Abstract
BackgroundEndothelial dysfunction is a hallmark of diabetes mellitus and systemic arterial hypertension (SAH) and an early maker for atherosclerosis. Aerobic exercise training is known to enhance endothelial function, but little is understood about the effects of resistance or combined exercise training on endothelial function. The aim of this study is to investigate the effect of a 12-week aerobic (AT), resistance (RT), or combined (aerobic and resistance, CT) training program on endothelial function and assess associated effects on blood pressure in individuals with SAH.Methods/designEighty-one subjects with SAH aged 18 to 70 years will be selected and randomly assigned to three types of exercise training: AT, RT or CT. The study will involve the following procedures and tests: anamnesis, anthropometric assessment, echocardiography, blood pressure measurements through ambulatory blood pressure monitoring, flow-mediated dilation, ergospirometry, one repetition maximum test (1-RM), and blood collection (number of circulating endothelial progenitor cells, number of circulating endothelial microparticles, lipid profile, glucose, glycated hemoglobin, and creatinine). The AT intervention will consist of a 40-min exercise session with progressive intensities ranging from 50 to 75 % of heart rate reserve. The RT intervention will consist of a 40-minute session with four sets of six to 12 repetitions with a rest period of 60 to 90 seconds between each set and each type of exercise. Weight loads will be adjusted to 60 to 80 % of 1-RM for six types of exercise. The CT intervention will consist of a 20-min aerobic exercise session, followed by an additional 20-min resistance exercise session; each resistance exercise will have two sets less to match the total training volume.DiscussionThe study results are expected evidence of cardiovascular protective effects of different types of exercise training through the modulation of endothelial function in hypertensive individuals. Knowing the magnitude of improvement of endothelium-dependent vasodilation for the different types of exercise training can provide scientific evidence for the prescription of exercise programs for vascular protection targeting hypertensive individuals.Trial registrationThe Brazilian Clinical Trials Registry (http://www.ensaiosclinicos.gov.br/) under RBR-9ygmdn and dated 1 March 2015.
Highlights
Endothelial dysfunction is a hallmark of diabetes mellitus and systemic arterial hypertension (SAH) and an early maker for atherosclerosis
The objective of this study is to evaluate the chronic effects of exercise training on endothelial function modulation in hypertensive patients undergoing a 12week exercise intervention of aerobic, resistance, or combined training
The Study of Endothelial Function Response to Exercise Training (SEFRET) is a single-site study that will be conducted in the city of Porto Alegre, Brazil
Summary
Endothelial dysfunction is a hallmark of diabetes mellitus and systemic arterial hypertension (SAH) and an early maker for atherosclerosis. Obesity [1, 2], physical inactivity [3, 4], and insulin resistance [5] are all risk factors closely associated with systemic arterial hypertension (SAH) and diabetes mellitus type 2. In addition to these risk factors, smoking [6] and excess weight [7] contribute to endothelial dysfunction [8, 9], which is a hallmark of diabetes mellitus [10] and SAH [11] and an early maker for atherosclerosis [12]. Endothelial dysfunction has been associated with a decreased number and impaired function of EPCs in patients with SAH, diabetes mellitus, and metabolic syndrome, and an increased risk of atherosclerosis would be expected [24]
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