IMPROVEMENT ON INSULIN SENSITIVITY AND MUSCLE BLOOD FLOW IN AEROBIC TRAINED OVERWEIGHT-OBESE HYPERTENSIVES IS NOT ASSOCIATED WITH AMBULATORY BLOOD PRESSURE: PP.37.504

Abstract

Background: The effects aerobic training on ambulatory blood pressure (ABP) and vascular function in essential hypertension was not fully investigated and is still poorly understood. Objective: The aim of this randomized controlled trial was to investigate effects of a supervised aerobic training program on ABP, vascular function, and hormonal profile in essential hypertension. Methods: Sedentary non-medicated hypertensive subjects were randomized to an aerobic training (n = 55, electronic treadmill, intensity 50–75% VO2max, 3–5 45-min sessions per week) program or a postural protocol (n = 24, control group), on a 2/1 proportion. Prescribed exercise intensity was controlled in every aerobic session through Polar A3 monitor. At the beginning and after 3 months of intervention, subjects were evaluated for 24-hr ABP (SpaceLabs 90207 monitor, USA), arterial compliance (radial tonometry, CR 2000, HDI, USA), forearm blood flow and flow-mediated vasodilation (EC6 venous occlusion pletysmograph, Hokanson, USA), and hormonal profile including HOMA-RI calculation. Results: The aerobic training was effective to promote a 12% increase in VO2max (p = 0.0001), while no significant variation was observed in the control group. In both groups, ambulatory blood pressure did not significantly modify, as well as arterial compliance, plasma renin, aldosterone, C-peptide, and urine metanephrines. In the aerobic, but not in the control group, was observed a decrease in insulin resistance (HOMA-RI, p = 0.039), a decrease in plasma cortisol (p = 0.006), an increase in flow-mediated vasodilation (p = 0.002), and an increase in forearm blood flow (p = 0.001). Conclusion: The 3-month supervised aerobic training did not significantly modify the blood pressure profile of hypertensive subjects when compared to a postural control protocol. Nevertheless, the results suggest that fitness gain can promote a decrease in cardiovascular risk of hypertensive subjects, improving endothelial function and insulin resistance.