Different exercise training modalities produce similar endothelial function improvements in individuals with prehypertension or hypertension: a randomized clinical trial Exercise, endothelium and blood pressure

Endothelial dysfunction is a characteristic of systemic arterial hypertension (SAH) and an early marker of atherosclerosis. Aerobic exercise training (AT) improves endothelial function. However, the effects of resistance training (RT) and combined training (CT) on endothelial function remain controversial in individuals with SAH. We determined the effects of AT, RT, and CT on endothelial function and systolic (SBP)/diastolic blood pressure (DBP) in individuals with prehypertension or hypertension. Forty-two participants (54 +/- 11y, resting SBP/DBP 137 +/- 9/86 +/- 6mmHg) were randomly allocated into AT (n=14, 40min of cycling, 50-75% heart rate reserve), RT (n=14, 6 resistance exercises, 4 x 12 repetitions, 60% maximum strength) and CT (n=14, 2 x 12 repetitions of RT+20min of AT). All participants performed a 40-minute exercise session twice a week for 8 weeks. Endothelial function was evaluated by brachial artery flow-mediated dilation (FMD). Blood pressure was evaluated through ambulatory monitoring for 24hours. After 8 weeks of exercise training, blood pressure was reduced in all 3 groups: -5.1mmHg in SBP (95%CI -10.1, 0.0; p=0.003) in AT; -4.0mmHg in SBP (95%CI -7.8, -0.5; p=0.027) in RT; and -3.2mmHg in DBP (95%CI -7.9, 1.5; p=0.001) in CT. All 3 exercise training modalities produced similar improvements in FMD:+3.2% (95%CI 1.7, 4.6) (p<0.001) in AT;+4.0% (95%CI 2.1, 5.7) (p<0.001) in RT; and +6.8% (95%CI 2.6, 11.1) (p=0.006) in CT. In conclusion, different exercise training modalities were similarly effective in improving endothelial function but impacts on ambulatory blood pressure appear to be variable in individuals with prehypertension or hypertension.