Regulation of increased blood flow (hyperemia) to muscles during exercise: a hierarchy of competing physiological needs

Michael J Joyner; Darren P Casey

doi:10.1152/physrev.00035.2013

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Regulation of increased blood flow (hyperemia) to muscles during exercise: a hierarchy of competing physiological needs

Journal article

Open access

Peer reviewed

Regulation of increased blood flow (hyperemia) to muscles during exercise: a hierarchy of competing physiological needs

Michael J Joyner and Darren P Casey

Physiological reviews, Vol.95(2), pp.549-601

04/2015

DOI: 10.1152/physrev.00035.2013

PMCID: PMC4551211

PMID: 25834232

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Abstract

This review focuses on how blood flow to contracting skeletal muscles is regulated during exercise in humans. The idea is that blood flow to the contracting muscles links oxygen in the atmosphere with the contracting muscles where it is consumed. In this context, we take a top down approach and review the basics of oxygen consumption at rest and during exercise in humans, how these values change with training, and the systemic hemodynamic adaptations that support them. We highlight the very high muscle blood flow responses to exercise discovered in the 1980s. We also discuss the vasodilating factors in the contracting muscles responsible for these very high flows. Finally, the competition between demand for blood flow by contracting muscles and maximum systemic cardiac output is discussed as a potential challenge to blood pressure regulation during heavy large muscle mass or whole body exercise in humans. At this time, no one dominant dilator mechanism accounts for exercise hyperemia. Additionally, complex interactions between the sympathetic nervous system and the microcirculation facilitate high levels of systemic oxygen extraction and permit just enough sympathetic control of blood flow to contracting muscles to regulate blood pressure during large muscle mass exercise in humans.

Blood Pressure

Humans

Cardiac Output

Oxygen Consumption

Muscle, Skeletal - innervation

Muscle, Skeletal - metabolism

Autonomic Nervous System - physiopathology

Regional Blood Flow

Oxygen - blood

Vasodilation

Animals

Exercise

Muscle Contraction

Energy Metabolism

Hyperemia - physiopathology

Blood Flow Velocity

Hyperemia - blood

Hemodynamics

Muscle, Skeletal - blood supply

Details

Title: Subtitle: Regulation of increased blood flow (hyperemia) to muscles during exercise: a hierarchy of competing physiological needs
Creators: Michael J Joyner - Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota; and Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, Iowa
Darren P Casey - Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota; and Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, Iowa
Resource Type: Journal article
Publication Details: Physiological reviews, Vol.95(2), pp.549-601
DOI: 10.1152/physrev.00035.2013
PMID: 25834232
PMCID: PMC4551211
NLM abbreviation: Physiol Rev
ISSN: 0031-9333
eISSN: 1522-1210
Publisher: United States
Grant note: AR55819 / NIAMS NIH HHS UL1TR000135 / NCATS NIH HHS HL46493 / NHLBI NIH HHS R01 HL119337 / NHLBI NIH HHS HL105467 / NHLBI NIH HHS
Language: English
Date published: 04/2015
Academic Unit: Physical Therapy and Rehabilitation Science; Fraternal Order of Eagles Diabetes Research Center
Record Identifier: 9984047744002771

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