Vascular function is related to blood flow during high-intensity, but not low-intensity, knee extension exercise

While vascular function, assessed as the ability of the vasculature to dilate in response to a stimulus, is related to cardiovascular health, its relationship to exercise hyperemia is unclear. This study sought to determine if blood flow during submaximal and maximal exercise is related to vascular function. Nineteen healthy adults completed multiple assessments of vascular function specific to the leg, including passive leg movement (PLM), rapid onset vasodilation (ROV), reactive hyperemia (RH), and flow-mediated dilation (FMD). On a separate day, exercise blood flow (Doppler ultrasound) was assessed in the same leg during various intensities of single-leg, knee-extension (KE) exercise. Vascular function, determined by PLM, ROV, and RH, was related to exercise blood flow at high intensities, including maximum work rate (WRmax) ( r = 0.58–0.77, P < 0.001), but not low intensities, like ~21% WRmax ( r = 0.12–0.34, P = 0.12–0.62). Relationships between multiple indices of vascular function and peak exercise blood flow persisted when controlling for quadriceps mass and exercise work rate ( P < 0.05), indicating vascular function is independently related to the blood flow response to intense exercise. When divided into two groups based upon the magnitude of the PLM response, subjects with a lower PLM response exhibited lower exercise flow at several absolute work rates, as well as lower peak flow ( P < 0.05). In conclusion, leg flow during dynamic exercise is independently correlated with multiple different indices of microvascular function. Thus microvascular function appears to modulate the hyperemic response to high-intensity, but not low-intensity, exercise. NEW & NOTEWORTHY While substantial evidence indicates that individuals with lower vascular function are at greater risk for cardiovascular disease, with many redundant vasodilator pathways present during exercise, it has been unclear if low vascular function actually impacts blood flow during exercise. This study provides evidence that vascular function, assessed by multiple noninvasive methods, is related to the blood flow response to high-intensity leg exercise in healthy young adults. Importantly, healthy young adults with lower levels of vascular function, particularly microvascular function, exhibit lower blood flow during high-intensity, and maximal knee extension exercise. Thus it appears that in addition to increasing one’s risk of cardiovascular disease, lower vascular function is also related to a blunted blood flow response during high-intensity exercise.