The time is now: regular exercise maintains vascular health in ageing women

• Published in: The Journal of physiology 2023-06, Vol.601 (11), p.2085-2098
• Main Authors: Tamariz‐Ellemann, Andrea, Wickham, Kate Aiko, Nørregaard, Line Boel, Gliemann, Lasse, Hellsten, Ylva
• Format: Article
• Language: English
• Subjects: ageing; Aging; Aging - physiology; Cardiovascular system; Cardiovascular System - metabolism; Estrogens; Estrogens - metabolism; Exercise; Exercise - physiology; Female; Humans; Male; Menopause; Menopause - physiology; Physical activity; Physical fitness; Physical training; Skeletal muscle; vascular health; Womens health
• ISSN: 0022-3751; 1469-7793
• DOI: 10.1113/JP282896

Although ageing impairs cardiovascular health in both men and women, the timeline is different between the sexes. This is at least partially attributed to the loss of oestrogen in women at midlife, in connection with menopause. Oestrogen has protective effects on the cardiovascular system, and menopause consequently leads to a rapid and significant decline in cardiovascular health. Notably, oestrogen interacts with its nuclear and membrane receptors leading to changes in proteins of importance for cardiovascular health. Skeletal muscle activity, which affects the expression of many of the same proteins as oestrogen, could potentially counteract the loss of oestrogen at menopause. The hypothesis that exercise can counteract the loss of oestrogen has been explored in several recent studies. It has been found that regular physical activity opposes the detrimental effects not only of ageing, but also of the menopausal transition, on cardiovascular health. Although, vascular benefits can be gained at all ages, initiating physical activity at or soon after menopause may be more effective than at a later time point in life. Intuitively, it is easier to prevent decrements than attempting to regain lost vascular health. This idea is supported by evidence at the molecular level, suggesting that exercise‐induced activation of the oestrogen‐related receptor‐α pathway is more effective soon after menopause compared to later. Together, although a decline in cardiovascular health due to chronological ageing cannot be completely prevented, a physically active lifestyle mitigates age‐related cardiovascular impairments. Importantly, regular physical activity through life should always be addressed as the biological norm. figure legend Compared to a physically inactive lifestyle, lifelong participation in physical activity protects against the development of vascular disease. However, ageing and menopause, irrespective of physical activity status, have inevitable, negative effects on vascular health. Importantly, if regular exercise is initiated around the menopausal transition, the vascular consequences of ageing and menopause can be, at least partially, mitigated.