Intensive cholesterol reduction may be beneficial in the treatment of patients with ISH and normal lipid levels, through a reduction in large artery stiffness.

Abstract-The present study characterized large-artery properties in patients with isolated systolic hypertension (ISH) and determined the efficacy of exercise training in modifying these properties. Twenty patients (10 male and 10 female) with stage I ISH and 20 age-and gender-matched control subjects were recruited, and large-artery properties were assessed noninvasively. Ten ISH patients (5 male and 5 female) were enrolled in a randomized crossover study comparing 8 weeks of moderate intensity cycling with 8 weeks of sedentary activity. Brachial and carotid systolic, diastolic, mean, and pulse pressures were higher in the ISH group than in the control group. Systemic arterial compliance (0.43Ϯ0.04 versus 0.29Ϯ0.02 arbitrary compliance units for the control versus ISH groups, respectively; Pϭ0.01) was lower, and carotid-to-femoral pulse-wave velocity (9.67Ϯ0.36 versus 11.43Ϯ0.51 m · s Ϫ1 for the control versus ISH groups, respectively; Pϭ0.007), input impedance (2.39Ϯ0.19 versus 3.27Ϯ0.34 mm Hg · s · cm Ϫ1 for the control versus ISH groups, respectively; Pϭ0.04), and characteristic impedance (1.67Ϯ0.17 versus 2.34Ϯ0.27 mm Hg · s · cm Ϫ1 for the control versus ISH groups, respectively; Pϭ0.05) were higher in the ISH group than in the control group. Training increased maximal oxygen consumption by 13Ϯ5% (Pϭ0.04) and maximum workload by 8Ϯ4% (Pϭ0.05); however, there was no effect on arterial mechanical properties, blood lipids, or left ventricular mass or function. These results suggest that the large-artery stiffening associated with ISH is resistant to modification through short-term aerobic training. (Hypertension. 2001;38:222-226.)

Aims/hypothesis. Our aim was to test the hypothesis that TNF-α protein levels in skeletal muscle are important in mediating the improvements in glucose homeostasis that are associated with diet and exercise regimens intended to reduce cardiovascular risk. Methods. We recruited 20 people with a body mass index of 32.1±1.2 kg/m 2 (mean ± SEM) and one other component of the metabolic syndrome. The average age was 51.2±8.1 years (mean ± SD). Of the 20 subjects, 6 were men and 14 were women. All subjects completed an 8-week control period, followed by randomisation to 8 weeks of moderate cycling exercise (30 min, three times per week) or to a diet with the following characteristics: low in saturated fat, high in fibre, low glycaemic index, rich in complex carbohydrates.Results. Diet induced a small reduction in body mass index (3.0±0.7%, p<0.05), although weight loss was not intended. Exercise training increased maximum oxygen consumption by 12±6% (p<0.05). Both interventions reduced fasting plasma insulin levels by about 20%. Diet reduced skeletal muscle TNF-α protein by 54±10% (p<0.05), an effect that was independent (p=0.94 in covariate analysis) of the small concurrent weight loss (−2.8±0.7 kg). Levels of GLUT4 protein were unchanged in the diet group. In contrast, exercise training did not significantly change TNF-α protein expression, but GLUT4 protein expression increased by 105±37% (p<0.05). Conclusions/interpretation. These data indicate that the metabolic benefits of a diet aimed at cardiovascular risk reduction are associated with a decrease in skeletal muscle TNF-α protein.

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