Authors:
Danny Green
1
and
Raden Argarini
2
Affiliations:
1
School of Human Science – Sport Science, Exercise and Health University of Western Australia 35 Stirling Highway and Crawley WA 6009, Australia
;
2
Physiology Department and Faculty of medicine Universitas Airlangga Surabaya, Indonesia
Keyword(s):
Cardiovascular, cerebrovascular, flow-mediated dilatation (FMD), cerebral FMD, exercise
Abstract:
Abstract: Cardiovascular and cerebrovascular disease (CVD) is the number one cause of global premature death and disability with high economic burden. This is due, in part, to changing demographics combined with inadequate control of dyslipidaemia, hypertension, obesity and diabetes. The underlying cause of CVD is atherosclerosis, a systemic disease of the vessel wall, which occasionally encroaches on the lumen and remains asymptomatic for many years. This long latent period offers a window of opportunity for early detection and prevention. Current diagnostic approaches detect the disease in its latter stages, when regression is difficult and treatment is costly. In addition, current medical treatment is based on the management of symptoms related to ischemia, rather than the underlying atherosclerotic disease per se. Reliable and accurate pre-clinical detection of disease is needed if primary prevention strategies are to be effectively targeted and individualised. Endothelial dysfun
ction, which can be assessed by vasodilatory response to increases in flow and shear stress, is the earliest detectable manifestation of atherosclerotic CVD. Flow mediated dilation (FMD) strongly predicts prognosis in the context of coronary disease. Recently, our team developed a new FMD approach which is specific to assessment of cerebrovascular function and health. Cerebral FMD (cFMD) utilizes an increase in shear stress through the internal carotid arteries, induced by breathing a CO2 gas mixture thereby providing a potentially effective, non-invasive and novel insight into cerebrovascular function. In summary, atherosclerosis is a systemic disease but highly preventable disease, and prevention is most effective if risk is individually assessed and the progress of underlying disease is closely monitored. Exercise exerts systemic beneficial effects on large and small artery function, not only by modifying traditional and novel risk factors, but also by exerting direct effects on the vascular wall.
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