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Vascular function after acute aerobic exercise in adults with and without type 2 diabetes mellitus

Publication . Marôco, João Luís; Arrais, Inês; Silvestre, Tiago; Pinto, Marco; Laranjo, Sergio; Magalhães, João P.; Santa-Clara, Helena; Fernhall, Bo; Melo, Xavier

It is unknown whether type 2 diabetes mellitus (T2DM) influences the vascular function response to aerobic exercise. We examined brachial artery flow-mediated dilation (FMD) and flow-mediated slowing (FMS) of pulse wave velocity (PWV), 10-and 60-min after a high-intensity interval exercise (HIIE) and moderate-intensity continuous exercise (MICE) in adults with and without T2DM. Twelve older male adults with T2DM (57-84 years), and twenty-four healthy young and older adults (12 per group, aged 20-40 years and 57-76 years, respectively), completed an acute bout of HIIE, MICE, and a non-exercise condition. FMD was evaluated by the same researcher following standardized guidelines. FMS was calculated from the manufacturer's PWV beta formulas. Central arterial stiffness was estimated via carotid-femoral PWV (cfPWV). %FMD was reduced (d= - 5.94%, 95% CI: - 10.50 to - 1.38%, p = 0.002), whereas %FMS increased (d = 4.55%, 95% CI: 0.62 to 8.48%, p = 0.01), 10-min after HIIE only in adults with T2DM, normalizing 60-min into recovery. Conversely, %FMD was increased (d = 5.33%, 95% CI: 0.76 to 9.89%, p = 0.009) 10-min after MICE only in adults with T2DM. cfPWV remained unchanged following HIIE and MICE in all groups. We report disease-associated vascular function responses to aerobic exercise suggesting both HIIE and MICE uncover transient vascular alterations in older adults with T2DM.

2025Journal article

Open access

Post-exercise differential response of central and brachial blood pressure in patients with coronary artery disease: a randomized crossover trial

Publication . Marôco, João Luís; Angarten, Vitor; Pinto, Rita; Santos, Vanessa; Fernhall, Bo; Santa-Clara, Helena; Melo, Xavier

The post-exercise hypotension response is controversial among patients with coronary artery disease (CAD). Factors behind this disparity may include post-exercise differential effects on central and brachial blood pressure (BP), exercise intensity and inter-individual variability. Thus, we investigate group and individual central and brachial BP responses 5, 15 and 30-min after combined exercise of different intensities in participants with and without CAD. Seventeen participants with stable CAD and eighteen aged-matched controls (52-81 years) completed an acute bout of high and moderate-intensity combined exercise. Brachial and central systolic (cSBP) pressures were assessed via oscillometry and carotid tonometry, respectively. Central pulse wave velocity was also measured. Group mean changes were examined with linear mixed models, and bSBP and cSBP post-exercise individual responsiveness quantified via the region of practical equivalence and highest density interval, a Bayesian decision rule. Regardless of exercise intensity, cSBP was persistently increased during recovery in participants with CAD (difference 30 -baseline (d30-bas) = 10, 95% CI: 4 to 17 mmHg, p = 0.001) but reduced in controls (d30-bas = -13, 95% CI: -19 to -7 mmHg, p = 0.003). bSBP was unchanged in both groups (CAD: d30-bas = 1, 95% CI: -3 to 6 mmHg, p = 0.995, control: d30-bas = -4, 95% CI: -2 to 8 mmHg, p = 0.999). Most participants with CAD exhibited sustained elevations in cSBP (n = 10), while most controls were post-exercise hypertensive responders (n = 11) with changes >|5| mmHg. We found differential post-exercise effects on central and brachial BP independent from combined exercise intensity but not clinical population. Clinical trials.gov registration ID: NCT06617117.

2025Journal article

Open access