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Curso de Atualização em Medicina Cardiovascular 2019
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Effects of exercise training on aortic blood pressure and aerobic fitness in resistant hypertension
Session:
Posters 1 - Écran 7 - Hipertensão Arterial
Speaker:
Alberto Alves
Congress:
CPC 2019
Topic:
I. Hypertension
Theme:
27. Hypertension
Subtheme:
27.4 Hypertension – Treatment
Session Type:
Posters
FP Number:
---
Authors:
Alberto Jorge Alves; Catarina Garcia; Susana Lopes; Veronica Ribau; Ilda Ribeiro; Daniela Figueiredo; João Luís Viana; Susana Bertoquini; José Oliveira; Mesquita Bastos; Jorge Polónia; Fernando Ribeiro
Abstract
<p><strong>Objective:</strong> To assess whether aerobic exercise training improves blood pressure (BP) and cardiorespiratory fitness in patients with resistant hypertension.</p> <p><strong>Methods:</strong> Seventeen patients with resistant hypertension (age: 61.1±6.5 years, weight: 78.5±10.6 kg, body mass index: 28.9±2.6 kg/m<sup>2</sup>, 10 men) were randomized to either the exercise training (EG, n=10) or control group (CG, n=7). Exercise training consisted of 3 months of aerobic exercise composed by 3 sessions of 40 min per week at 50-70% of VO<sub>2</sub>peak. Both groups received usual care. Outcome measures included cardiorespiratory fitness (VO<sub>2</sub>peak) evaluated with submaximal Chester step test, brachial BP measured with a validated digital BP monitor, and aortic BP measured by applanation tonometry (ClinicalTrials.gov: NCT03090529).</p> <p><strong>Results:</strong> The number of antihypertensive drugs was similar between EG and CG (5.0±1.0 vs. 4.4±0.5, p=0.209). There were no differences between groups at baseline in aortic systolic BP (141.0±19.3 vs. 122.8±15.0 mmHg, p=0.054), aortic diastolic BP (85.9±9.1 vs. 79.1±9.8 mmHg, p=0.166), brachial systolic BP (145.8±18.9 vs. 131.5±14.6 mmHg, p=0.114) and brachial diastolic BP (85.6±8.7 vs. 78.9±9.5 mmHg, p=0.153). VO<sub>2</sub>peak was also similar among groups at baseline (37.5±5.2 vs. 32.5±5.7 mLO<sub>2</sub>.kg<sup>-1</sup>.min<sup>-1</sup>, p=0.081). Conversely, the response to treatment was significant different among groups in aortic systolic BP (-17.6±25.9 vs. 8.3±11.3 mmHg, p=0.024), aortic diastolic BP (-11.9±13.8 vs. 3.8±7.3 mmHg, p=0.015), brachial diastolic BP (-12.0±13.5 vs. 3.8±7.3 mmHg, p=0.015) and VO<sub>2</sub>peak (5.6±3.6 vs. -0.7±3.7 mLO<sub>2</sub>.kg<sup>-1</sup>.min<sup>-1</sup>, p=0.003). No differences were found in brachial systolic BP (-15.6±27.2 vs. 7.7±12.5 mmHg, p=0.053). Exercise training showed a tendency to decrease aortic systolic BP (141.0±19.3 to 123.4±22.5 mmHg, p=0.056), and significantly reduced aortic (85.9±9.0 to 73.9±9.9 mmHg, p=0.023) and brachial diastolic BP (82.8±9.4 to 77.3±12.4 mmHg, p=0.002). No changes were observed in the control group. VO<sub>2</sub>peak also increased after exercise training (37.5±5.2 to 43.1±6.1 mLO<sub>2</sub>.kg<sup>-1</sup>.min<sup>-1</sup>, p=0.001), while it remained unchanged in the CG (32.5±5.7 to 31.8±8.4 mLO<sub>2</sub>.kg<sup>-1</sup>.min<sup>-1</sup>, p=0.658).</p> <p><strong>Conclusion:</strong> Exercise training seems to decrease aortic and brachial blood pressure and increases cardiorespiratory fitness in resistant hypertension patients.</p>
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