Mechanoreceptor-mediated adaptations to physical exercise: from acute responses to long-term training effects

Acute exercise induces a marked increase in blood flow to active muscles, elevating mechanical forces on the vascular wall, most notably fluid shear stress and circumferential stretch. These stimuli are sensed by endothelial and vascular smooth muscle cells, triggering intracellular signaling cascades that, over time, drive vascular remodeling and long-term functional adaptation. Although growing evidence supports the role of hemodynamic forces in vascular remodeling, the precise mechanistic pathways and their relative contributions remain incompletely defined. This narrative review synthesizes current knowledge on peripheral vascular responses to exercise increased hemodynamic mechanical forces, with particular emphasis on cellular mechanotransduction. Further, it also describes long term vascular adaptations, which differ according to vessel type and function, thereby shaping overall vascular structure.