Abstract
The aim of this study is to evaluate the association between usual physical activity and 24 h blood pressure (BP) profile in people with type 2 diabetes mellitus (DM). This is a cross-sectional study of 151 participants with type 2 DM. Usual physical activity was assessed by step counting and self-reported questionnaire. BP was measured in office and by 24 h ambulatory BP monitoring (ABPM; 24 h, daytime and nighttime). Mean participant age was 61.1 ± 8.4 years, 64% was women, and mean duration of diabetes was 14.3 ± 8.5 years. Ninety-two percent of participants had hypertension, and office BP was 138 ± 18/78 ± 10 mmHg. Inverse correlations were observed between step count and 24 h BP (systolic, r = −0.186; p = 0.022), daytime BP (systolic, r = −0.198; p = 0.015), and nighttime BP (pulse pressure, r = −0.190; p = 0.019). People were categorized into tertiles of daily step count, and the 1st tertile had higher 24 h systolic BP, daytime systolic BP, daytime mean BP, and daytime systolic BP load than those in the other tertiles, even after adjusting for age and HbA1c. Participants with type 2 DM and low levels of physical activity exhibit higher 24 h and daytime systolic ambulatory BP values as compared with those who performed more steps per day, even after adjustments for confounding factors.
Highlights
Hypertension is a major risk factor for the development and progression of chronic complications in diabetes mellitus
We evaluated the effects of structured exercise training and physical activity advice only on blood pressure (BP) of people with type 2 diabetes mellitus (DM) [9]
Fasting plasma glucose levels were measured by the hexokinase method, and HbA1c was measured by a high-performance liquid chromatography (HPLC) assay (Merck-Hitachi 9100, normal range 4–6%)
Summary
Hypertension is a major risk factor for the development and progression of chronic complications in diabetes mellitus. Sixty to 80% of persons with type 2 DM have hypertension [1, 2], and the majority of these have blood pressure (BP) values above the recommended targets even after intensive optimization of antihypertensive therapy [3, 4]. All types of structured exercise, including aerobic, resistance, and their combination, are associated with improvement in glucose control in type 2 DM [7], but the precise effect of these different modalities of exercise on BP control in persons with diabetes has been questioned. In our meta-analysis, aerobic and resistance exercises were associated with declines in BP, but only a high-intensity protocol of combined training was able to impact BP
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