Effects of high-intensity aerobic interval training vs. moderate exercise on hemodynamic, metabolic and neuro-humoral abnormalities of young normotensive women at high familial risk for hypertension

Abstract

Exercise training has an important role in the prevention and treatment of hypertension, but its effects on the early metabolic and hemodynamic abnormalities observed in normotensive offspring of hypertensive parents (FH+) have not been studied. We compared high-intensity interval (aerobic interval training, AIT) and moderate-intensity continuous exercise training (CMT) with regard to hemodynamic, metabolic and hormonal variables in FH+ subjects. Forty-four healthy FH+ women (25.0 ± 4.4 years) randomized to control (ConFH+) or to a three times per week equal-volume AIT (80-90% of VO 2MAX ) or CMT (50-60% of VO 2MAX ) regimen, and 15 healthy women with normotensive parents (ConFHÀ; 25.3 ± 3.1 years) had their hemodynamic, metabolic and hormonal variables analyzed at baseline and after 16 weeks of follow-up. Ambulatorial blood pressure (ABP), glucose and cholesterol levels were similar among all groups, but the FH+ groups showed higher insulin, insulin sensitivity, carotid-femoral pulse wave velocity (PWV), norepinephrine and endothelin-1 (ET-1) levels and lower nitrite/nitrate (NOx) levels than ConFHÀ subjects. AIT and CMT were equally effective in improving ABP (Po0.05), insulin and insulin sensitivity (Po0.001); however, AIT was superior in improving cardiorespiratory fitness (15 vs. 8%; Po0.05), PWV (Po0.01), and BP, norepinephrine, ET-1 and NOx response to exercise (Po0.05). Exercise intensity was an important factor in improving cardiorespiratory fitness and reversing hemodynamic, metabolic and hormonal alterations involved in the pathophysiology of hypertension. These findings may have important implications for the exercise training programs used for the prevention of inherited hypertensive disorder. Keywords: arterial stiffness; endothelial function; exercise; nervous system, sympathetic; prevention INTRODUCTION Essential arterial hypertension (HPT) is the most common risk factor for cardiovascular morbidity and mortality and is associated with substantial health-care expenditures. 1,2 Consequently, primary prevention for individuals at high risk for HPT has been emphasized. 3 Among the population at high risk for HPT, those who have hypertensive parents (FH+) are worthy of special attention. It has been well established that a positive family history of HPT is a strong risk factor for future HPT in nonhypertensive offspring, independent of other risk factors. 4 Moreover, hemodynamic, metabolic and hormonal abnormalities, as well as concentrations of biomarkers that may have a key role in the development of HPT, are increased in nonhypertensive offspring of parents with HPT. [5][6][7]

The effect of 4 weeks of aerobic exercise on vascular and baroreflex function of young men with a family history of hypertension

“…VO 2max . In contrast, Ciolac et al 33 trained young women with high familial risk of hypertension and found a reduction in PWV after 16 weeks of high-intensity (80 --90% of .…”

Atualização da diretriz brasileira de insuficiência cardíaca crônica - 2012

“…Estudo no nosso meio demonstrou que a idade não influencia a resposta ao exercício 69 . Outros métodos de treinamento têm sido utilizados como o treinamento complementar de músculos inspiratórios que pode ser indicado naqueles pacientes com IC que apresentam fraqueza da musculatura respiratória (> 70% da pressão inspiratória máxima predita) [70][71][72] ; pilates 73,74 ; treino intervalado e contínuo 66,75,76 ; eletroestimulação 77 ; e hidroterapia 78,79 . Intensidades diferentes de exercício podem ter ação diferente na fisiopatologia da IC 80 .…”

High-Intensity Interval Training Versus Moderate-Intensity Continuous Training in the Prevention/Management of Cardiovascular Disease

“…23 More recently, however, high-intensity interval training (HIIT) has raised considerable interest in the clinical context as a potential alternative to MICT for reducing the risk of CVD as well as improving the health and wellbeing outcomes of those affected. [26][27][28][29][30][31][32][33][34] It may be thought that the higher intensity of exercise as with HIIT may increase the risk of an acute cardiovascular event in comparison to MICT. However, HIIT applied in the settings discussed in this paper has been shown to be low risk and is adapted to maintain safety (See safety issues/clinical perspectives section).…”