustained physical activity. Experimental regimens consisted of aerobic exercise over weeks of training resulting in high levels of sustained EPCs for over 7 days of no training. The increase caused by activity was directly measured in patients suffering from CHF and PAD yielding levels near that of control patients post-exercise. Extrapolating, these results show that exercise can return EPC levels to normal in patients suffering from diabetes and similar conditions in which significantly decreased levels are seen.

Conclusively, long-term physical activity seems to increase EPC levels with the capability to improve conditions in those suffering from vascular diseases.

Matina Koutroumpi, Stavros Dimopoulos, Katherini Psarra, Theodoros Kyprianou, Serafim Nanas. 2012. Circulating endothelial and progenitor cells: Evidence from acute and long-term exercise effects. World Journal of Cardiology.


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