Research
Hormonal
Exercise training improves endothelial function primarily by increasing nitric oxide bioactivity, which counteracts oxygen free radicals and upregulates eNOS expression, leading to structural arterial remodeling over the long term.
Consistent exercise helps your blood vessels produce more nitric oxide, which protects them from damage by free radicals. Over time, this not only improves blood flow but can physically remodel arteries to be healthier, especially if you have existing cardiovascular risks.
GoodSupportsHIGH confidence
Increased NO bioactivity with exercise training has been readily and consistently demonstrated in subjects with cardiovascular disease and risk factors... repeated exercise and shear stress stimulation of NO bioactivity redresses this radical imbalance... Recent human studies also indicate that exercise training may improve endothelial function by up-regulating eNOS protein expression and phosphorylation.
Why this rating
Supported by multiple human studies cited in the review regarding eNOS upregulation and NO bioactivity.
Source
Effect of exercise training on endothelium‐derived nitric oxide function in humans
Daniel J. Green et al. · The Journal of Physiology · 2004
DOI 10.1113/jphysiol.2004.068197
narrative_reviewCited 1,007×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Exercise training improves endothelium-derived nitric oxide (NO) function in humans, with the magnitude of improvement depending on the muscle mass trained and the presence of pre-existing endothelial dysfunction.Good
- The contribution of nitric oxide to exercise hyperaemia (blood flow increase during exercise) is significant (20-30%) but not obligatory, with redundancy in vasodilator mechanisms allowing other pathways to compensate.Moderate
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