Cardiovascular responses to exercise
To meet the increased energy demand of muscles during exercise, the primary
cardiovascular response is in the form of:
• Increase in the skeletal muscle blood flow,
• Redistribution of blood flow in the body,
• Increase in the cardiac output,
• Blood pressure changes and
• Changes in blood volume.
Skeletal muscle blood flow
During exercise. During strenuous exercise muscle blood flow can increase up to 20 times.
It is made possible by
• Arteriolar dilatation (β2 receptors)
• Opening up of closed capillaries
Redistribution of blood flow in the body,
1. Coronary blood flow increased 3 to 4 times by metabolic factors over sympathetic
stimulation
2. Visceral blood flow decreased due sympathetic vasoconstriction especially renal
and splanchnic circulation (α1 receptors)
3. Cerebral remains same as it depends on local factors mostly
Increase in the cardiac output
1. Tachycardia
2. Increase in stroke volume
3. Blood pressure changes during exercise
Tachycardia
Heart rate increases linearly with the severity of exercise up to a maximum, which is
determined by the subject’s age. The maximum heart rate (HR max) is approximately
equal to 210 − (0.65 × age in years), and is unaffected by conditioning.
Is due to-
• Increased sympathetic discharge (β1 receptors)
• Peripheral reflexes from proprioceptors, muscle spindle etc
• Humoral factors
• Local metabolites,
• Increase in temperature
• Intrinsic – Bain bridge reflex.
Increase in stroke volume
Under normal conditions, the average stroke volume is about 80 ml/beat and may
increase up to twice the normal value during exercise. It is due to
- Intrinsic autoregulation or Frank–Starling mechanism
- Extrinsic regulation due to increased symphathetic stimulation
(β1 receptors)
Blood pressure changes during exercise
Systolic blood pressure – increases due to increase in heart rate and stroke
volume(sympathetic stimulation)
Diastolic blood pressure - Mostly the vasodilatation in the skeletal muscles
balances the vasoconstriction in other tissues, so the diastolic blood pressure is
slightly decreased or unchanged
Mean blood pressure is usually slightly increased. It helps to increase the
skeletal muscle blood flow by providing greater pressure head in the face of
dilated resistance vessels.
Summary of cardiovascular responses to exercise.
Respiratory changes during Exercise
1. Increase in pulmonary ventilation
2. Increase in Oxygen uptake in the lungs
3. Increase in Oxygen uptake in the tissues
4. Bronchodialation due to adrenergic stimulation(β2 receptors)
1. Increase in pulmonary ventilation
Increase in rate and depth of respiration
- The pulmonary ventilation increases linearly with the increase in
intensity of exercise (O2 consumption) until the anaerobic threshold
is reached
- Pulmonary ventilation increases because of increase in depth as well
as rate of respiration
- Mechanism of increased pulmonary ventilation
1. Neural control mechanisms
Cerebral cortex, the seat of conscious thought and voluntary activity
may be responsible for the anticipatory hyperpnoea, which may occur
due to psychic stimuli just before the beginning of exercise.
Afferent impulses from proprioceptors in the muscles and joints
Increase in body temperature
Ventilatory response to mild exercise showing abrupt change
at beginning and at the end of exercise.
2. Chemical mechanism
Accentuations of the normal oscillations in pO2 and pCO2
synchronous with respiration might stimulate the carotid body
chemoreceptors and explain part of exercise hyperpnoea.
Acidosis produced due to accumulation of lactic acid during severe exercise
(above the aerobic threshold level)
2. Increase in Oxygen uptake in the lungs
i. Increased pulmonary perfusion
during exercise about six times more blood passes through the lungs per
minute and so more O2 per minute is carried by the blood from the lungs.
ii. Increased alveolar capillary pO2 gradient.
During exercise, because of greater extraction of O2 by the muscles, the O2 content
of the mixed venous blood reaching the lungs may be as low as 3 ml/100 ml of
blood (compared with 14–15 ml% at rest). Thus the alveolar capillary pO2 gradient
is increased due to marked desaturation of the venous blood and so more O2 is
taken up by the blood in the lungs
iii. Increased pulmonary diffusion capacity.
About sixfold increase in pulmonary blood flow due to increased cardiac output
during exercise is not accompanied by rise in the pressure in the pulmonary
capillaries. This is made possible by the opening of several pulmonary capillaries
which are closed at rest.
As a result, the alveoli are better perfused with blood. The larger number of open up
capillaries increases the surface area available for diffusion.
In this way, there occurs threefold increase in the diffusion capacity of the lungs
from 21 ml/min/mmHg at rest to about 65 ml/min/mmHg during exercise
iv. Safety factor
because of increased cardiac output during exercise, the time that the blood remains
in the pulmonary capillary may be reduced to less than one half normal. Yet,
because of the great safety factor for diffusion of oxygen through the pulmonary
membrane, the blood still becomes almost saturated with oxygen by the time it
leaves the pulmonary capillaries.
under nonexercising conditions, the blood becomes almost saturated with oxygen
by the time it has passed through one third of the pulmonary capillary
Changes at the tissue level
• Gradient of pO2
between capillary blood and tissue fluid is increased. This happens because during
exercise contracting muscles extract more O2 from tissue fluid. Due to increased
gradient of pO2 between capillaries and tissue fluid, more O2 is removed from the
capillary blood into the tissue fluid.
• O2-HB dissociation curve
shifts to the right due to accumulation of CO2, rise in temperature and rise in red
blood cell 2,3-DPG. This results in a threefold increase in O2 extraction from each
unit of blood. Since there is associated (about 30- fold) increase in muscle blood
flow (as mentioned above), so a net increase of about 100-fold in metabolic rate of
muscle is possible during exercise.