The authors determined the effect of high‐intensity aerobic interval training on arterial stiffness and microvascular dysfunction in patients with metabolic syndrome with hypertension. Applanation tonometry was used to measure arterial stiffness and laser Doppler flowmetry to assess microvascular dysfunction before and after 6 months of stationary cycling (training group; n = 23) in comparison to a group that remained sedentary (control group; n = 23). While no variable improved in controls, hypertension fell from 79% (59%–91%) to 41% (24%–61%) in the training group, resulting in lower systolic and diastolic pressures than controls (−12 ± 3 and −6 ± 2 mm Hg, P < .008). Arterial stiffness declined (−17% augmentation index, P = .048) and reactive hyperemia increased (20%, P = .028) posttreatment in the training group vs controls. Blood constituents associated with arterial stiffness and a prothrombotic state (high‐sensitivity C‐reactive protein, fibrinogen, platelets, and erythrocytes) remained unchanged in the training and control groups. In summary, 6 months of an intense aerobic exercise program reduced both arterial stiffness and microvascular dysfunction in patients with metabolic syndrome despite unchanged blood‐borne cardiovascular risk factors. Training lowers blood flow resistance in central and peripheral vascular beds in a coordinated fashion, resulting in clinically relevant reductions in hypertension.

The purpose of this study was to compare the magnitude of post-exercise hypotension (PEH) after a bout of cycling exercise using high-intensity interval training (HIIT) in comparison to a bout of traditional moderate-intensity continuous exercise (CE). After supine rest 14 obese (31±1 kg·m) middle-age (57±2 y) metabolic syndrome patients (50% hypertensive) underwent a bout of HIIT or a bout of CE in a random order and then returned to supine recovery for another 45 min. Exercise trials were isocaloric and compared to a no-exercise trial (CONT) of supine rest for a total of 160 min. Before and after exercise we assessed blood pressure (BP), heart rate (HR), cardiac output (Q), systemic vascular resistance (SVR), intestinal temperature (T), forearm skin blood flow (SBF) and percent dehydration. HIIT produced a larger post-exercise reduction in systolic blood pressure than CE in the hypertensive group (-20±6 vs. -5±3 mmHg) and in the normotensive group (-8±3 vs. -3±2 mmHg) while HIIT reduced SVR below CE (P<0.05). Percent dehydration was larger after HIIT, and post-exercise T and SBF increased only after HIIT (all P<0.05). Our findings suggest that HIIT is a superior exercise method to CE to acutely reduce blood pressure in MSyn subjects.

Background To determine the trustworthiness of graded exercise test to exhaustion (GXT) to assess maximal oxygen uptake (normalV˙O2max) in metabolic syndrome individuals with obesity and poor cardiorespiratory fitness. Methods normalV˙O2max was assessed in 100 metabolic syndrome adults (57 ± 8 years; 34% women), with obesity (BMI 32 ± 5 kg·m−2) using GXT followed by supramaximal constant‐load verification test (VerT) at 110% of maximal GXT work rate. trueV˙normalO2 data from GXT and VerT were compared using paired t test and plotted for Bland‐Altman analysis. GXT sensitivity and specificity to detect normalV˙O2max were also calculated. Results Seventy individuals did not achieve trueV˙normalO2 plateau during GXT. GXT underestimated normalV˙O2max in 40 subjects. In these subjects, the magnitude of normalV˙O2max underestimation with GXT was 9% (167 mLO2·min−1; P < .001). In the whole sample (n = 100), bias error differences between GXT and VerT was 63 mLO2·min−1 (3% underestimation). This error was constant regardless of differences in fitness levels among individuals (R = −0.07; homoscedasticity). GXT results were unreliable in 62% of the sample with 16% of false‐positive and 46% of false‐negative results. Sensitivity and specificity of GTX to assess normalV˙O2max were low (ie, 23% and 60%, respectively). Conclusion Our data indicate that the magnitude (3%‐9%) and prevalence (40% of subjects) of normalV˙O2max underestimation with the use of a GXT alone is high in a large sample of unfit metabolic syndrome individuals with obesity. Our data advocate for the need of using VerT after GXT to avoid significant cardiorespiratory fitness underestimation in metabolic syndrome individuals with obesity and low fitness level.

This study suggests that the blood pressure reducing effect of a bout of exercise is influence by the intensity of exercise. A HIIT exercise bout is superior to an equivalent bout of continuous exercise when used as a non-pharmacological aid in the treatment of hypertension in MetS.

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NCT03019796.

NCT03019796.

No abstract