Effects of Caloric Intake and Aerobic Activity in Individuals with Prehypertension and Hypertension on Levels of Inflammatory, Adhesion and Prothrombotic Biomarkers-Secondary Analysis of a Randomized Controlled Trial.

En-Young N Wagner,Kathleen L Wilson,Suzi Hong,Karen J Calfas,Laura S Redwine,Roland Von Känel,Paul J Mills,Cheryl L Rock

doi:10.3390/jcm9030655

Abstract

Background: Cardiopulmonary fitness and low calorie diets have been shown to reduce inflammation but few studies have been conducted in individuals with elevated blood pressure (BP) in a randomized intervention setting. Thereby, adhesion biomarkers, e.g., soluble intercellular adhesion molecule (sICAM)-3, have not been examined so far. Methods: Sixty-eight sedentary prehypertensive and mildly hypertensive individuals (mean age ± SEM: 45 ± 1 years; mean BP: 141/84 ± 1/1 mmHg) were randomized to one of three 12-week intervention groups: cardio training and caloric reduction, cardio training alone, or wait-list control group. Plasma levels of inflammatory, adhesion and prothrombotic biomarkers were assessed. In a second step, intervention groups were combined to one sample and multivariate regression analyses were applied in order to account for exercise and diet behavior changes. Results: There were no significant differences among the intervention groups. In the combined sample, greater caloric reduction was associated with a larger increase of sICAM-3 (p = 0.026) and decrease of C-reactive protein (p = 0.018) as a result of the interventions. More cardio training was associated with increases of sICAM-3 (p = 0.046) as well as interleukin-6 (p = 0.004) and a decrease of tumor necrosis factor-α (p = 0.017) levels. Higher BP predicted higher plasminogen activator inhibitor (PAI)-1 (p = 0.001), and greater fitness predicted lower PAI-1 levels (p = 0.006) after the intervention. Conclusions: In prehypertensive and hypertensive patients, plasma levels of the adhesion molecule sICAM-3 and inflammatory biomarkers have different response patterns to cardio training with and without caloric reduction. Such anti-inflammatory and anti-thrombotic effects may have implications for the prevention of atherothrombotic cardiovascular disease among individuals at increased risk.

Highlights

The pathogenesis of hypertension seems to be more complex, as it is difficult to treat despite established antihypertensive drugs and longtime cardiovascular research
We did not adjust p-values for multiple comparisons, as the main primary outcome was C-reactive protein (CRP); as we examined the potential interaction among inflammatory, adhesion and prothrombic markers, we defined one primary outcome marker in each of these three biomarker domains playing different roles in CVD: CRP for inflammation, soluble intercellular adhesion molecule (sICAM)-1 for adhesion molecules, and plasminogen activator inhibitor (PAI)-1 for prothrombotic factors
We examined the differential effects of aerobic cardio training and caloric reduction on inflammatory, adhesion and prothrombotic biomarkers in prehypertensive and hypertensive subjects

Summary

Introduction

The pathogenesis of hypertension seems to be more complex, as it is difficult to treat despite established antihypertensive drugs and longtime cardiovascular research. Lifestyle modifications including adopting a regular exercise regimen are key constituents of treatment [18,19] This recommendation might apply to prehypertension (BP > 120/80 and

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