Preliminary Study: Physiological Responses to a Single Bout of Nordic Walking Exercise in Patients with Pre-hypertensive Post-menopausal Women

Abstract

Objective: Cardiovascular diseases are a significant cause of morbidity and mortality globally, particularly among post-menopausal women who face heightened risk. Exercise is recognized for its preventive benefits on cardiovascular health and enhancement of vascular function; yet, the effects of various exer cise modalities remain inadequately understood. This study aimed to assess alterations in erythrocyte deformability, total oxidant/antioxidant status (TOS/TAS), oxidative stress index (OSI), and serum levels of leptin and irisin in pre-hypertensive post-menopausal women following one session of Nordic walking (NW) exercise. Materials and Methods: The study cohort comprised 11 post-menopausal women with pre-hypertension (mean age 57.91 ± 7.23 years) and 12 age-matched healthy women (mean age 55.17 ± 5.29 years). Venous blood was taken before and just after the exercise session. The deformability of red blood cells (RBCs) was assessed using an ektacytometer. TOS/TAS, irisin, and leptin were quantified using commercial assays. Results: A session of NW exercise did not influence oxidative stress indices or blood levels of irisin and leptin; nevertheless, erythrocyte deformability assessed at 30.00 Pa significantly increased post-exercise (p=0.043). Conclusion: Our findings indicate that enhanced RBC deformability after an acute session of NW may facilitate blood flow.

Keywords

• Red blood cell deformability
• Nordic walking exercise
• Oxidative stress
• Irisin and Leptin

References

1. 1. Materson BJ, Garcia-Estrada M, Degraff SB, Preston RA. Prehypertension is real and can be associated with target organ damage. J Am Soc Hypertens 2017; 11: 704-8. google scholar
2. 2. Egan BM, Stevens-Fabry S. Prehypertension–prevalence, health risks, and management strategies. Nat Rev Cardiol 2015; 12(5): 289-300. google scholar
3. 3. Zaydun G, Tomiyama H, Hashimoto H, Arai T, Koji Y, Yambe M, et al. Menopause is an independent factor augmenting the age-related increase in arterial stiffness in the early postmenopausal phase. Atherosclerosis 2006; 184(1): 137-42. google scholar
4. 4. Skórkowska-Telichowska K, Kropielnicka K, Bulińska K, Pilch U, Woźniewski M, Szuba A, et al. Nordic walking in the second half of life. Aging Clin Exp Res 2016; 28: 1035-46. google scholar
5. 5. Bla´ha M, Rencova´ E, Bla´ha V, Maly´ R, Blazek M, Studnicka J, et al. The importance of rheological parameters in the therapy of microcirculatory disorders. Clin Hemorheol Microcirc 2009; 42: 37-46. google scholar
6. 6. Connes P, Simmonds MJ, Brun JF, Baskurt OK. Exercise hemorheology: classical data, recent findings and unresolved issues. Clin Hemorheol Microcirc 2013; 53(1-2): 187-99. google scholar
7. 7. Cicco G, Pirrelli A. Red blood cell (RBC) deformability, RBC aggregability and tissue oxygenation in hypertension. Clin Hemorheol Microcirc 1999; 21: 169-77. google scholar
8. 8. Pilch W, Tota Ł, Piotrowska A, Śliwicka E, Czerwińska-Ledwig O, Zuziak R, et al. Effects of nordic walking on oxidant and antioxidant status: levels of calcidiol and proinflammatory cytokines in middle-aged women. Oxid Med Cell Longev 2018; 2018: 6468234. google scholar

9. 9. Kortas J, Kuchta A, Prusik K, Prusik K, Ziemann E, Labudda S, et al. Nordic walking training attenuation of oxidative stress in association with a drop in body iron stores in elderly women. Biogerontology 2017; 18: 517-24. google scholar
10. 10. Perakakis N, Triantafyllou GA, Fernández-Real JM, Huh JY, Park KH, Seufert J, et al. Physiology and role of irisin in glucose homeostasis. Nat Rev Endocrinol 2017; 13(6): 324-37. google scholar
11. 11. Kohrt WM, Landt M, Birge SJ Jr. Serum leptin levels are reduced in response to exercise training, but not hormone replacement therapy, in older women. J Clin Endocrinol Metab 1996; 81: 3980-5. google scholar
12. 12. Kraemer RR, Johnson LG, Haltom R, Kraemer GR, Hebert EP, Gimpel T, et al. Serum leptin concentrations in response to acute exercise in postmenopausal women with and without hormone replacement therapy. Proc Soc Exp Biol Med 1999; 221: 171-7. google scholar
13. 13. Piotrowicz E, Zieliński T, Bodalski R, Rywik T, Dobraszkiewicz-Wasilewska B, Sobieszczańska-Małek M, et al. Home-based telemonitored Nordic walking training is well accepted, safe, effective and has high adherence among heart failure patients, including those with cardiovascular implantable electronic devices: a randomised controlled study. Eur J Prev Cardiol 2015; 22: 1368-77. google scholar
14. 14. Muollo V, Rossi AP, Milanese C, Zamboni M, Rosa R, Schena F, et al. Prolonged unsupervised Nordic walking and walking exercise following six months of supervision in adults with overweight and obesity: A randomised clinical trial. Nutr Metab Cardiovasc Dis 2021; 31: 1247-56. google scholar
15. 15. Alzahrani E, Alyazedi FM. The impact of a 10-week military training course on Saudi medical recruits' fitness and physical activity levels. Cureus 2023; 15(10): e46593. google scholar
16. 16. López-Miñarro PÁ, Vaquero-Cristóbal R, Muyor JM, Espejo-Antúnez L. Related validity of sit-and-reach test as a measure of hamstring extensibility in older women. Nutr Hosp 2015; 32(1): 312-7. google scholar
17. 17. Wang YC, Bohannon RW, Li X, Sindhu B, Kapellusch J. Hand-grip strength: normative reference values and equations for individuals 18 to 85 years of age residing in the United States. J Orthop Sports Phys Ther 2018; 48(9): 685-93. google scholar
18. 18. Gulati M, Shaw LJ, Thisted RA, Black HR, Bairey Merz CN, Arnsdorf MF. Heart rate response to exercise stress testing in asymptomatic women: the st. James women take heart project. Circulation 2010; 122: 130-7. google scholar
19. 19. Baskurt OK, Boynard M, Cokelet GC, Connes P, Cooke BM, Forconi S, et al. International expert panel for standardization of hemorheological methods. New guidelines for hemorheological laboratory techniques. Clin Hemorheol Microcirc 2009; 42: 75-97. google scholar
20. 20. Hardeman MR, Goedhart P, Shin S. Methods in hemorheology. In: Baskurt OK, Hardeman MR, Rampling MR, Meiselman HJ, eds. Handbook of Hemorheology and Hemodynamics. Netherlands: IOS Press; 2007: 242-66. google scholar
21. 21. Ozdamar M, Kilic Erkek O, Tumkaya S, Ozdamar HC, Ozdamar A, Pakyurek H et al. Examination of the effectiveness of 12-week Nordic Walking exercise in prediabetic individuals. Pam Med J 2022; 15: 285-301. google scholar
22. 22. Kilic-Toprak E, Unver F, Kilic-Erkek O, Korkmaz H, Ozdemir Y, Oymak B, et al. Increased erythrocyte aggregation following an acute bout of eccentric isokinetic exercise does not exceed two days. Biorheology 2018; 55: 15-24. google scholar
23. 23. Erel O. A new automated colorimetric method for measuring total oxidant status. Clin Biochem 2005; 38(12): 1103-11. google scholar
24. 24. Erel O. A novel automated direct measurement method for total antioxidant capacity using a new generation, more stable ABTS radical cation. Clin Biochem 2004; 37(4): 277-85. google scholar
25. 25. Kaminsky LA, Arena R, Myers J. Reference standards for cardiorespiratory fitness measured with cardiopulmonary exercise testing: data from the fitness registry and the importance of exercise national database. Mayo Clin Proc 2015; 90(11): 1515-23. google scholar
26. 26. Pescatello LS, Blanchard BE, Tsongalis GJ, Maresh CM, Griffiths B, Thompson PD. The GNAS 393 T>C polymorphism and the blood pressure response immediately following aerobic exercise among men with elevated blood pressure. Vasc Dis Prev 2009; 6: 56-64. google scholar
27. 27. Thompson PD, Crouse SF, Goodpaster B, Kelley D, Moyna N, Pescatello L. The acute versus the chronic response to exercise. Med Sci Sports Exerc 2001; 33: S438-45 google scholar
28. 28. Latosik E, Zubrzycki IZ, Ossowski Z, Bojke O, Clarke A, Wiacek M, et al. Physiological responses associated with nordic-walking training in systolic hypertensive postmenopausal women. J Hum Kinet 2014; 43: 185-90. google scholar
29. 29. Brun JF. Exercise hemorheology as a three acts play with metabolic actors: is it of clinical relevance? Clin Hemorheol Microcirc 2002; 26(3): 155-74. google scholar
30. 30. Suhr F, Brenig J, Müller R, Behrens H, Bloch W, Grau M. Moderate exercise promotes human RBC-NOS activity, NO production and deformability through Akt kinase pathway. PLoS One 2012; 7: e45982. google scholar
31. 31. Tomschi F, Bloch W, Grau M. Impact of type of sport, gender and age on red blood cell deformability of elite athletes. Int J Sports Med 2018; 39: 12-20. google scholar
32. 32. Cebula A, Tyka A, Pilch W. Effects of 6-week Nordic walking training on body composition and antioxidant status for women 55 years of age. Int J Occup Med Environ Health. 2017; 30: 445-54. google scholar
33. 33. Sari R, Balci MK, Balci N, Karayalcin U. Acute effect of exercise on plasma leptin level and insulin resistance in obese women with stable caloric intake. Endocr Res 2007; 32: 9-17. google scholar
34. 34. Bouassida A, Zalleg D, Bouassida S, Zaouali M, Feki Y, Zbidi A, et al. Leptin, its implication in physical exercise and training: a short review. J Sports Sci Med 2006; 5: 172-81. google scholar
35. 35. Fox J, Rioux BV, Goulet EDB, Johanssen NM, Swift DL, Bouchard DR, et al. Effect of an acute exercise bout on immediate post-exercise irisin concentration in adults: A meta-analysis. Scand J Med Sci Sports 2018; 28: 16-28. google scholar
36. 36. Rashti BA, Mehrabani J, Damirchi A, Babaei P. The influence of concurrent training intensity on serum irisin and abdominal fat in postmenopausal women. Prz Menopauzaly 2019; 18: 166-73. google scholar