Study of endothelial function response to exercise training in hypertensive individuals (SEFRET): study protocol for a randomized controlled trial

Abstract

BackgroundEndothelial dysfunction is a hallmark of diabetes mellitus and systemic arterial hypertension (SAH) and an early maker for atherosclerosis. Aerobic exercise training is known to enhance endothelial function, but little is understood about the effects of resistance or combined exercise training on endothelial function. The aim of this study is to investigate the effect of a 12-week aerobic (AT), resistance (RT), or combined (aerobic and resistance, CT) training program on endothelial function and assess associated effects on blood pressure in individuals with SAH.Methods/designEighty-one subjects with SAH aged 18 to 70 years will be selected and randomly assigned to three types of exercise training: AT, RT or CT. The study will involve the following procedures and tests: anamnesis, anthropometric assessment, echocardiography, blood pressure measurements through ambulatory blood pressure monitoring, flow-mediated dilation, ergospirometry, one repetition maximum test (1-RM), and blood collection (number of circulating endothelial progenitor cells, number of circulating endothelial microparticles, lipid profile, glucose, glycated hemoglobin, and creatinine). The AT intervention will consist of a 40-min exercise session with progressive intensities ranging from 50 to 75 % of heart rate reserve. The RT intervention will consist of a 40-minute session with four sets of six to 12 repetitions with a rest period of 60 to 90 seconds between each set and each type of exercise. Weight loads will be adjusted to 60 to 80 % of 1-RM for six types of exercise. The CT intervention will consist of a 20-min aerobic exercise session, followed by an additional 20-min resistance exercise session; each resistance exercise will have two sets less to match the total training volume.DiscussionThe study results are expected evidence of cardiovascular protective effects of different types of exercise training through the modulation of endothelial function in hypertensive individuals. Knowing the magnitude of improvement of endothelium-dependent vasodilation for the different types of exercise training can provide scientific evidence for the prescription of exercise programs for vascular protection targeting hypertensive individuals.Trial registrationThe Brazilian Clinical Trials Registry (http://www.ensaiosclinicos.gov.br/) under RBR-9ygmdn and dated 1 March 2015.

Effects of Aloe Vera and Swimming Training on Lipid Profile of Streptozotocin Induced Diabetic Rats

“…Dyslipidemia and insulin resistance are associated with increased body fat, especially visceral fats (23). In addition to glycemic control and increased insulin sensitivity (24), exercise can improve CVD risk factors such as visceral fats, lipid profiles, atherosclerosis and endothelial functions (25). Studies on lipid profiles in diabetic patients have been linked to controversial results, some of which changed lipid profiles (26-28) while others did not significantly make changes (29,30) in diabetics following exercises.…”

Pathophysiological mechanisms underlying the beneficial effects of physical activity in hypertension

“…19 A direct evidence of the improvement of endothelial function as a pivotal mechanism underlying the antihypertensive effect of physical exercise comes from the SEFRET study (Study of endothelial function response to exercise training in hypertensive individuals). 20 In this report, the authors unveil two crucial points: (a) physical activity ameliorates the endothelium-dependent vasodilation in a hypertensive population;…”

“…Indeed, exercise training has been shown to attenuate endothelial dysfunction during aging, probably increasing NO synthesis to counteract ROS generation . A direct evidence of the improvement of endothelial function as a pivotal mechanism underlying the antihypertensive effect of physical exercise comes from the SEFRET study ( Study of endothelial function response to exercise training in hypertensive individuals ) . In this report, the authors unveil two crucial points: (a) physical activity ameliorates the endothelium‐dependent vasodilation in a hypertensive population; and (b) the magnitude of the improvement of endothelial function depends on the type of exercise training (aerobic, resistance, or concurrent training).…”

Hypertension: Protective Effects of Physical Exercise on Cognition Function, Arterial Function and Brain Health

“…Additionally, the cause and effect relationship between PE and cerebral perfusion [86] may be attributed to hemodynamics effects, including BP [35][36][37][38]63], endothelial function [41,49,50,65,87,88] and arterial remodeling [42,43,61,[89][90][91][92]. PE provides benefits not only to the vascular beds that are involved during the session, but also to those in non-working sites or limbs [93,94].…”