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Original article
Exercise duration as a determinant of vascular function and antioxidant balance in patients with coronary artery disease
  1. A P Michaelides1,
  2. D Soulis1,
  3. C Antoniades1,
  4. A S Antonopoulos1,
  5. A Miliou1,
  6. N Ioakeimidis1,
  7. E Chatzistamatiou1,
  8. C Bakogiannis1,
  9. K Marinou2,
  10. C Liakos1,
  11. C Stefanadis1
  1. 1Department of Cardiology, Athens University Medical School, Athens, Greece
  2. 2Department of Experimental Physiology, Athens University Medical School, Athens, Greece
  1. Correspondence to Dr Andreas P Michaelides, Department of Cardiology, Athens University Medical School, 66 Thermopylon str, Vrilissia, TK 15235, Athens, Greece; michaelides{at}


Background Exercise improves the clinical outcome of patients with coronary artery disease (CAD); however, the ideal exercise duration for each patient remains unclear.

Objective To investigate the effects of exercise duration on arterial elastic properties and antioxidant/pro-oxidant mechanisms in patients with CAD.

Design, setting, patients, interventions Sixty male patients with CAD were randomised into two groups, and underwent exercise for 30 min or 60 min in a crossover design with 2 weeks' wash-out period. In all participants aortic and radial blood pressures (BP) and arterial elastic properties (augmentation index (AIx)/pulse wave velocity (PWV)) were determined at baseline and 24 h after exercise. Plasma malonyldialdehyde (MDA) and superoxide dismutase (SOD)1 and SOD2 levels were also measured.

Results Exercise had no effect on aortic and radial BP (p=NS for all). Walking for 30min improved AIx (from 33.79±0.91% to 31.73±0.86%, p<0.001) and PWV (from 9.26±0.95m/s to 9.06± 0.21m/s, p<0.001), while exercise for 60min had adverse effects on vascular stiffness (for AIx: from 33.37± 0.93% to 33.73± 1.05%, p=NS and for PWV: from 9.25±0.19m/s to 9.37±0.21m/s, p<0.05 mainly in older patients). Exercise for 60min was associated with a significant 20% increase in MDA levels (p<0.05). Exercise had no effects on SOD1 levels, however it significantly increased SOD2 levels after 30min (from 2.26±0.22ng/mL to 2.36±0.18ng/mL, p<0.05) but not after 60min (p=NS).

Conclusion Shorter exercise duration was associated with favourable antioxidant and vascular effects, while longer exercise blunted these beneficial effects and was accompanied by adverse effects on vascular function, mainly in older coronary patients. Further studies are required to explore the hypothesis that a more individualised approach to the selection of the appropriate exercise programme should be considered for patients with CAD.

  • Exercise
  • coronary artery disease
  • MDA
  • superoxide dismutase
  • augmentation index
  • pulse wave velocity
  • electrocardiography
  • exercise testing
  • exercise training
  • atherosclerosis
  • free radicals

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  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Hippokration Hospital Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.