Ramp and step increases in shear stress result in a similar magnitude of brachial artery flow-mediated dilation

Purpose: There is evidence that the endothelium is responsive to both the rate and magnitude of increases in shear stress. However, whether flow-mediated dilation stimulated by sustained increases in shear stress (SS-FMD) is rate sensitive in humans is unknown. The purpose of this investigation was to test whether ramp (gradual) and step (instantaneous) increases in shear stress elicit disparate SS-FMD. Methods: Young, healthy men (n = 18, age = 22 ± 2 years, body mass index = 25 ± 3 kg m ⁻² ) performed two 11-min bouts of rhythmic handgrip exercise; one with a 5.5-min ramp-increase in shear stress and one with an immediate step increase in shear stress. Ramp increases in shear stress were achieved through incremental increases in handgrip exercise intensity [increases of 4% maximum voluntary contraction (MVC) every 30 s for 5.5 min, ending at 44% MVC] and step increases in shear stress were achieved through a combination of arterial compression and commencing handgrip exercise at 44% MVC. Results: Shear rate was greater in the step versus ramp protocol in minutes 1–6, but not different thereafter. Similarly, SS-FMD was greater in the step versus ramp protocol during minutes 2–6, but similar in minutes 7–11 (minute 11: ramp 8.7 ± 4.6%; step 9.4 ± 3.6%; P = 0.343). SS-FMD continued to increase over time with maintenance of a steady shear stress stimulus (step minutes 2–11: 0.51 ± 0.36% min ⁻¹ ; ramp minutes 7–11: 0.64 ± 0.57% min ⁻¹ ; P = 0.259). Conclusions: These findings indicate that in the brachial artery of humans, the magnitude of SS-FMD is determined by the magnitude and duration, but not the rate, of increases in shear stress.