Effects of different aerobic exercise programmes with nutritional intervention in sedentary adults with overweight/obesity and hypertension: EXERDIET-HTA study

Gorostegi-Anduaga, Ilargi; Corres, Pablo; MartinezAguirre-Betolaza, Aitor; Pérez-Asenjo, Javier; Aispuru, Gualberto Rodrigo; Fryer, Simon M; Maldonado-Martín, Sara

doi:10.1177/2047487317749956

Cited by 71 publications

(86 citation statements)

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“…Previous data from the EXERDIET-HTA investigation found that all study groups improved body composition, BP, and CRF following a 16-week intervention program [11]. However, there was a significant reduction in the improvements found after the 6-month (6 M) follow up, when the exercise and diet supervision were removed and only recommendations were applied [14].…”

Section: Introductionmentioning

confidence: 87%

“…The Clinical Investigation of Araba University Hospital (2015-030) and the Ethics Committee of The University of the Basque Country (UPV/EHU, CEISH/279/2014) approved the study design, protocols, and informed consent. More details regarding the design, selection criteria, and procedures of the EXERDIET-HTA study have been explained in previous publications [11,14,18].…”

Section: Methodsmentioning

confidence: 99%

“…All participants received exercise intensity domains (i.e., individual heart rate values at moderate-and high-intensity ranges) to self-monitor. All the protocols for each group, including procedures and diet intervention, have been previously published [11,18].…”

Section: Participantsmentioning

confidence: 99%

“…Major international guidelines recommend non-pharmacological, tailored, and long-term lifestyle changes for the prevention and treatment of HTN and obesity in this population [8][9][10]. Previously, interventions with engagement in regular physical activity, exercise, and a healthy diet in overweight/obese individuals with HTN reported significantly reduced blood pressure (BP) [10,11], and improved body composition [8,11], CRF [11,12], and biochemical profile [12,13]. In addition, it was suggested that physical activity and diet recommendations were not enough to improve biochemical profile alone and that supervision was needed [14].…”

Section: Introductionmentioning

confidence: 99%

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A Metabolically Healthy Profile Is a Transient Stage When Exercise and Diet Are Not Supervised: Long-Term Effects in the EXERDIET-HTA Study

Corres

Fryer

Aguirre-Betolaza

et al. 2020

IJERPH

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Metabolically unhealthy obesity (MUO) is a regular state in people with primary hypertension (HTN), obesity, and who are physically inactive. To achieve and maintain a metabolically healthy overweight/obese (MHO) state should be a main treatment goal. The aims of the study were (1) to determine differences in metabolic profiles of overweight/obese, physically inactive individuals with HTN following a 16-week (POST) supervised aerobic exercise training (SupExT) intervention with an attentional control (AC) group, and (2) to determine whether the changes observed were maintained following six months (6 M) of unsupervised time. Participants (n = 219) were randomly assigned into AC or SupExT groups. All participants underwent a hypocaloric diet. At POST, all participants received diet and physical activity advice for the following 6 M, with no supervision. All measurements were assessed pre-intervention (PRE), POST, and after 6 M. From PRE to POST, MUO participants became MHO with improved (p < 0.05) total cholesterol (TC, ∆ = −12.1 mg/dL), alanine aminotransferase (∆ = −8.3 U/L), glucose (∆ = −5.5 mg/dL), C-reactive protein (∆ = −1.4 mg/dL), systolic blood pressure (SBP), and cardiorespiratory fitness (CRF) compared to unhealthy optimal cut-off values. However, after 6 M, TC, glucose, and SBP returned to unhealthy values (p < 0.05). In a non-physically active population with obesity and HTN, a 16-week SupExT and diet intervention significantly improves cardiometabolic profile from MUO to MHO. However, after 6 M of no supervision, participants returned to MUO. The findings of this study highlight the need for regular, systematic, and supervised diet and exercise programs to avoid subsequent declines in cardiometabolic health.

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Section: Introductionmentioning

confidence: 87%

Section: Methodsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Metabolically Healthy Profile Is a Transient Stage When Exercise and Diet Are Not Supervised: Long-Term Effects in the EXERDIET-HTA Study

Corres

Fryer

Aguirre-Betolaza

et al. 2020

IJERPH

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“…Other studies and meta-analyses have also evaluated the impact of ET on BP, [11][12][13] including one with water ET. In comparison to the prior meta-analysis by Naci et al, 11 the same issue plagues both reviews/analyses, specifically a dearth of RCTs of ET in the population with HTN (N ¼ 1057 exercise HTN patients in the current study and N ¼ 3508 in the study by Naci et al).…”

mentioning

confidence: 99%

Benefits of exercise training on blood pressure and beyond in cardiovascular diseases

Lavie¹,

Stewart²,

Ozemek

2019

Eur J Prev Cardiolog

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Considerable evidence has emphasized that despite the substantial recommendations for major societies, sedentary behavior and physical inactivity remain high and physical activity (PA) and exercise training (ET) remains low in the US and much of the world. [1][2][3][4][5][6] Therefore, greater efforts are needed to improve PA/ET in the primary and secondary prevention of cardiovascular disease (CVD) risk factors, including hypertension (HTN), and CVD. Although the European Society of Cardiology did not adopt the lower blood pressure (BP) guidelines that are now present in the US guidelines, still in Europe, the US and most of the world HTN is extremely prevalent and it contributes to markedly increased the risk of CVD and CVD-related morbidity and mortality. 7-9 Studies have emphasized the potential for ET to reduce BP and HTN and to improve overall CVD prognosis.In the current issue of the European Journal of Preventive Cardiology, Noone et al. 10 performed perhaps the largest and most thorough meta-analysis to date on the impact of ET on BP in people with HTN, while also comparing the anti-HTN effects of ET versus modern-day pharmacological intervention for HTN. In an analysis of 93 randomized controlled trials (RCTs), in 32 of those trials (404 patients with HTN), both ET and medications, together, effectively lowered BP compared to controlled conditions. Although the point estimate suggested that the anti-HTN medications were more effective than ET, there was insufficient evidence to suggest that first-line anti-HTN medications (including angiotensin-converting-enzyme inhibitors (ACEIs), angiotensin-receptor blockers (ARBs), calcium-channel blockers (CCBs) and thiazide-like diuretics) significantly reduced BP to a greater extent than ET intervention did, supporting the idea that vigorous non-pharmacologic therapy, including ET, should be considered as first-line therapy for at least mild HTN.Other studies and meta-analyses have also evaluated the impact of ET on BP, 11-13 including one with water ET. In comparison to the prior meta-analysis by Naci et al., 11 the same issue plagues both reviews/analyses, specifically a dearth of RCTs of ET in the population with HTN (N ¼ 1057 exercise HTN patients in the current study and N ¼ 3508 in the study by Naci et al.). While ET is proven equal to medications, as suggested by Naci et al., or slightly inferior to medications as firstline therapy, as the current study suggests, this does not impact a recommendation for ET for all individuals as either first-line or as an adjunct to initial therapy in uncomplicated HTN. Given its low cost, lack of side effects and no medication interactions, especially considering the known benefits of ET well beyond just BP lowering and especially on its impact to improve levels of cardiorespiratory fitness (CRF), perhaps the strongest CVD risk marker, ET should be part of every anti-HTN regimen.In the present study, the authors correctly alluded to the need for future studies to examine the effects of varying ET intensities on resting s...

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Hypertension

2023

Prevention and Management of Cardiovascular and Metabolic Disease

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Effects of different aerobic exercise programmes with nutritional intervention in sedentary adults with overweight/obesity and hypertension: EXERDIET-HTA study

Cited by 71 publications

References 36 publications

A Metabolically Healthy Profile Is a Transient Stage When Exercise and Diet Are Not Supervised: Long-Term Effects in the EXERDIET-HTA Study

A Metabolically Healthy Profile Is a Transient Stage When Exercise and Diet Are Not Supervised: Long-Term Effects in the EXERDIET-HTA Study

Benefits of exercise training on blood pressure and beyond in cardiovascular diseases

Hypertension

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