High-Intensity Endurance and Strength Training in Water Polo Olympic Team Players: Impact on Arterial Wall Properties

Abstract

Introduction: Regular physical activity is recommended to minimize health risk. However, the upper intensity threshold associated with the best health outcomes is difficult to be determined. Water polo (WP) Olympic athletes present unique characteristics such as high-intensity exercise, long training sessions, and a combination of endurance and strength training. Therefore, we examined in which way the long-term, intense, mixed endurance and strength training affects the peripheral and central hemodynamics. Methods: The study population consisted of 20 WP Olympic team players, 20 matched recreationally active (RA) subjects, and 20 sedentary control subjects (Cl). Reflected waves were assessed with the augmentation index (AIx), central aortic stiffness with pulse wave velocity (PWV), and endothelial function with flow-mediated dilation (FMD). Results: Amongst Cl subjects, RA subjects, and WP players, there was no difference in age (p = 0.33) as well as in brachial systolic pressure (p = 0.52), while there was a stepwise decrease in aortic systolic pressure (116 ± 16 mm Hg vs. 107 ± 14 mm Hg vs. 106 ± 6 mm Hg, p = 0.03). There was also a stepwise improvement in AIx (–4.22 ± 9.97% vs. –6.97 ± 11.28% vs. –12.14 ± 6.62%, p = 0.03) and FMD (6.61 ± 1.78% vs. 7.78 ± 1.98% vs. 8.3 ± 2.05%, p = 0.04) according to the intensity of exercise, with WP players having lower AIx and higher FMD compared to RA subjects and Cl subjects. No difference was found in PWV (Cl: 5.88 ± 0.72 m/s vs. RA: 6.04 ± 0.75 m/s vs. WP: 5.97 ± 1.09 m/s, p = 0.82) among the three studied groups. Conclusions: Young WP Olympic team players depict improved arterial wall properties and endothelial function compared to RA and Cl subjects.

Mixed Signals: Arterial Stiffness and Elite Sports

“…In this issue of Cardiology , Oikonomou et al [7] report their investigations on arterial wall properties in Olympic-level water polo players. Water polo players are subjected to high loads of high-intensity training, including both endurance and strength components.…”

“…Water polo players are subjected to high loads of high-intensity training, including both endurance and strength components. Compared with the control groups, consisting of sedentary and recreationally active subjects, Oikonomou et al [7] demonstrate mixed arterial findings in these athletes. In water polo players, aortic systolic pressure is decreased, and augmentation index – an indirect measure of arterial stiffness – improved.…”

“…The elegant analysis by Oikonomou et al [7] can teach us 2 important things about arterial properties in elite athletes. First, arterial stiffness does not seem to be either negatively or positively affected by the mix of endurance and strength training.…”

“…Second, a mixed picture emerges of the effects of high-intensity training in water polo players on different arterial wall properties: Oikonomou et al [7] demonstrate a lack of effect on PWV but an improvement in augmentation index. The lack of effect of mixed exercise on PWV is in line with previously published studies [8, 9].…”

“…The improvement in augmentation index has not been previously been reported in this group. Oikonomou et al [7] suggest that the improvement in augmentation index could be the result of improved endothelial function. However, this finding could also partly be explained by how arterial stiffness is measured.…”