# Exercise as it relates to Disease/Pumping Blood: Can Exercise Improve Arterial Health

Introduce paper/topic. Statement: this has been created by u31192358.

## What is the background to this research?

Atherosclerosis and coronary artery disease are serious issues. Due to the deposition of fatty substances on the inner walls of blood vessels, the amount of blood able to flow through them is significantly inhibited. As a result, patients can suffer from heart attack, stroke and death. Research into this area is particularly important given high, and rising obesity levels across the world. As such, it is a topic that should be well publicised in a way that educates the greater population.

## Where is the research from?

The study was undertaken through the University of Leipzig, Germany. It was published in the New England Journal of Medicine. As such, it underwent ethics board approval and was published in a reliable medical publication. The authors of this article are renowned experts in the field of cardiovascular health. Each having published articles in the area, as well as practicing.

## What kind of research was this?

This was a randomised control trial, whereby participants were assigned to one of two groups. The first; the exercise group, undertook a four week exercise program which was closely monitored to ensure it was completed correctly. The second; the control group, did not undertake any extra exercise. Prior to this four week period, participants were given doses of acetylcholine - a neurotransmitter - which was used to test vasoconstriction responses of their blood vessels. This research format is important to determine the effect of a chosen variable - in this case exercise. The effect of exercise can therefore be observed by comparing a control group to those that exercise.

## What did the research involve?

The study group was made up of 19 males aged 70 or below, with documented coronary artery disease. The study involved initial assessment of participants’ blood vessel diameter to attain a benchmark before the intervention was introduced. Subsequently, the participants were assigned to either a training group or a control group. They were then given increasing doses of acetylcholine to assess vasoconstriction in their blood vessels. Once these baseline measures were completed, a four week block of training or non-training was implemented. At the completion of the four weeks, participants’ were assessed again and the results compared to the baseline tests. The study was limited to using participants who fitted a very specific set of criteria. They needed to have significant coronary artery disease while not having any of the following conditions:
* Diabetes
* Hypertension
* Smoker within the last 3 months
* Ventricular tachyarrhythmias
* Chronic obstructive pulmonary disease
* Valvular heart disease
* Left ventricular ejection fraction of less than 40%
Despite this, the participants still yielded valid data that gave a clear result.

## What were the basic results?

The results from the research show that exercise increases blood flow in the blood vessels. In the exercising group, mean coronary blood flow increased from 27±11% to 110±24% above baseline levels. Meanwhile in the non-exercising groups, changes in results were not deemed statistically relevant. In other words, there was very little to no change.

## What conclusions can we take from this research?/Practical advice

Based on the findings from this research, it can be established that exercise plays an important role in improving vascular function in coronary patients. Additionally, it suggests that exercise could play a role in preventing the onset of coronary artery disease. Other studies have been conducted to assess the impact exercise has on cardiovascular health. These have shown that regular physical activity is linked to reductions in the risk of ischemia. Taken together, these results highlight the important role physical activity and exercise has in maintaining good health - namely in cardiovascular health.

## References

* ↑ Atherosclerosis. (2016). National Institutes of Health: National Heart, Lung, and Blood Institute. Retrieved 18 September 2016, from
* ↑ Masters et al. (2013). The Impact of Obesity on US Mortality Levels: The Importance of Age and Cohort Factors in Population Estimates. American Journal of Public Health 103(10):1895-1901.
* ↑ Hambrecht, R., Wolf, A., Gielen, S., Linke, A., Hofer, J., & Erbs, S. et al. (2000). Effect of Exercise on Coronary Endothelial Function in Patients with Coronary Artery Disease. New England Journal Of Medicine, 342(7), 454-460. http://dx.doi.org/10.1056/nejm200002173420702
* ↑ Ehsani AA, Heath GW, Hagberg JM, Sobel BE, Holloszy JO. Effects of 12 months of intense exercise training on ischemic ST-segment depression in patients with coronary artery disease. Circulation 1981;64:1116- 24.