THE EFFECT OF PHYSICAL EXERCISE ON CENTRAL VASCULAR FUNCTION IN OVERWEIGHT AND OBESE NORMOTENSIVE ADULTS: INTERIM ANALYSIS OF LONGITUDINAL BEFORE-AND-AFTER STUDY SPANNING 14 WEEKS

Abstract

Objective: Physical activity is a relevant modifier of cardiovascular risk and is recommended to control BP levels in obese hypertensive patients. This study is aimed at assessing its effect on central vascular function (CVF), a potential preventive target known to impact high-flow end-organs, in overweight and obese normotensive participants. Design and method: We enrolled normotensive overweight and obese (classes 1–3) participants who joined lifestyle modification programme at a local gym. The programme includes two 7-week cycles of 1-hour mixed cardio and strength training, 5 sessions/week. CVF parameters (arterial stiffness and hemodynamics) were measured with the SphygmoCor XCEL device at 4 timepoints: baseline and after 3, 7, and 14 weeks of training; on a day when participants had not exercised for at least 24 hours. We used the Friedman test for repeated measures in data analysis. Results: An interim analysis included 15 participants (median BMI 33, range 27–43). Their median age was 35 years (25–49) and were predominantly women (n = 11). We observed a significant improvement after initiation of physical activity in all assessed parameters of CVF (P < 0.05 for all). The greatest improvement was observed at 3 weeks, which continued to 7 weeks but to a lesser extent. At 14 weeks, parameter values deteriorated, likely due to 8 participants not adhering to the 8–14 week schedule, but values were still significantly better than baseline. The median improvement at 7 weeks included a 0.5 m/s reduction in carotid-femoral pulse wave velocity, a 9% reduction in central augmentation index corrected for changes in HR, and a 5 and 6 mmHg reduction in cSBP and cDBP, respectively. The median weight lost from baseline was 1.8, 2.4 and 5.8 kg at 3, 7, and 14-weeks respectively. Conclusions: Physical activity induced non-trivial improvement in CVF in people at increased risk of CVD. While training was accompanied with weight loss, this likely did not affect CVF outcomes as median body mass loss up to 7 weeks was small (2.8%) and direction of the effect on CVF at week 14 was aligned with exercising, not weight loss.