Aerobic Exercise Training Enhances The Blood Pressure-lowering Effect Of Antihypertensive Medication.

Abstract

Hypertension is an important risk factor for suffering cardiovascular diseases and many hypertensive individuals are under pharmacological treatment (antihypertensive medication; AHM). Aerobic exercise training in hypertensive individuals has been shown to reduce their blood pressure. However, information is scarce on the effects of aerobic training and AHM on the control of hypertension. PURPOSE: To analyze the effects of AHM on 21-h ambulatory blood pressure (ABP) before and after an aerobic exercise training program in hypertensive individuals. METHODS: Twenty-seven participants chronically medicated with angiotensin receptor blockers or angiotensin-converting enzyme inhibitors antihypertensive medicine (AHM) underwent high-intensity interval training (HIIT; 3 sessions per week, 4x4´at 90 HRMAX/3´at 70% HRMAX) during 4-months. Before and after training, 21-h ABP was monitored under 2 conditions in a double-blind, placebo randomized design: a) PLAC trial substituting for 3 consecutive days antihypertensive medicine by placebo, and b) AHM trial, taking their prescribed antihypertensive medicine. Cardiorespiratory fitness (CRF), body weight and aldosterone to plasma renin activity ratio (ARR) were measured as secondary outcomes. Differences among the 4 trials (i.e., PLACPRE, AHMPRE, PLACPOST, AHMPOST) were analyzed by one-way repeated-measures ANOVA. RESULTS: CRF increased significantly from 2.45±0.02 to 2.58±0.02 L·min-1 (P=0.025), body weight decreased from 95.6±2.5 to 93.6±2.4 kg (P=0.007), whilst ARR only decreased significantly after training (-10.8±2.6 a.u., P=0.002). At baseline, AHM reduced daytime ambulatory mean arterial pressure by 4.5±1.1 mmHg, being that reduction enhanced to 7.4±1.1 mmHg after 4-months of training (P=0.047). However, at nighttime this difference faded out and the reductions of AHM before (6.1±1.5 mmHg) and after training (4.7±1.2 mmHg) remained similar (P=0.437). CONCLUSIONS: The present data show that 4 months of HIIT enhances the effects of antihypertensive medication on blood pressure during daytime. This effect fades out during the night, a time where BP naturally falls. These results demonstrate that aerobic training could be used as a strategy to improve pharmacological treatment in hypertensive individuals.