12-week Moderate-intensity Brisk Walking Improved Chronotropic Response In 40- To 69-year-old Patients With Hypertension

Abstract

PURPOSE: The aim of this study was to investigate the effect of 12-week brisk walking on chronotropic response in 40- to 69-year-old hypertensive patients in order to provide a scientific theory for improving the prognosis of hypertension with exercise. METHODS: In this study, we included 68 hypertensive patients aged 40-69 in Beijing and Hebei Province in 12-week brisk walking intervention, and 34 hypertensive patients age- and gender-matched as control group. The patients included were free of beta blocker therapy. Participants in exercise group underwent 12-week brisk walking 3 times a week, with the intensity gradually increased from 40-49% to 50-59% heart rate reserve, and the duration gradually increased from 30 to 60 minutes each time. Resting blood pressure, resting heart rate and peak oxygen consumption (VO2peak) were measured. Chronotropic parameters were calculated according to the formula, including metabolic chronotropic relationship (MCR), chronotropic response index (CRI) at all stages. %Δ means the percentage of the difference of indicators between before and after intervention. RESULTS: (1) The systolic blood pressure of hypertensive patients was decreased after intervention of 12-week brisk walking (135.60 ± 13.08 vs 128.52 ± 12.62 mmHg, p < 0.0001) compared to the control group. (2) The %ΔMCR was increased in exercise group after intervention compared to the control group. ((-0.94 ± 25.20) vs (7.14 ± 27.11) %, p = 0.013). (3) The CRI at 50 W- and 75 W-load, CRI2 and CRI3, were decreased after 12 weeks in control group (CRI2: 0.87 ± 0.22 vs 0.77 ± 0.20, p = 0.033; CRI3: 0.96 ± 0.12 vs 0.89 ± 0.10, p = 0.022), while no statistical difference was seen in the exercise group. (4) VO2peak was increased in exercise group after intervention compared to the control group (29.23 ± 4.84 vs 30.52 ± 5.21 mL/kg/min, p = 0.008). (5) The %ΔVO2peak was positively correlated with the %ΔMCR in exercise group (r = 0.269, p = 0.027). CONCLUSIONS: The 12-week moderate-intensity brisk walking significantly reduced systolic blood pressure and improved chronotropic response in 40- to 69-year-old hypertensive patients. Furthermore, the improvement of chronotropic response was associated with increased cardiopulmonary fitness. Supported by National Key Research and Development Program in China (NO. 2016YFC1300202).