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Abstract

Background

Both exercise training and diet are recommended to prevent and control hypertension and overweight/obesity.

Purpose

The purpose of this study was to determine the effectiveness of different 16-week aerobic exercise programmes with hypocaloric diet on blood pressure, body composition, cardiorespiratory fitness and pharmacological treatment.

Methods

Overweight/obese, sedentary participants (n = 175, aged 54.0 ± 8.2 years) with hypertension were randomly assigned into an attention control group (physical activity recommendations) or one of three supervised exercise groups (2 days/week: high-volume with 45 minutes of moderate-intensity continuous training (MICT), high-volume and high-intensity interval training (HIIT), alternating high and moderate intensities, and low-volume HIIT (20 minutes)). All variables were assessed pre- and post-intervention. All participants received the same hypocaloric diet.

Results

Following the intervention, there was a significant reduction in blood pressure and body mass in all groups with no between-group differences for blood pressure. However, body mass was significantly less reduced in the attention control group compared with all exercise groups (attention control –6.6%, high-volume MICT –8.3%, high-volume HIIT –9.7%, low-volume HIIT –6.9%). HIIT groups had significantly higher cardiorespiratory fitness than high-volume MICT, but there were no significant between-HIIT differences (attention control 16.4%, high-volume MICT 23.6%, high-volume HIIT 36.7%, low-volume HIIT 30.5%). Medication was removed in 7.6% and reduced in 37.7% of the participants.

Conclusions

The combination of hypocaloric diet with supervised aerobic exercise 2 days/week offers an optimal non-pharmacological tool in the management of blood pressure, cardiorespiratory fitness and body composition in overweight/obese and sedentary individuals with hypertension. High-volume HIIT seems to be better for reducing body mass compared with low-volume HIIT. The exercise-induced improvement in cardiorespiratory fitness is intensity dependent with low-volume HIIT as a time-efficient method in this population.

ClinicalTrials.gov Registration: NCT02283047.

Keywords

Obesity hypertension high-intensity interval training low-volume training blood pressure cardiorespiratory fitness body composition

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References

Jordan

Yumuk

Schlaich

et al.

Joint statement of the European Association for the Study of Obesity and the European Society of Hypertension: obesity and difficult to treat arterial hypertension. J Hypertens 2012; 30: 1047–1055.

Landsberg

Aronne

Beilin

et al.

Obesity-related hypertension: pathogenesis, cardiovascular risk, and treatment – a position paper of the Obesity Society and the American Society of Hypertension. Obesity (Silver Spring) 2013; 21: 8–24.

Jensen

Ryan

Apovian

et al.

2013 AHA/ACC/TOS Guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association task force on practice guidelines and the Obesity Society. J Am Coll Cardiol 2014; 63(25 Pt B): 2985–3023.

Authors/Task Force Members, Piepoli MF, Hoes AW, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: the sixth joint task force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of 10 societies and by invited experts): developed with the special contribution of the European Association for Cardiovascular Prevention and Rehabilitation (EACPR). Eur J Prev Cardiol 2016; 23: NP1–NP96.

Mancia

Fagard

Narkiewicz

et al.

2013 ESH/ESC Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013; 31: 1281–1357.

Neter

Stam

Kok

et al.

Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension 2003; 42: 878–884.

Saneei

Salehi-Abargouei

Esmaillzadeh

et al.

Influence of dietary approaches to stop hypertension (DASH) diet on blood pressure: a systematic review and meta-analysis on randomized controlled trials. Nutr Metab Cardiovasc Dis 2014; 24: 1253–1261.

Siervo

Lara

Chowdhury

et al.

Effects of the dietary approach to stop hypertension (DASH) diet on cardiovascular risk factors: a systematic review and meta-analysis. Br J Nutr 2015; 113: 1–15.

Blumenthal

Babyak

Sherwood

et al.

Effects of the dietary approaches to stop hypertension diet alone and in combination with exercise and caloric restriction on insulin sensitivity and lipids. Hypertension 2010; 55: 1199–1205.

10.

Pescatello

MacDonald

Lamberti

et al.

Exercise for hypertension: a prescription update integrating existing recommendations with emerging research. Curr Hypertens Rep 2015; 17: 87–015-0600-y.

11.

Boutcher

. Exercise intensity and hypertension: what’s new? J Hum Hypertens 2017; 31: 157–164.

12.

Molmen-Hansen

Stolen

Tjonna

et al.

Aerobic interval training reduces blood pressure and improves myocardial function in hypertensive patients. Eur J Prev Cardiol 2012; 19: 151–160.

13.

Karlsen

Aamot

Haykowsky

et al.

High intensity interval training for maximizing health outcomes. Prog Cardiovasc Dis 2017; 60: 67–77.

14.

Lollgen

Bockenhoff

Knapp

. Physical activity and all-cause mortality: an updated meta-analysis with different intensity categories. Int J Sports Med 2009; 30: 213–224.

15.

Gibala

Little

Macdonald

et al.

Physiological adaptations to low-volume, high-intensity interval training in health and disease. J Physiol 2012; 590: 1077–1084.

16.

Maldonado-Martín

Gorostegi-Anduaga

Aispuru

et al.

Effects of different aerobic exercise programs with nutritional intervention in primary hypertensive and overweight/obese adults: EXERDIET-HTA controlled trial. J Clin Trials 2016; 6: 1–10.

17.

World Health Organization. Global recommendations on physical activity for health. WHO Guidelines Approved by the Guidelines Review Committee. Geneva: WHO, 2010.

18.

Mezzani

Hamm

Jones

et al.

Aerobic exercise intensity assessment and prescription in cardiac rehabilitation: a joint position statement of the European Association for Cardiovascular Prevention and Rehabilitation, the American Association of Cardiovascular and Pulmonary Rehabilitation, and the Canadian Association of Cardiac Rehabilitation. J Cardiopulm Rehabil Prev 2012; 32: 327–350.

19.

De Keyzer

Huybrechts

De Vriendt

et al.

Repeated 24-hour recalls versus dietary records for estimating nutrient intakes in a national food consumption survey. Food Nutr Res 2011; 55: 10.3402/fnr.v55i0.7307–10.3402/fnr.v55i0.7307.

20.

Mifflin

St Jeor

Hill

et al.

A new predictive equation for resting energy expenditure in healthy individuals. Am J Clin Nutr 1990; 51: 241–247.

21.

Gargallo Fernandez

Basulto Marset

Breton Lesmes

et al.

Evidence-based nutritional recommendations for the prevention and treatment of overweight and obesity in adults (FESNAD-SEEDO consensus document). Methodology and executive summary (I/III). Nutr Hosp 2012; 27: 789–799.

22.

Faul

Erdfelder

Lang

et al.

G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007; 39: 175–191.

23.

Gorostegi-Anduaga

Corres

Jurio-Iriarte

et al.

Clinical, physical, physiological, and dietary patterns of obese and sedentary adults with primary hypertension characterized by sex and cardiorespiratory fitness: EXERDIET-HTA study. Clin Exp Hypertens 2017; 7: 1–9.

24.

Smith

Blumenthal

Babyak

et al.

Effects of the dietary approaches to stop hypertension diet, exercise, and caloric restriction on neurocognition in overweight adults with high blood pressure. Hypertension 2010; 55: 1331–1338.

25.

Maruf

Salako

Akinpelu

. Can aerobic exercise complement antihypertensive drugs to achieve blood pressure control in individuals with essential hypertension? J Cardiovasc Med (Hagerstown) 2014; 15: 456–462.

26.

La Rovere

Pinna

Raczak

. Baroreflex sensitivity: measurement and clinical implications. Ann Noninvasive Electrocardiol 2008; 13: 191–207.

27.

Halliwill

Buck

Lacewell

et al.

Postexercise hypotension and sustained postexercise vasodilatation: what happens after we exercise?

Exp Physiol 2013; 98: 7–18.

28.

Donnelly

Blair

Jakicic

et al.

American College of Sports Medicine position stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc 2009; 41: 459–471.

29.

Hopkins

Gibbons

Caudwell

et al.

The adaptive metabolic response to exercise-induced weight loss influences both energy expenditure and energy intake. Eur J Clin Nutr 2014; 68: 581–586.

30.

Harber

Kaminsky

Arena

et al.

Impact of cardiorespiratory fitness on all-cause and disease-specific mortality: advances since 2009. Prog Cardiovasc Dis 2017; 60: 11–20.

31.

Ortega

Ruiz

Labayen

et al.

The fat but fit paradox: what we know and don’t know about it. Br J Sports Med 2017. (published Online First 5 June 2017). doi: 10.1136/bjsports-2016-097400.

32.

Eckel

Meidtner

Kalle-Uhlmann

et al.

Metabolically healthy obesity and cardiovascular events: a systematic review and meta-analysis. Eur J Prev Cardiol 2016; 23: 956–966.

33.

American College of Sports Medicine. ACSM’s Guidelines for exercise testing and prescription, 10th edn. Philadelphia: Wolters Kluwer, 2017.

34.

Ross

Blair

Arena

et al.

Importance of assessing cardiorespiratory fitness in clinical practice: a case for fitness as a clinical vital sign: a scientific statement from the American Heart Association. Circulation 2016; 134: e653–e699.

35.

Kessler

Sisson

Short

. The potential for high-intensity interval training to reduce cardiometabolic disease risk. Sports Med 2012; 42: 489–509.

36.

Gaesser

Angadi

. High-intensity interval training for health and fitness: can less be more? J Appl Physiol (1985) 2011; 111: 1540–1541.

37.

Smith-Ryan

Melvin

Wingfield

. High-intensity interval training: modulating interval duration in overweight/obese men. Phys Sportsmed 2015; 43: 107–113.

38.

Pescatello

MacDonald

Ash

et al.

Assessing the existing professional exercise recommendations for hypertension: a review and recommendations for future research priorities. Mayo Clin Proc 2015; 90: 801–812.

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

Abstract

Background

Purpose

Methods

Results

Conclusions

Keywords

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References