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To the Editor: Exercise training is widely used as an efficient method of rehabilitation from or prevention of cardiovascular diseases. Improvement in endothelium-dependent vasodilation could be one of the underlying mechanisms of this effect, as was recently suggested by Higashi et al.1 Because the intensity and duration of training are directly related to performance improvement, it could be expected that highly trained athletes would be at a particularly low risk of vascular disease. Therefore, the recent description of endofibrosis (an original arterial disease affecting mainly highly trained cyclists) is puzzling.2 Endofibrosis occurs principally in the external iliac artery and is characterized by the progressive thickening of the endothelial arterial wall by fibrosis. Mechanical trauma, jet lesions, and local shear stress mechanisms have been suggested as …

Can Aerobic Exercise Training Be Hazardous to Human Vessels?