Stepping away from pharmaceutical therapies: Exercise and supplementation with fermented red clover extract as alternative strategies to promote vascular health in postmenopausal women

Abstract

Cardiovascular disease is the leading cause of death worldwide. Both aging and menopause, associated with the cessation of endogenous estrogen production, are key factors that contribute to the development of cardiovascular disease in women. Over the last few decades, an interest in alternatives to pharmaceutical interventions for promoting and/or rescuing cardiovascular health in postmenopausal women has emerged, where both exercise and phytoestrogen supplementation have been deemed effective candidates. However, due to the paucity of intervention studies in postmenopausal women, knowledge gaps remain in these strategies that need to be elucidated in the context of vascular health. This dissertation aims to answer three main questions that will refine the scientific community’s understanding of alternative interventions for vascular health in postmenopausal women: (1) Can exercise training work synergistically with in-vitro dual anti-platelet therapy to improve platelet function, as determined by basal platelet reactivity and prostacyclin sensitivity (Chapter 4)? (2) Does the timing of the initiation of exercise training after menopause affect the degree of vascular adaptations and thrombotic risk profile (Chapters 5 and 6)? (3) Can short-term supplementation with the novel phytoestrogen fermented red clover extract improve markers of vascular inflammation (Chapter 7)?

Together, the findings from this dissertation highlight that exercise and fermented red clover extract are effective alternative strategies to improving vascular health in postmenopausal women. Specifically, exercise training improves platelet function and sensitivity and can work synergistically with in-vitro dual anti-platelet therapy (Chapter 4). In addition, short-term supplementation with fermented red clover extract improves the vascular inflammatory profile in recently postmenopausal women (Chapter 7). However, the timing of exercise training after menopause may influence the magnitude of thrombogenic adaptations, as recently postmenopausal women experience more robust thrombogenic benefits than women who are a greater number of years postmenopausal (i.e., late postmenopausal women) (Chapter 5 and 6).