PURPOSE: Endothelial dysfunction is an early and integral atherogenic event. Interventions that improve endothelial function also reduce cardiovascular risk. Due largely to the direct hemodynamic effects of repetitive exercise on the artery wall, exercise training has shown to enhance endothelial function. Land-walking (LW) and water-walking (WW) induce distinct hemodynamic responses, so comparison of their impacts provides an approach to study shear stress effects on endothelial function. We hypothesized that LW and WW training would have different impacts on peripheral artery endothelial function. METHODS: Fifty-one sedentary, older (age 61.9 +/- 6.6 yrs, 23.5% male) individuals were randomized into 1 of 3 groups: control (CG, n = 16), or one of two exercise groups consisting of 3 x 50 min supervised and individually tailored walking sessions per week for 24 consecutive weeks, performed either on land (LW, n = 17) or in water (WW, n = 18). Brachial artery endothelial function (flow mediated dilation FMD) and smooth muscle cell function (glyceryl trinitrate GTN administration) was tested in all participants before (week 0) and after (week 24) the intervention. RESULTS: Differences were apparent in FMD change between the LW (week 0 5.39 +/- 0.71% to week 24 7.77 +/- 0.78%, p = 0.009) versus CG (week 0 5.87 +/- 0.73% to week 24 5.78 +/- 0.78%) groups. No differences in artery dilation response were found following GTN administration (all p > 0.05). CONCLUSION: This study suggests that 6 month centre-based LW may be superior to WW in terms of improvement in arterial endothelial function in older sedentary individuals.

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