Korean J Sports Med.  2016 Dec;34(2):169-175. 10.5763/kjsm.2016.34.2.169.

Effects of Ultra-Marathon Running on Pro-inflammatory, Anti-inflammatory and Endothelial Function Factors in Athletes with Exercise-induced Hypertension

• Kim CH
• Kang DH
• Kim YJ

• KMID: 2382055
• DOI: http://doi.org/10.5763/kjsm.2016.34.2.169

Abstract

Running for a long distance in runners with exercise-induced hypertension (EIH) increases high blood pressure (BP) which causes myocardial burden, inducing elevation of cardiac markers. It is assumed to be associated with endothelial dysfunction, but has not been studied so far. The purpose of this study is to exam the responses of anti-inflammatory, inflammatory, and endothelial regulation factors to 100 km ultra-marathon of athletes who have EIH. For this study, we obtain and analysis interleukin-6, tumor necrosis factor-α, interleukin-10 (IL-10), monocyte chemoattractant protein-1, creatine kinase and nitric oxide (NO) from 100 km ultra-marathoners before and right after the 100 km race. There were 40 volunteers who had ever won the 100 km marathon race before more than one time. They had the graded exercise test with measurement of BP for assessing EIH. Among them, eight athletes were categorized to normal control group (NCG) and 10 athletes were assessed by EIH group (EIHG). The graded exercise test with treadmill was performed for the maximal strenuous exercise and BP. EIH was diagnosed as <140/90 mm Hg in normal and ≥210 mm Hg in maximal exercise. Marathoners including EIHG (n=10) and NCG (n=8) participated in the race and blood extracted from them before the race and right after the race. As results, EIHG had lower IL-10 than NCG during resting states and after the 100 km race EIHG had significantly lower NO concentration than NCG. Therefore, the NO in the endothelial is inhibited during strenuous endurance exercise, resulting in vasoconstriction with increasing the BP.

Keyword

Cardiovascular disease; Cytokines; Exercise-induced hypertension; Nitric oxide

MeSH Terms

Athletes*
Cardiovascular Diseases
Chemokine CCL2
Continental Population Groups
Creatine Kinase
Cytokines
Exercise Test
Humans
Hypertension*
Interleukin-10
Interleukin-6
Necrosis
Nitric Oxide
Running*
Vasoconstriction
Volunteers
Chemokine CCL2
Creatine Kinase
Cytokines
Interleukin-10
Interleukin-6
Nitric Oxide

Reference

References

1. Scherr J, Braun S, Schuster T, et al. 72-h kinetics of high-sensitive troponin T and inflammatory markers after marathon. Med Sci Sports Exerc. 2011; 43:1819–27.

2. Gremeaux V, Gayda M, Lepers R, Sosner P, Juneau M, Nigam A. Exercise and longevity. Maturitas. 2012; 73:312–7.

3. Petersen AM, Pedersen BK. The antiinflammatory effect of exercise. J Appl Physiol (1985). 2005; 98:1154–62.

4. Siegel AJ. Pheidippides redux: reducing risk for acute cardiac events during marathon running. Am J Med. 2012; 125:630–5.

5. Vlachopoulos C, Kardara D, Anastasakis A, et al. Arterial stiffness and wave reflections in marathon runners. Am J Hypertens. 2010; 23:974–9.

6. Lauer MS, Levy D, Anderson KM, Plehn JF. Is there a relationship between exercise systolic blood pressure response and left ventricular mass? The Framingham heart study. Ann Intern Med. 1992; 116:203–10.

7. Singh JP, Larson MG, Manolio TA, et al. Blood pressure response during treadmill testing as a risk factor for new-onset hypertension: the Framingham heart study. Circulation. 1999; 99:1831–6.

8. Kurl S, Laukkanen JA, Rauramaa R, Lakka TA, Sivenius J, Salonen JT. Systolic blood pressure response to exercise stress test and risk of stroke. Stroke. 2001; 32:2036–41.

9. Maron BJ. Sudden death in young athletes. N Engl J Med. 2003; 349:1064–75.

10. Ross R, Janssen I. Physical activity, total and regional obesity: dose-response considerations. Med Sci Sports Exerc. 2001; 33(6 Suppl):S521–7.

11. Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation. 2002; 105:1135–43.

12. Hasdai D, Scheinowitz M, Leibovitz E, Sclarovsky S, Eldar M, Barak V. Increased serum concentrations of interleukin-1 beta in patients with coronary artery disease. Heart. 1996; 76:24–8.

13. Packard RR, Libby P. Inflammation in atherosclerosis: from vascular biology to biomarker discovery and risk prediction. Clin Chem. 2008; 54:24–38.

14. Biasucci LM, Vitelli A, Liuzzo G, et al. Elevated levels of interleukin-6 in unstable angina. Circulation. 1996; 94:874–7.

15. Ridker PM. High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. Circulation. 2001; 103:1813–8.

16. Tedgui A, Mallat Z. Anti-inflammatory mechanisms in the vascular wall. Circ Res. 2001; 88:877–87.

17. Nieman DC. Immune response to heavy exertion. J Appl Physiol (1985). 1997; 82:1385–94.

18. Ostrowski K, Rohde T, Asp S, Schjerling P, Pedersen BK. Pro- and antiinflammatory cytokine balance in strenuous exercise in humans. J Physiol. 1999; 515:287–91.

19. Rubinshtein R, Kuvin JT, Soffler M, et al. Assessment of endothelial function by non-invasive peripheral arterial tonometry predicts late cardiovascular adverse events. Eur Heart J. 2010; 31:1142–8.

20. Kim YJ, Shin YO, Lee YH, et al. Effects of marathon running on cardiac markers and endothelin-1 in EIH athletes. Int J Sports Med. 2013; 34:777–82.

21. Kim YJ, Kim CH, Shin KA, et al. Cardiac markers of EIH athletes in ultramarathon. Int J Sports Med. 2012; 33:171–6.

22. Gibbons RJ, Balady GJ, Beasley JW, et al. ACC/AHA guidelines for exercise testing: executive summary. A report of the American College of Cardiology/American Heart Association task force on practice guidelines (Committee on Exercise Testing). Circulation. 1997; 96:345–54.

23. Ding AH, Nathan CF, Stuehr DJ. Release of reactive nitrogen intermediates and reactive oxygen intermediates from mouse peritoneal macrophages: comparison of activating cytokines and evidence for independent production. J Immunol. 1988; 141:2407–12.

24. Dill DB, Costill DL. Calculation of percentage changes in volumes of blood, plasma, and red cells in dehydration. J Appl Physiol. 1974; 37:247–8.

25. Nieman DC, Henson DA, Smith LL, et al. Cytokine changes after a marathon race. J Appl Physiol (1985). 2001; 91:109–14.

26. Kim HJ, Lee YH, Kim CK. Biomarkers of muscle and cartilage damage and inflammation during a 200 km run. Eur J Appl Physiol. 2007; 99:443–7.

27. Shanely RA, Nieman DC, Zwetsloot KA, et al. Evaluation of Rhodiola rosea supplementation on skeletal muscle damage and inflammation in runners following a competitive marathon. Brain Behav Immun. 2014; 39:204–10.

28. Pinderski Oslund LJ, Hedrick CC, Olvera T, et al. Interleukin-10 blocks atherosclerotic events in vitro and in vivo. Arterioscler Thromb Vasc Biol. 1999; 19:2847–53.

29. Goldhammer E, Tanchilevitch A, Maor I, Beniamini Y, Rosenschein U, Sagiv M. Exercise training modulates cytokines activity in coronary heart disease patients. Int J Cardiol. 2005; 100:93–9.

31. Mirhafez SR, Mohebati M, Feiz Disfani M, et al. An imbalance in serum concentrations of inflammatory and antiinflammatory cytokines in hypertension. J Am Soc Hypertens. 2014; 8:614–23.

32. Maeda S, Tanabe T, Otsuki T, et al. Moderate regular exercise increases basal production of nitric oxide in elderly women. Hypertens Res. 2004; 27:947–53.

33. Boos CJ, Lip GY. Is hypertension an inflammatory process? Curr Pharm Des. 2006; 12:1623–35.

34. Wilson MF, Sung BH, Pincomb GA, Lovallo WR. Exaggerated pressure response to exercise in men at risk for systemic hypertension. Am J Cardiol. 1990; 66:731–6.

35. Jungersten L, Ambring A, Wall B, Wennmalm A. Both physical fitness and acute exercise regulate nitric oxide formation in healthy humans. J Appl Physiol (1985). 1997; 82:760–4.

36. Park IW, Chang HJ, Chung J, et al. Alteration of nitric oxide/cyclic-GMP pathway in patients with exaggerated systolic blood pressure response during exercise test. Korean J Med. 2003; 65:90–98.