The acute and chronic effects of local aerobic exercise on cardiovascular physiology

Exercise training has beneficial effects for primary and secondary prevention of cardiovascular disease (CVD). Effects of exercise training have typically been studied in the form of whole-body exercise training, partly driven by the assumption that larger effects of exercise training can be achieved by involving more and larger muscle groups. Nonetheless, also local aerobic exercise provides valuable insight into cardiovascular responses and the mechanisms by which exercise training leads to lower CVD risk by being able to discriminate between local and remote effects of exercise. Therefore, it is important to understand the acute effects of local exercise on cardiovascular physiology, as well as how adaptations occur following exercise training. Furthermore, acute responses to local aerobic exercise may lead to (remote) cardioprotective effects, and is associated with blood pressure-lowering effects. Understanding these effects may help to further elucidate the mechanisms through which exercise decreases the risk of CVD, while it also highlights that local aerobic exercise may prove useful for systemic adaptations. This review aims to provide an overview of the acute and chronic effects of local aerobic exercise on cardiovascular physiology. Specifically, we describe the acute and chronic effects on local vascular haemodynamics and function, including changes in blood flow, diameter response, endothelial function and responses to ischaemia-reperfusion injury. Furthermore, the acute and chronic effects of local aerobic exercise on central haemodynamics will be discussed, including blood pressure, cardiac output and total peripheral resistance. Finally, we consider how several variables such as subject characteristics and training characteristics modulate these changes.