| Summary: | Atherosclerotic cardiovascular diseases remain the most common causes of death in the developed world. Vascular endothelial dysfunction is considered to be central to, and the precursor of, atherosclerosis and subsequent clinical syndromes. Brachial artery reactivity using high-resolution ultrasound is the most commonly used method for non-invasive endothelial function assessment. With this method, endothelial function has been shown to be impaired by postprandial lipaemia (PPL) and improved by exercise. This thesis comprises of three studies that examined the relationship between EDV and PPL, as well as exercise, in a variety of subjects. FMD as measured during BAR testing was used to represent EDV in all studies. The first study examined the EDV response to PPL in 20 male CHD patients. There was no overall change in FMD following both meal challenge and no significant difference in the postprandial FMD between the two meals. The second study examined the effect of very short-term prior moderate-intensity exercise on EDV response to PPL in healthy male subjects. The study demonstrated a highly significant improvement in FMD during PPL in sedentary subjects when they had undertaken prior exercise. The third study examined the effect of six weeks of moderate-intensity exercise on EDV response to PPL in he'althy postmenopausal women. The study showed that FMD during PPL was significantly better when the subjects had been exercising. In these two studies, the protective effect of exercise on endothelial function appeared to be an independent and direct one. These studies add to the accumulating body of evidence that postprandial lipid metabolism is relevant to the development of atherosclerosis through its potentially adverse influence on endothelial function. They also contribute novel insights into the potential protective effect of exercise in this pro-atherogenic setting - an area that clearly deserves further research.
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