¿Crisis de los 40? Ejercicio contra el envejecimiento vascular
Numerosos estudios han demostrado que la realización de una actividad física continua y habitual protege contra la muerte cardiovascular prematura. La función de las células musculares del corazón mejora con el entrenamiento físico. Todo el sistema circulatorio se beneficia, de tal modo que las variaciones hemodinámicas durante el ejercicio provocan unos cambios positivos sobre la pared de nuestras arterias. Este efecto beneficioso de la actividad física sobre la mortalidad es consistente en todos los grupos de edad, pero algunos estudios han demostrado una tendencia a un mayor beneficio en sujetos mayores (> 45 años). Sí, has leído bien, ¡¡¡mayores por encima de 45 años!!! (qué horror, nos hacemos mayores).
El envejecimiento está asociado con un endurecimiento de nuestras arterias, y esa rigidez provocará el desarrollo de hipertensión sistólica, problemas coronarios, hipertrofia de las células musculares cardíacas y alteraciones en la microcirculación, con la posibilidad de una futura insuficiencia cardíaca, la pandemia cardiovascular del siglo XXI.
Asimismo, el resto del sistema vascular se verá afectado, con posibles daños en órganos tan vitales como son los riñones y el cerebro. Por lo tanto, el endurecimiento de nuestras grandes arterias es el factor determinante de los problemas que tendremos con el incremento de nuestra edad.
Y aquí es donde la actividad física tiene un papel importante. Se ha comprobado que el ejercicio produce una mejoría en la dilatación de los vasos sanguíneos, provoca un aumento de la densidad capilar (aumenta el número de vasos), ocasiona una positiva remodelación excéntrica de las arterias, y sobre todo una mayor producción de óxido nítrico que es esencial en la función contráctil del corazón, reduciendo la rigidez del músculo cardíaco y bloqueando el desarrollo de hipertrofia de células musculares del corazón. Es decir, se producen una serie de adaptaciones que afectan positivamente a la estructura y función del corazón, así como a los distintos componentes de nuestro sistema circulatorio.
Recientemente se ha publicado un trabajo muy interesante en 237 personas sanas no entrenados que se ofrecieron como voluntarios para su primera maratón, en los que se realizó estudio con resonancia magnética cardíaca. Se comprueba que las personas más jóvenes (<35 años) mostraron una remodelación clásica del «corazón del atleta», mientras que los sujetos mayores (≥35 años; O35) tuvieron una remodelación cardíaca menos prominente, pero, sin embargo, sí que se apreció una mayor remodelación vascular. Es decir, el entrenamiento físico podría detener efectivamente el supuesto proceso inevitable de envejecimiento vascular. Uno de los efectos del entrenamiento fue la reducción de la presión arterial sistólica central en 6 mmHg en O35, lo cual es significativo con respecto a la reducción del riesgo cardiovascular. Además, los efectos inducidos por el entrenamiento sobre el consumo máximo de oxígeno (V02max) son positivos, lo que también explica los posibles beneficios del ejercicio sobre nuestra salud.
Evidentemente, se precisan estudios más concretos, pero a la luz de los hallazgos de este trabajo podemos destacar que el entrenamiento físico es beneficioso para la salud vascular, con el potencial de reducir el riesgo cardiovascular a largo plazo, especialmente en sujetos de mediana edad, lo cual puede apoyar la conocida leyenda de las “crisis de los 40” en la cual muchas personas empiezan a hacer el ejercicio que previamente no habían realizado. Nunca es tarde, si la dicha es buena.
REFERENCIA
Torlasco, Camilla, et al. “Age Matters: Differences in Exercise-Induced Cardiovascular Remodelling in Young and Middle Aged Healthy Sedentary Individuals.”
European Journal of Preventive Cardiology, June 2020,
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