The Molecular Mechanism of Aerobic Exercise Improving Vascular Remodeling in Hypertension

Abstract

The treatment and prevention of hypertension has been a worldwide medical challenge. The key pathological hallmark of hypertension is altered arterial vascular structure and function, i.e., increased peripheral vascular resistance due to vascular remodeling. The aim of this review is to elucidate the molecular mechanisms of vascular remodeling in hypertension and the protective mechanisms of aerobic exercise against vascular remodeling during the pathological process of hypertension. The main focus is on the mechanisms of oxidative stress and inflammation in the pathological condition of hypertension and vascular phenotypic transformation induced by the trilaminar structure of vascular endothelial cells, smooth muscle cells and extracellular matrix, and the peripheral adipose layer of the vasculature. To further explore the possible mechanisms by which aerobic exercise ameliorates vascular remodeling in the pathological process of hypertension through anti-proliferative, anti-inflammatory, antioxidant and thus inhibiting vascular phenotypic transformation. It provides a new perspective to reveal the intervention targets of vascular remodeling for the prevention and treatment of hypertension and its complications.

Keywords: aerobic exercise; endothelial cells; hypertension; vascular remodeling; vascular smooth muscle cells.

FIGURE 1

When hypertension occurs, the continuous increase of blood pressure leads to chronic poor vascular adaptation and dysfunction. The specific manifestations are changes in the structure and function of vascular endothelial cells, smooth muscle cells, extracellular matrix, and perivascular adipose tissue. ECs, endothelial cells; VSMCs, vascular smooth muscle cells; ECM, extracellular matrix; PVAT, perivascular adipose tissue.

FIGURE 2

Aerobic exercise improves molecular changes in vascular remodeling of hypertension. NO, nitric oxide; ROS, reactive oxygen species; eNOS, endothelial nitric oxide synthase; OPN, osteopontin; α-SMA, α-smooth muscle actin; NLRP3, NOD-like receptor thermal protein domain associated protein 3; ANG, angiotensin; MMP-9, matrix metallopeptidase 9; MMP-2, matrix metallopeptidase 2; IL-6, interleukin-6; TNF-α, tumor necrosis factor-α; Adiponectin; Leptin.

FIGURE 3

Aerobic exercise improves hypertension by reducing inflammation, reducing fibrosis and proliferation, mediating vasodilation, and reducing perivascular adipose tissue.