Cardiac Adaptations to High‐Intensity Aerobic Training in Premenopausal and Recent Postmenopausal Women: The Copenhagen Women Study

Abstract

BackgroundWe examined the role of menopause on cardiac dimensions and function and assessed the efficacy of exercise training before and after menopause.Methods and ResultsTwo groups of healthy premenopausal (n=36, 49.4±0.3 years) and postmenopausal (n=37, 53.5±0.5 years) women with no history of cardiovascular disease and with a mean age difference between groups of only 4 years were studied. Cardiac dimensions and systolic and diastolic function were determined by transthoracic echocardiography with tissue Doppler imaging and 2‐dimensional speckle tracking. Measurements were performed at baseline and after a 12‐week period of high‐intensity aerobic cycle training. LV internal diastolic diameter and LV mass were similar in the 2 groups at baseline and increased by ≈2% to 8% (P=0.04–0.0007) with training in both groups. Left atrial end‐diastolic and end‐systolic volumes were similar for both groups and increased by 23% to 36% (P=0.0006–0.0001) with training. Systolic function assessed by mean global strain was similar in both groups at baseline and increased by ≈8% (P=0.0004) with training in the postmenopausal group. LV displacement increased by ≈3% (P=0.04) in the premenopausal women only. Diastolic function assessed by E/A ratio was similar at baseline and increased by ≈7% (P=0.01) in the premenopausal group and 11% (P=0.0001) in the postmenopausal group with training.ConclusionsThese results suggest that training‐induced cardiac adaptations are preserved in the early postmenopausal phase. Furthermore, the hormonal changes associated with the menopausal transition do not appear to affect cardiac dimensions and function.Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT02135575.

Cardiovascular and metabolic health effects of team handball training in overweight women: Impact of prior experience

“…Although randomized trials of physical training with hard clinical end points have not been performed, the wealth of evidence linking physical activity with favorable effects on cardiovascular morbidity and mortality suggests that increased LVM/LVMI after physical exercise interventions may be a marker of improved prognosis. In the “Copenhagen Women Study,” the increase in VO 2max was supported by both structural and functional effects for echocardiographic parameters and furthermore also observed in premenopausal women after a period of recreational football . Compared to the aforementioned studies, the present study had fewer involved participants, which may partly explain why we did not observe any other adaptations on echocardiography.…”

The exercise timing hypothesis: can exercise training compensate for the reduction in blood vessel function after menopause if timed right?

“…, ; Egelund et al . ). One of the differences in design between these studies was the age of the postmenopausal women, where vascular benefits were achieved in recent (Nyberg et al .…”

“…In addition, training‐induced adaptations in cardiac function were similar in pre‐ and recent postmenopausal women and exercise training lowered platelet reactivity in both groups (Egelund et al . ; Lundberg Slingsby et al . ).…”

“…Regular exercise training is clearly beneficial for men at all ages and numerous studies have shown that men up to very old age profit from training in terms of vascular and cardiac function (Schmidt et al 2014;Vorup et al 2017). In women at older age, however, there are limited and conflicting data on a positive effect of exercise training on cardiac (Spina et al 1993;Egelund et al 2017) and vascular function (Pierce et al 2011a;Moreau et al 2013;Nyberg et al 2016;Seidelin et al 2017). Here we propose that greater improvements in vascular function may be achieved in women if training is initiated in middle age, soon after menopause, as opposed to many years (5-10 years) after menopause.…”

“…Here we propose that greater improvements in vascular function may be achieved in women if training is initiated in middle age, soon after menopause, as opposed to many years (5-10 years) after menopause. The rationale behind this thinking stems from observations in studies on women at or beyond middle age, in which some studies show no improvement in cardiovascular function after a period of physical activity (Spina et al 1993;Pierce et al 2011b;Moreau et al 2013) whereas others show a substantial improvement (Nyberg et al , 2016Egelund et al 2017). One of the differences in design between these studies was the age of the postmenopausal women, where vascular benefits were achieved in recent (Nyberg et al , 2016 but not late (Pierce et al 2011a;Moreau et al 2013) postmenopausal women.…”