ADDITIVE BLOOD-PRESSURE LOWERING EFFECT OF AEROBIC TRAINING ON ANTIHYPERTENSIVE MEDICATION IN METABOLIC SYNDROME INDIVIDUALS

Abstract

Objective: In hypertensive individuals with metabolic syndrome (MetS), antihypertensive medications (AHM) are prescribed in conjunction with lifestyle advice (i.e., exercise) to reduce blood pressure (BP). However, if the combination of both treatments results in better BP control remains unknown. The objective of this study was to analyze the separated and combined effects of AHM and exercise training on ambulatory blood pressure (ABP). Design and method: Thirty-six hypertensive individuals with MetS under long-term prescription with AHM targeting the renin-angiotensin-aldosterone system (RAAS) were recruited. Before and after a 4-month aerobic interval training their AHM prescription was withdrawn during 3 days (i.e., PLAC trials) and 24-h ABP compared to when individuals held their habitual dose of medication (i.e., AHM trial) using a double-blind, randomized design. Plasma renin activity (PRA) and aldosterone concentration were measured to confirm withdrawal effects on RAAS. Urine albumin and creatinine ratio (UACR) was measured to assess kidney function. Results: Before the intervention AHM reduced 24-h mean arterial pressure (MAP) by -5 ± 5 mmHg (P < 0.001, Figure 1). After 4-months of aerobic training AHM reduced MAP an additional -3 ± 5 mmHg (92 ± 9 to 89 ± 8 mmHg; P = 0.014). However, BP lowering effect was not observed when AHM was withdrawn after training (97 ± 8 vs 96 ± 8 mmHg; P = 507). AHM increased PRA before and after training (P < 0.005) whilst had no effect on plasma aldosterone concentration (P = 1.000). Aerobic training did not significantly reduced RAAS hormones or the UACR. Conclusions: Aerobic training and AHM in conjunction reduce BP to a higher extent than each treatment in isolation. These findings support the combination of habitual AHM with exercise training with the goal to reduce BP in hypertensive MetS individuals.