Response to Letter to Editor

Response to “Aerobic Exercise and Endothelial Function in Pre- and Post-Menopausal Women” Koichiro Tanahashi,1 Nobuhiko Akazawa,2 and Seiji Maeda2

Correspondence: Seiji Maeda (maeda@taiiku. tsukuba.ac.jp). 1Graduate School of Comprehensive Human

Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan; 2Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.

Initially submitted March 6, 2014; date of first revision March 7, 2014; accepted for publication March 7, 2014. doi:10.1093/ajh/hpu069 © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: [email protected]

the other hand, hormone replacement therapy with estrogen decreased plasma levels of ADMA in postmenopausal women.4 In our study, we demonstrated that aerobic exercise training decreased plasma ADMA concentrations in estrogen-deficient postmenopausal women without hormone replacement therapy.1 However, effects of aerobic exercise training on ADMA in premenopausal women, with sufficient estrogen, are unclear. Further studies are required to investigate the exercise training effect on ADMA in premenopausal women. Aerobic exercise training enhances endothelial function through an increase in nitric oxide (NO) production.5 ADMA is an endogenous competitive inhibitor of NO synthase. An increase in ADMA is a cause of reduction in NO synthesis, leading to endothelial dysfunction.6 Therefore, a decrease in plasma ADMA concentrations, induced by aerobic exercise training, may contribute to an improvement in endothelial function. However, we did not measure the effect of different plasma ADMA concentrations on endothelial function using any index. Whether the decrease in plasma ADMA concentrations contributes to enhancement in endothelial function after exercise training remains undetermined. Further studies are needed to examine the effects of aerobic exercise training on ADMA and endothelial function. Taken together, a study conducted to investigate the effect of aerobic exercise training on endothelial

990  American Journal of Hypertension  27(7)  July 2014

function with circulating concentrations of ADMA and estrogen (i.e., premenopause or menopause) may be important for cardiovascular disease prevention in women.

Disclosure

The authors declared no conflict of interest.

References 1. Tanahashi K, Akazawa N, Miyaki A, Choi Y, Ra SG, Matsubara T, Kumagai H, Oikawa S, Maeda S. Aerobic exercise training decreases plasma asymmetric dimethylarginine concentrations with increase in arterial compliance in postmenopausal women. Am J Hypertens 2014; 27:415–421. 2. Tsuda K. Aerobic exercise and endothelial function in pre- and post-menopausal women. Am J Hypertens 2014; 27:989. 3. Schulze F1, Maas R, Freese R, Schwedhelm E, Silberhorn E, Böger RH. Determination of a reference value for N(G), N(G)-dimethylL-arginine in 500 subjects. Eur J Clin Invest 2005; 35:622–626. 4. Teerlink T, Neele SJ, de Jong S, Netelenbos JC, Stehouwer CD. Oestrogen replacement therapy lowers plasma levels of asymmetrical dimethylarginine in healthy postmenopausal women. Clin Sci 2003; 105:67–71. 5. Green DJ, Maiorana A, O’Driscoll G, Taylor R. Effect of exercise training on endotheliumderived nitric oxide function in humans. J Physiol 2004; 561:1–25. 6. Cooke JP. Asymmetrical dimethylarginine: the Uber marker? Circulation 2004; 109:1813–1818.

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To the Editor: We thank Dr Tsuda for the interest in our article, “Aerobic Exercise Training Decreases Plasma Asymmetric Dimethylarginine Concentrations With Increase in Arterial Compliance in Postmenopausal Women.”1 In this study, we demonstrated that 12 weeks of aerobic exercise training decreased plasma asymmetric dimethylarginine (ADMA) concentrations in postmenopausal women. In his letter to the editor, Tsuda suggested that the effect of aerobic exercise training on endothelial function should be evaluated with changes in plasma ADMA levels after exercise in pre- and postmenopausal women.2 We appreciate this comment and agree that this may be important. ADMA is partly modulated by estrogen in women. As a consequence, plasma ADMA concentrations increase with the onset of menopause.3 On

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