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Cited by 833Cardiovascular and exercise physiologyThermoregulation and physiological responsesExercise and Physiological Responses

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

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Joyner, Michael J., Casey, Darren P.·2015·Physiological Reviews
DOI 10.1152/physrev.00035.2013PMC PMC4551211
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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.

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Authors
Joyner, M. J., & Casey, D. P.
Affiliations
University of Iowa (US)
ORCID
Venue
Physiological Reviews
Publisher
American Physiological Society
Published
2015-04
Volume
95
Issue
2
Pages
549-601
ISSN
  • 0031-9333 (ISSN-L)
  • 1522-1210
DOI
10.1152/physrev.00035.2013
PMC
PMC4551211
OpenAlex
W2017754173
Cited by
833
References
532
Citations by year
2026: 98 · 2025: 100 · 2024: 93 · 2023: 98 · 2022: 79 · 2021: 88 · 2020: 84 · 2019: 59 · 2018: 50 · 2017: 45 · 2016: 29 · 2015: 8 · 2014: 1
FWCI
10.54
Type
journal article
Language
en
Open access
Locations
  • Physiological Reviews (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (UL1TR000135)
  • National Heart, Lung, and Blood Institute (R01HL119337, HL-46493, HL‐105467)
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases (F32AR055819, AR55819)
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
  • Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
Keywords
exercise hyperemia, skeletal muscle blood flow, exercise oxygen consumption, vasodilation, systemic hemodynamics, cardiac output, blood pressure regulation, sympathetic nervous system, microcirculation, oxygen extraction, training effects
MeSH terms
Animals, Autonomic Nervous System, Blood Flow Velocity, Blood Pressure, Cardiac Output, Energy Metabolism, Hemodynamics, Humans, Hyperemia, Muscle Contraction, Oxygen, Oxygen Consumption, Regional Blood Flow, Vasodilation, Exercise, Muscle, Skeletal

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