3 Comments

It is evident that insufficient physical activity represents an important risk factor for cardiovascular diseases. Adaptation to exercise intensely suppresses the subsequent cortisol response to a psychosocial stressor. Exercise plays a crucial role in influencing the vascular system and is essential for maintaining vascular health. Hemodynamic stimuli generated by exercise, such as stress, directly impact vascular structure and function, resulting in adaptive changes. Heat adaptation is also a popular strategy to combat the negative effects of heat stress.

When the HPA axis is activated with chronic stress, negative effects occur with effects on cardiovascular health such as:---

1) Increases visceral fat deposits---

2) Decreases bone and connective tissue metabolism in general---

3) Increases insulin resistance---

4) Produces irritability and mood disturbances--

5) Alters the perception of reality---

6) Lower tolerance to stress (greater perception of it)--

7) Alters decision making and judgment-----

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5988244/ (2013).—

https://www.sciencedirect.com/science/article/pii/S0306453021002109 (2021).--

https://www.tandfonline.com/doi/full/10.1080/10253890.2023.2199886 (2023).--

https://www.frontiersin.org/articles/10.3389/fbioe.2024.1370234/full (2024).--

https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-2296-7604 (2024).--

https://link.springer.com/article/10.1007/s42978-023-00263-8 (2024).--

Expand full comment

These reviews comprehensively explored the latest evidence and potential mechanisms of various exercise modalities in relation to atrial fibrillation (AF) incidence and therapeutic outcomes. Multiple studies underline the effectiveness of moderate intensity continuous training (MICT) in reducing AF incidence and symptom burden, making it the currently preferred exercise therapy for AF patients. High-intensity interval training (HIIT) shows promise, potentially outperforming MICT, especially in reducing susceptibility to age-related AF and improving symptoms and exercise capacity. In contrast, prolonged high-intensity resistance exercise exacerbates the risk of AF due to excessive exercise volume, with potential mechanisms encompassing irreversible atrial remodeling, increased inflammation, and increased vagal tone.

There is a J-shaped dose-response relationship between physical activity and cardiovascular health outcomes, where moderate exercise provides protection against many cardiovascular diseases, while chronic resistance exercise can promote atrial fibrillation (AF).

These adverse effects on the atria associated with excessive daily exercise occurred despite improved aerobic conditioning, skeletal muscle adaptation, and physiological ventricular remodeling.

The specific atrial changes observed with exercise arise from excessive elevations in venous filling pressures during prolonged exercise sessions, with implications for all patients with AF.

https://www.sciencedirect.com/science/article/pii/S1050173824000021 (2024).--

https://physoc.onlinelibrary.wiley.com/doi/full/10.1113/JP285697 (2024).--

Expand full comment

Excellent essay and words of wisdom, but don’t forget the gut! Our guts have direct access to the brain through the messentary and unconscious gut stress monocytes and macrophages are imported into the brain across the BBB in this way affecting microglia and astrocytes to upgrade inflammation into through amygdala hijack. Be careful how you think!

Expand full comment