An Ecosystem to Support Traditional Clinical Investigation

Abstract

See related article, pp 1011–1020 In this edition of Hypertension , Nyberg et al1 from the University of Copenhagen report that both prostacyclin- and acetylcholine-induced vasodilation are blunted in the legs of young (mean age, 54 years) postmenopausal women and subsequently improved by endurance exercise training. At first glance, this is a terrific piece of mechanistic physiology and high resolution or deep phenotyping combined with an exercise training intervention in humans. It also begins to fill an important gap in our understanding of sex differences, aging, exercise, and resistance vessel physiology and pharmacology in humans that has relevance to blood pressure regulation and hypertension. As humans, age there is a generalized decline in endothelial-mediated vasodilator function. In older men, exercise training can limit the decline in resistance vessel vasodilator function with aging.2 In older women, much less is known—the effects of exercise training on resistance vessel function have been studied minimally, and the studies on larger arteries suggest that endothelial function in older women may be less trainable than men.3 There is also speculation that the loss of estrogen at menopause contributes to potential sex differences in blood vessel trainability. In this context, the key finding of Nyberg et al1 is that the resistance vessel vasodilator responses to both prostacyclin and acetylcholine are improved by training in a relatively young group of postmenopausal women. By contrast, training had minimal effects in a group of slightly younger (mean age, 50 versus 54 …