Combined resistance, endurance training improves BP in obese patients with heart disease
MedWire News: Combined resistance and endurance training significantly improves diastolic blood pressure (BP) and insulin resistance compared with endurance training alone in obese hypertensive patients with coronary artery disease, researchers say.
The findings were presented at the 22nd European Meeting on Hypertension and Cardiovascular Protection in London, UK, by Giuseppe Caminiti (IRCCS San Raffaele Pisana, Rome, Italy).
His team studied the data of 35 men with stable coronary artery disease, and a waist circumference of more than 104 cm, who were classified as having New York Heart Association class II-III heart failure symptoms.
Twenty patients were randomly assigned to undergo combined training and 15 to endurance training only, in all cases on top of optimal medical therapy. Both groups took part in three sessions a week over 24 weeks.
Endurance training involved walking or running on the treadmill, with the goal of reaching 60%-70% of maximal oxygen consumption. Resistance training involved 40%-60% of maximal oxygen consumption and 10-15 repetitions of leg and arm exercises.
Exercise testing was performed at baseline and after 24 weeks, and cardiopulmonary testing, fasting insulin, glycemia assessment with homeostasis model assessment-estimated insulin resistance (HOMA-IR) index calculation, and 24-hour ambulatory BP monitoring were performed at baseline and 12 weeks.
Exercise training was well-tolerated in both groups, with none of the patients reporting adverse effects, say the authors.
At the end of the 24-week exercise program, the amount of time spent on exercise had significantly improved in both groups, by 88 seconds versus 62 seconds in the combined group and endurance group respectively, corresponding to a significant intergroup difference (p=0.033).
After 12 weeks, the combined group had a significantly greater reduction in daytime and nighttime diastolic BP than the endurance group, at 16% versus 7%, and 19% versus 8%, respectively (p<0.02 for both).
The combined training group also had significantly greater reductions in daytime and nighttime heart rate than the endurance training group, at 12% versus 9%, and 13% versus 6%, respectively. However, the difference in daytime heart rate between the two groups was nonsignificant.
Further analysis revealed that the combined group showed significantly greater improvements in heart recovery at 1 minute, at -18 versus -11 beats per minute, and HOMA-index, at 1.1 versus 0.61, respectively.
Caminiti concluded: "The combined training seems to determine greater effects on systolic blood pressure, exercise tolerance, and insulin resistance compared with endurance training alone in hypertensive patients with coronary artery disease."
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By Piriya Mahendra