Effect of aerobic and resistance exercise training on inflammation, endothelial function and ambulatory blood pressure in middle-aged hypertensive patients

Abstract

Objective: The current randomized controlled trial tested the hypothesis that both aerobic training and dynamic resistance training will improve inflammation, endothelial function and 24-h ambulatory blood pressure (ABP) in middle-aged adults with hypertension, but aerobic training would be more effective. Methods: Forty-two hypertensive patients on at least one antihypertensive medication (19 men/23 women; 30–59 years of age) were randomly assigned to 12 weeks of supervised aerobic training (n = 15), resistance training (n = 15) or a nonexercise control (n = 12) group. Inflammation, endothelial function, 24-h ABP and related measures were evaluated at pre and postintervention. Results: We found that aerobic training and resistance training were well tolerated. Both aerobic training and resistance training reduced daytime systolic ABP (−7.2 ± 7.9 and −4.4 ± 5.8 mmHg; P < 0.05) and 24-h systolic ABP (−5.6 ± 6.2 and −3.2 ± 6.4 mmHg; P < 0.05). aerobic training and resistance training both improved brachial artery flow-mediated dilation by 1.7 ± 2.8 and 1.4 ± 2.6%, respectively (7.59 ± 3.36 vs. 9.26 ± 2.93 and 7.24 ± 3.18 vs. 8.58 ± 2.37; pre vs. post P < 0.05). However, only aerobic training decreased markers of inflammation (C-reactive protein, monocyte chemoattractant protein-1, vascular cell adhesion molecule-1 and lectin-like oxidized LDL receptor-1) and endothelin-1 and increased nitrite and nitrate levels (P < 0.05). Conclusion: Healthcare providers should continue to emphasize aerobic training for hypertension management given the established role of nitric oxide, endothelin-1 and chronic low-level inflammation in the pathogenesis of cardiovascular disease. However, our study demonstrates that resistance training should also be encouraged for middle-aged hypertensive patients. Our results also suggest that even if patients are on antihypertensive medications, regular aerobic training and resistance training are beneficial for blood pressure control and cardiovascular disease risk reduction.

Postexercise hypotension predicts the chronic effects of resistance training in middle-aged hypertensive individuals: a pilot study

“…In addition, systolic OBP significantly decreased over the follow-up period (−6 ± 4.9 mmHg), even when the participants used antihypertensive drugs. Therefore, we confirm that our RT program was effective in lowering BP, although BP was well controlled with medications [6].…”

“…The RT protocol consisted of 2-3 sets of 10-20 submaximal repetitions. To prevent the BP from peaking during exercise sessions, individuals performed the target range of repetitions of the following exercises at the maximum weight that they could move with a good technique (without concentric failure): bench press, leg press, lat pulldown, leg extension, shoulder press, leg curl, bicep curl, triceps pulley [6]. The significance level for the α error was set at P < 0.05.…”

Regular swimming exercise improves metabolic syndrome risk factors: a quasi-experimental study

“…The mechanisms include neurohumoral, vascular and structural adaptation. The antihypertensive effect is believed to be mediated via reduced sympathetically induced vasoconstriction in the trained state, and decreased catecholamine levels [31].…”

Low-to-Moderate-Intensity Resistance Exercise Is More Effective than High-Intensity at Improving Endothelial Function in Adults: A Systematic Review and Meta-Analysis

“…Aerobic exercise training is an effective evidence-based strategy to reduce CVD risk factors, possibly by promoting EF and arterial stiffness. Several studies have confirmed the efficacy of aerobic exercise in improving the EF in healthy young adults [ 8 , 9 , 10 ], older adults [ 11 , 12 , 13 ], and unhealthy men [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. It is further emphasized that the greater beneficial effects of exercise intervention on EF are associated with exercise modalities and intensity [ 13 , 21 , 22 , 23 ].…”