Abstract
Background: Migraine is associated with increased cardiovascular risk and vascular dysfunction. Since aerobic exercise can reduce cardiovascular risk, the present randomized controlled trail aimed at investigating the effects of high-intensity interval training (HIT) vs. moderate continuous exercise training (MCT) on arterial stiffness in migraine patients.Methods: Forty-eight episodic migraineurs were initially enrolled in the study. 37 patients [female: 30; age: 37 (SD: 10); BMI: 23.1 (5.2); Migraine days per month: 3.7 (2.5)] completed the intervention. Central blood pressure, pulse wave reflection, and aortic pulse wave velocity (PWV) were obtained by an oscillometric monitor. Incremental treadmill exercise testing yielded maximal and submaximal fitness parameters. Participants were randomly assigned to either HIT, MCT, or a control group (CON). The intervention groups trained twice a week over a 12-week intervention period.Results: After adjustment for between-group baseline differences, a moderate meaningful overall reduction of the augmentation index at 75 min−1 heart rate (AIx@75) was observed [partial eta squared () = 0.16; p = 0.06]. With 91% likely beneficial effects, HIT was more effective in reducing AIx@75 than MCT [HIT: pre 22.0 (9.7), post 14.9 (13.0), standardized mean difference (SMD) = 0.62; MCT: pre 16.6 (8.5), post 21.3 (10.4), SMD −0.49]. HIT induced a relevant reduction in central systolic blood pressure [cSBP: pre 118 (23) mmHg, post 110 (16) mmHg, SMD = 0.42] with a 59% possibly beneficial effect compared to CON, while MCT showed larger effects in lowering central diastolic blood pressure [pre 78 (7) mmHg, post 74 (7) mmHg, SMD = 0.61], presenting 60% possibly beneficial effects compared to CON. Central aortic PWV showed no changes in any of the three groups. Migraine days were reduced more successfully by HIT than MCT (HIT: SMD = 1.05; MCT: SMD = 0.43).Conclusion: HIT but not MCT reduces AIx@75 as a measure of pulse wave reflection and indirect marker of systemic arterial stiffness. Both exercise modalities beneficially affect central blood pressure. HIT proved to be an effective complementary treatment option to reduce vascular dysfunction and blood pressure in migraineurs.
Highlights
Migraine is considered a debilitating neurological disease which recurs in the form of severe headache attacks accompanied with nausea, vomiting, phonophobia, and photophobia (Jiménez Caballero and Muñoz Escudero, 2013)
After the run-in period and pre-testing measurements, 48 patients were randomly assigned [minimization method (Pocock and Stone, 2016), strata: age, gender, BMI, PA, migraine assessment according to MIDAS score, physical fitness determined by VO2max] to one of three groups: high intensity aerobic interval training group (HIT), moderate continuous aerobic training group (MCT), or control group (CON)
Pairwise comparison of AIx@75 showed moderate effects in high-intensity interval training (HIT) [pre: 22.0 (9.7), post: 14.9 (13.0), SMD = 0.62] with a likelihood of a meaningful effect of 85% likely beneficial compared to CON and 91% likely beneficial compared to moderate continuous exercise training (MCT) (Tables 2, 3)
Summary
Migraine is considered a debilitating neurological disease which recurs in the form of severe headache attacks accompanied with nausea, vomiting, phonophobia, and photophobia (Jiménez Caballero and Muñoz Escudero, 2013). Migraineurs have independently been associated with increased aortic stiffness and enhanced peripheral wave reflection (Schillaci et al, 2010), endothelial dysfunction (Jiménez Caballero and Muñoz Escudero, 2013) as well as increased hypercoagulability and inflammation (Kurth et al, 2008) This evidence suggests that functional properties of large arteries are altered in migraine patients (Liman et al, 2012), leading to an overall increase in cardiovascular risk (Liew et al, 2006; Rose et al, 2007; Kurth et al, 2008, 2016; Buse et al, 2017). Since aerobic exercise can reduce cardiovascular risk, the present randomized controlled trail aimed at investigating the effects of high-intensity interval training (HIT) vs. moderate continuous exercise training (MCT) on arterial stiffness in migraine patients
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