Control of skin circulation during exercise and heat stress.

At any given environmental and mean skin temperature, exercise brings about an increase in internal body temperature and skin blood flow. At high environmental temperatures, when skin temperature is elevated, skin blood flow at any given internal temperature reaches higher levels than at cooler skin temperatures. Increased cutaneous blood flow serves to deliver metabolic heat from the core to the skin, where the heat is lost to the environment by convective, radiative, and evaporative mechanisms. However, at high levels of skin blood flow, peripheral vascular pooling and fluid losses by filtration lead to reduced central venous pressure. This lowers cardiac stroke volume, and requires a higher heart rate to maintain a given cardiac output. Mechanisms which alleviate some of the cardiovascular strain produced by exercise in the heat include the following: acutely, reflexes which arise from receptors in working muscles produce vasoconstriction in a number of central and peripheral vascular beds. Other reflexes, arising from cardiac baroreceptors, produce additional peripheral vasoconstriction when cardiac filling is impaired. In the long term, physical conditioning and heat acclimation lead to increases in sweat output during thermal stress, leading to cooler skin and core temperature during exercise, and decreasing the level of skin blood flow needed for regulation of body temperature.