With advancing age, large conduit arteries (e.g., the aorta and carotid arteries) lose their ability to distend in response to fluctuations in arterial pressure. The impaired buffering or compliance function of the arteries contributes to a number of cardiovascular and autonomic nervous systems disorders, including increased systolic blood pressure and aortic impedance, decreased coronary perfusion, left ventricular hypertrophy, and a blunting of cardiovagal baroreflex sensitivity. Because of the clinical significance of this function, a number of methods have been developed to characterize the elastic property of the arteries. However, there is no consensus as to which method should be used. In regard to the prevention of arterial stiffening, mounting evidence suggests that regular physical activity could retard age-related arterial stiffening. The purpose of this review is to introduce methodologies used to derive arterial stiffness, to describe clinical significance of this measure, and to review the impacts of habitual physical activity on central artery stiffness.

It has been shown that the time constant of heart rate decline for the first 30 sec (T₃₀) after exercise, at an intensity lower than the ventilatory threshold (VT), can serve as a specific index to assess post-exercise vagal reactivation. The purpose of this study was to validate the use of a simpler alternative index, i. e. %Δ HR₃₀ (the ratio of heart rate decrement for the first 30 sec after exercise) for the evaluation of parasympathetic nervous reactivation, and to examine whether it would be a useful index in the conditioning of athletes. Eighteen college students performed 4 minutes cycle ergometer exercise routines at intensities of 40%, 80%, and 120% VT to compare the %Δ HR₃₀ and the T₃₀. In addition, the %Δ HR₃₀ was obtained by a field test (4 minutes jogging) in 15 college middle and long distance runners, every morning during summer camp training to assess the state of athletic conditioning. The %Δ HR₃₀ at 80% VT was similar to the value at 40% VT, but significantly different from the value at 120% VT, as was the T₃₀ at 80% VT.
The %Δ HR₃₀ significantly correlated with the T₃₀ and VO₂max. During the camp, the %Δ HR₃₀ was higher on mornings following light training days than on mornings following hard training days. These results suggest that the %Δ HR₃₀, at an exercise intensity lower than the VT, could be a simple and useful index to evaluate post-exercise parasympathetic nervous reactivation in the conditioning of athletes.

The engaging>30 minutes of physical activity (PA) at 4-6 METs has been recommended for the prevention of cardiovascular disease. We determined whether relatively low intensity (i. e., 3-5 METs) PA inhibits the age-related central arterial stiffening, a risk of cardiovascular disease. In the cross-sectional study, the association between carotid arterial properties (via ultrasound system) and daily PA (via electric accelerometer) were studied in 172 normotensive people (41-82 yrs). People engaging>30 min/day of PA corresponding to 3-5 METs had a significantly lower beta-stiffness index than sedentary peers after adjusting for covariates (i. e., age and PA time at more than 6 METs). In the interventional study, beta-stiffness index of nine normotensive postmenopausal women was significantly decreased after the 12-week aerobic training (cycling at 80% of ventiratory threshold, ≈4 METs, 30 min/day, 5 days/week). These results suggest that the increase in daily PA at 3-5 METs inhibits the age-related carotid arterial stiffening.

The effects of endurance training and detraining on cardiac autonomic nervous system activity were studied by using the power spectral analysis of heart rate (HR) variability. Twenty-one sedentary male subjects were trained for 8 weeks using cycle ergometer exercise [70% of maximal oxygen uptake (VO₂max), 60 min, 3.4 times/wk] . Resting HR for 5 min was recorded before the training, after the 8-week training period, and after the 2-week and 4-week detraining period. The indices of cardiac parasympathetic and sympathetic nervous system activity were determined by Mem-Calc method, as the high frequency power (HF : 0.15-0.50 Hz) and the ratio of the low frequency power (LF : 0.04-0.15 Hz) to the HF (LF/HF), respectively. The VO₂max after the training and 4 weeks detraining period were significantly higher than the initial value (before training : 41 ± 1 ml/kg/min ; after training: 48±2, P<0.0001; after detraining: 46±2, P<0.001) . The HF was significantly in-creased by the training (P<0.05), and maintained the increased level for the 2-week detraining period (before training : 6.4±0.3 In ms²; after training: 7.0±0.2, P<0.01; after 2-week detrain-ing: 7.0±0.2, P<0.05) . The increase in the HF, however, disappeared after the 4-week detraining period (6.8±0.31n ms²) . The LF/HF did not show any significant changes during the training and detraining period. These results suggest that an endurance exercise with moderate intensity enhan-ces cardiac parasympathetic nervous system activity, but not cardiac sympathetic nervous system activity. The enhanced cardiac parasympathetic nervous system activity, however, may regress rapidly during detraining period.

The effect of daily physical activity on oxidative stress is still an unknown issue, especially in middle-aged and elderly individuals. In this study, we examined the relationships of oxidative stress and antioxidant capacity with daily physical activity, taking into consideration the dietary antioxidant vitamin intake (vitamin B₂, C and E) of middle-aged and elderly people (66.0±7.0 years, n= 21; 10 males and 11 females, including 5 male trained runners) . Daily physical activity was measured using both a calorie counter and a questionnaire over a period of two weeks. The plasma concentration of thiobarbituric acid reactive substance ( [TBARS] ) and both oxidized and reduced glutathione concentrations ( [GSSG] and [GSH] ) in whole blood were determined in blood samples obtained at rest and immediately after two periods of acute exercise: maximal cycle ergometric exercise and steady state cycle exercise at 80% of ventilatory threshold (VT) for 30 minutes. At a given statistically controlled dietary antioxidant vitamin intake level (vitamin B₂, C and E), the amount of daily physical activity was associated with neither [TBARS], [GSH] and the ratio of [GSSG] / [GSH] at rest, nor changes in levels of these substances after both exercise tests. These data suggest that the amount of daily physical activity may have little influence on oxidative stress or antioxidant capacity at rest and after acute cycle ergometric exercise. Further investigation would be necessary to clarify how much volume or intensity of physical activity induces increased oxidative stress, from the aspect of habitual physical training and nutrition.

Resistance exercise in the elderly and patients with a cardiovascular disorder has been thought to have a high cardiovascular risk, because it has the tendency to cause an excessive rise in blood pressure and induce serious arrhythmia. But recently, resistance exercise has been introduced into physical therapy because the safety of such exercise has been confirmed in subjects without a cardiovascular disorder.
The purpose of this study was to investigate the safety of lower extremity resistance exercise in middle-aged or elderly subjects with hypertension and receiving medical treatment (n=24), and those without hypertension (n=40), by measuring cardiovascular response during resistance exercise of different loads (40% and 60% 1 RM), and usefulness of respiratory guidance during such exercise.
As a result, there was no difference in diastolic blood pressure between those with and without hypertension ; but systolic blood pressure and rate pressure product both at rest and during exercise were significantly greater in patients with hypertension. However, neither group showed symptoms of angina, ischemic signs in ECG, or serious arrhythmia ; and there was no difference in the frequency of excessive rise in blood pressure between the groups (2 subjects with hypertension and 1 subject without hypertension) . Blood pressure during exercise was significantly lowered by respiratory guidance.
These results show that it is important to measure blood pressure during exercise before resistance exercise training regardless of the presence of hypertension, although an excessive rise in blood pressure occurred in only a few subjects. Furthermore, it is important to exhale slowly and not hold one's breath during exercise.

Arterial compliance progressively decreases with aging. This aging-induced reduction of arterial compliance causes an increase of systolic blood pressure (SBP), whereas regular exercise increases arterial compliance. We hypothesized that an increase in daily physical activity (DPA) produces a beneficial effect on systemic arterial compliance (SAC ; an index of central arterial compliance) and this phenomenon could decrease SBP in the elderly. We investigated the relationship among DPA, SAC, SBP, diastolic blood pressure (DBP), and some other risk factors for cardiovascular and/or cerebrovascular events (total cholesterol, HDL-cholesterol, and HOMA-R) cross-sectionally in 127 elderly persons (42 male, 85 female : aged 74±4 years) . The DPA was estimated by expended calories using an accelerometer. The SAC was calculated from a finger pulse pressure waveform recorded by using PORTAPRES ; and stroke volume obtained from the same pressure waveform based on the volume-clump method. The analyses demonstrated that SBP was directly and decreasingly affected by SAC, and that DPA had an increasing effect on SAC. Furthermore, SBP was directly and increasingly affected by DBP, and DBP was directly and decreasingly affected by both SAC and DPA. Therefore, it is considered that DPA may have suppressive effects on the rise of SBP through the indirect effects of changing SAC and DBP. These findings suggest that an increase in DPA could improve the age-induced reduction of arterial compliance and rise of SBP in elderly humans.

This procedure was developed for preservation of the rectus muscle components and deep inferior epigastric vessel after deep inferior epigastric perforator (DIEP) flap harvesting. A 53-year-old woman with granuloma caused by silicone injection underwent bilateral nipple-sparing mastectomies and immediate reconstruction with "mini-flow-through" DIEP flaps. The flaps were dissected based on the single largest perforator with a short segment of the lateral branch of the deep inferior epigastric vessel that was transected as a free flap for breast reconstruction. The short segments of the donor deep inferior epigastric vessel branch are primarily end-to-end anastomosed to each other. A short T-shaped pedicle mini-flow-through DIEP flap is interposed in the incised recipient's internal mammary vessels with two arterial and four concomitant venous anastomoses. Although it requires multiple vascular anastomoses and a short pedicle for the flap setting, the mini-flow-through DIEP flap provides a large pedicle caliber, enabling safer microsurgical anastomosis and well-vascularized tissue for creating a natural breast without consuming time or compromising the rectus muscle components and vascular flow of both the deep inferior epigastric and internal mammary vessels.
Breast* ; Female ; Free Tissue Flaps ; Granuloma ; Humans ; Mammaplasty* ; Mastectomy ; Mastectomy, Subcutaneous ; Microsurgery ; Middle Aged ; Perforator Flap* ; Silicon ; Silicones ; Tissue Donors