Physical Activity prevents endothelial dysfunction irrespective of Kidney Status

Physical activity has long been associated with a lower risk of cardiovascular diseases, while excessive sedentary behavior is emerging as an independent risk factor. Now, a new study "The Maastricht Study" has found that physical activity is associated with better endothelial function. This association has been found beneficial for both individuals with normal kidney function and in those with chronic kidney disease.

The study was published in Atherosclerosis by Bellos and colleagues. The study, which used cross-sectional data from the population-based Maastricht Study, involved 2,668 participants, including 323 with chronic kidney disease. To measure physical activity and sedentary behavior, participants wore ActivPAL3 accelerometers 24 hours a day for eight consecutive days. Endothelial dysfunction was assessed by measuring plasma levels of various markers: soluble vascular cell adhesion protein-1, intercellular adhesion molecule-1, E-selectin, and von Willebrand factor. These markers were combined to create an ED score, where higher scores indicated more severe ED.

The study, which included 2,668 participants, revealed some crucial insights:

1. Kidney Function and Endothelial Dysfunction:

• Normal Kidney Function: Individuals with normal kidney function demonstrated a significant negative association between the ED score and the duration of total physical activity, lower-intensity physical activity, and moderate-to-vigorous physical activity. This means that more physical activity was linked to better endothelial function in those with healthy kidneys.
• Chronic Kidney Disease: Participants with chronic kidney disease also benefited from physical activity, as an increase in total and lower-intensity physical activity correlated with a lower ED score. In these individuals, physical activity appeared to protect against ED.
  

2. Impact of Sedentary Behavior:

• Normal Kidney Function: For those with normal kidney function, the study found a positive association between the ED score and total sedentary time, sedentary bout duration, and fewer sedentary breaks. In other words, prolonged sitting and a lack of breaks from sedentary behavior were associated with worse endothelial function.
• Chronic Kidney Disease: Individuals with chronic kidney disease who engaged in longer sedentary bouts experienced more significant endothelial dysfunction, emphasizing the adverse effects of sitting for extended periods, especially in this population.
  

This study underscores the critical role of physical activity in preserving endothelial function. These findings highlight that even individuals with chronic kidney disease can benefit from exercise. In contrast, excessive sedentary behavior, particularly in the form of prolonged sitting, was associated with worsened endothelial function.

The research emphasizes the importance of maintaining an active lifestyle and reducing sedentary time. By doing so, individuals can support better endothelial function and reduce the risk of cardiovascular diseases. This information is valuable for healthcare professionals and individuals alike, as it underscores the importance of both physical activity and avoiding prolonged sitting for heart health.

Reference:

Bellos, I., Marinaki, S., Lagiou, P., Boletis, I. N., Stehouwer, C. D. A., van Greevenbroek, M. M. J., Eussen, S. J. P. M., de Galan, B. E., Savelberg, H. H. C. M., Koster, A., Wesselius, A., & Benetou, V. Association of physical activity with endothelial dysfunction among adults with and without chronic kidney disease: The Maastricht Study. Atherosclerosis,2023;383(117330):117330. https://doi.org/10.1016/j.atherosclerosis.2023.117330