The Effect of Mat Pilates Training Combined With Aerobic Exercise Versus Mat Pilates Training Alone on Blood Pressure in Women With Hypertension: A Randomized Controlled Trial

Abstract

Objective The purpose of this study was to determine the effects of mat Pilates (MP) versus MP plus aerobic exercise (AE) compared with the effects of no intervention on ambulatory blood pressure (BP) in women with hypertension. Methods This 3-arm, parallel-group randomized clinical trial assessed 60 women who had hypertension and were 30 to 59 years old. The intervention lasted 16 weeks, and the participants were allocated into 3 groups: mat Pilates only (MP group), mat Pilates with alternating bouts of AE on a treadmill (MP + AE group), and control group (CG), with no exercises. Primary outcomes were the effects of the interventions on ambulatory BP assessed in the 24-hour, awake, and asleep periods of analysis. Results A 2-way analysis of variance did not reveal statistically significant differences in between-group comparisons in the 24-hour period of analysis for systolic BP (CG versus MP = 3.3 [95% CI = −7.1 to 13.8]; MP versus MP + AE = 0.7 [95% CI = −4 to 5.4]; CG versus MP + AE = 4.0 [95% CI = −5.2 to 13.4]), diastolic BP (CG versus MP = 2.2 [95% CI = −5.6 to 10.0]; MP versus MP + AE = 1.1 [95% CI = −4.3 to 6.5]; CG versus MP + AE = 3.3 [95% CI = −3.8 to 10.4]), and heart rate (CG versus MP = 3.4 [95% CI = −2 to 8.8]; MP versus MP + AE = 2.0 [95% CI = −3.4 to 7.5]; CG versus MP + AE = 5.4 [95% CI = −0.8 to 11.8]). The awake and asleep periods of analyses also showed similar behavior and did not reveal statistically significant between-group differences. Furthermore, in the responsiveness analysis based on the minimal clinically important difference, no differences were observed between groups. Conclusion The magnitudes of the decrease in systolic BP during the 24-hour period of analysis were − 3 and − 5.48 mm Hg for the MP and MP + AE groups, without differences for responsiveness between groups. The results suggest that MP supplemented with AE or not supplemented with AE may be an alternative adjuvant treatment for women who have hypertension and are using antihypertension medication. Impact. Sixteen weeks of MP training reduced ambulatory BP in women who had hypertension. The MP + AE group displayed a BP reduction similar to that of the MP group. A reduction in ambulatory BP can decrease the risk of cardiovascular disease.

Is the Combination of Aerobic Exercise with Mat Pilates Better than Mat Pilates Training Alone on Autonomic Modulation Related to Functional Outcomes in Hypertensive Women? Secondary Analysis of a Randomized Controlled Trial

“…This secondary analysis was embedded within a controlled, single-blind, randomized controlled trial (RCT) aiming to verify the long-term effects of MP and MP supplemented with AE training on ambulatory BP in hypertensive women [ 14 ]. Therefore, most of the methodology used in this secondary analysis was the same as for the RCT [ 14 ]. The study was carried out for 16 weeks at the School Clinic of the Catholic University of Brasília, conducted according to the Declaration of Helsinki.…”

“…The study is reported according to the Consolidated Standards of Reporting Trials Statement for Randomized Trials of Nonpharmacologic Treatments and the Template for Intervention Description and Replication [ 19 , 20 ]. The details of the RCT have been reported previously [ 14 ], jointly with randomization, allocation concealment, and blinding [ 14 ]. In brief, the participants were randomized into three groups: MP: performed traditional MP exercises, MP+AE: performed traditional MP exercises with additional bouts of AE, and CG: the participants did not perform physical training during the experimental period.…”

“…In brief, the participants were randomized into three groups: MP: performed traditional MP exercises, MP+AE: performed traditional MP exercises with additional bouts of AE, and CG: the participants did not perform physical training during the experimental period. Outcome measures were assessed before the 16-week intervention period and 48 h after the final intervention session [ 14 ]. Clinical BP and HR, HRV, and QOL were evaluated on the first day of the assessment.…”

“…The effects of the Pilates method have been little explored in the literature in hypertensive patients. We recently demonstrated that mat Pilates (MP) and MP with AE for 16 weeks of training reduced ambulatory BP in middle-aged women [ 14 ]. These results are in accordance with previous studies with MP in middle-aged [ 15 ] and hypertensive older women [ 16 ], justifying the use of the method in this population.…”

“…In addition, in a study analyzing only one session, Rocha et al [ 17 ] found a reduction in BP during the post-session recovery in hypertensive patients. Although previous studies have demonstrated that Pilates can decrease BP in hypertensive women [ 14 , 15 , 16 ], the mechanisms behind the process are poorly understood.…”