During strenuous exertion, sympathetic discharge is maximal and parasympathetic stimulation is withdrawn, resulting in vasoconstriction in most circulatory body systems, except for that in exercising muscle and in the cerebral and coronary circulations. At fixed submaximal workloads below ventilatory threshold in healthy persons, steady-state conditions are usually reached within minutes after the onset of exercise after this occurs, heart rate, cardiac output, blood pressure, and pulmonary ventilation are maintained at reasonably constant levels. In the early phases of exercise in the upright position, cardiac output is increased by an augmentation in stroke volume mediated through the use of the Frank-Starling mechanism and heart rate the increase in cardiac output in the latter phases of exercise is primarily due to an increase in heart rate. Customer Service and Ordering Information.Stroke: Vascular and Interventional Neurology. Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).
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