Effects of aerobic interval training on arterial stiffness and microvascular function in patients with metabolic syndrome

Abstract

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.

Effects of intense aerobic exercise and/or antihypertensive medication in individuals with metabolic syndrome

“…Following, in the trials with exercise (PLAC+EXER and AHM+EXER trial) subjects pedaled during 43 min alternating high (90% of HR PEAK ) and low intensities (70% HR PEAK ) since data supports the effectiveness of this exercise mode to lower BP in the short and long term. In the non‐exercise trials (AHM and PLAC trials), subjects remained resting supine during those 43 min.…”

Post-exercise Hypotension Produced by Supramaximal Interval Exercise is Potentiated by Angiotensin Receptor Blockers

“…General recommendations for hypertension treatment include lifestyle modifications with aerobic exercise to reduce high blood pressure (BP). It is well established that an aerobic training program long enough ( > 10 weeks) leads to chronic reductions in systolic blood pressure [4][5][6]. Furthermore, one bout of aerobic exercise elicits BP reductions that remain during several hours, a phenomenon named post-exercise hypotension (i. e., PEH; [7]).…”

“…Due to the short-and long-term effects on lowering blood pressure, continuous aerobic training at a moderate intensity is recommended in scientific hypertension guidelines [9]. However, since lack of time is one of the main reasons for not exercising, low volume high-intensity interval training (HIIT) has emerged as an option to fight hypertension [5]. Evidence is also accumulating to suggest that intense exercise could result in PEH greater in magnitude and/or duration than when using moderately-intense continuous exercise [6,10,11].…”

Exercise‐induced benefits in metabolic syndrome

“…However, studies, particularly randomized trials, regarding the effects of aerobic exercise in MetS are limited. In this issue of the Journal of Clinical Hypertension , Mora‐Rodriguez and colleagues present their randomized study on the effects of 6‐month high‐intensity aerobic interval training on arterial stiffness and microvascular dysfunction in patients with MetS and hypertension.…”

“…Arterial stiffness parallels structural changes in the medial layer of the elastic arteries (aorta and major arterial conduits) and is produced mainly by the progressive elastic fiber degeneration. An increase in stiffness occurs with aging and is accelerated in patients with hypertension . It is also seen in patients with end‐stage renal disease, diabetes and other cardiovascular risk factors .…”