Dataset Information

The effect of different doses of aerobic exercise training on exercise blood pressure in overweight and obese postmenopausal women.

ABSTRACT:

Objective

Abnormally elevated exercise blood pressure is associated with an increased risk of cardiovascular disease. Aerobic exercise training has been shown to reduce exercise blood pressure. However, it is unknown whether these improvements occur in a dose-dependent manner. The purpose of the present study was to determine the effect of different doses of aerobic exercise training on exercise blood pressure in obese postmenopausal women.

Methods

Participants (N = 404) were randomized to one of four groups--groups with 4, 8, or 12 kcal/kg of energy expenditure per week or a nonexercise control group--for 6 months. Exercise blood pressure was obtained during the 50-watt stage of a cycle ergometer maximal exercise test.

Results

There was a significant reduction in systolic blood pressure at 50 watts in the 4 kcal/kg per week (-10.9 mm Hg, P < 0.001), 8 kcal/kg per week (-9.9 mm Hg, P = 0.022), and 12 kcal/kg per week (-13.7 mm Hg, P < 0.001) compared with control (-4.2 mm Hg). Only the highest exercise training dose significantly reduced diastolic blood pressure (-4.3 mm Hg, P = 0.033) compared with control. In addition, resting blood pressure was not altered after exercise training (P > 0.05) compared with control and was not associated with changes in exercise systolic (r = 0.09, P = 0.09) or diastolic (r = 0.10, P = 0.08) blood pressure.

Conclusions

Aerobic exercise training reduces exercise blood pressure and may be more modifiable than changes in resting blood pressure. A high dose of aerobic exercise is recommended to successfully reduce both exercise systolic and diastolic blood pressure and therefore may attenuate the cardiovascular disease risk associated with abnormally elevated exercise blood pressure.

SUBMITTER: Swift DL

PROVIDER: S-EPMC3341588 | biostudies-literature | 2012 May

REPOSITORIES: biostudies-literature

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Publications

The effect of different doses of aerobic exercise training on exercise blood pressure in overweight and obese postmenopausal women.

Swift Damon L DL Earnest Conrad P CP Katzmarzyk Peter T PT Rankinen Tuomo T Blair Steven N SN Church Timothy S TS

Menopause (New York, N.Y.) 20120501 5

<h4>Objective</h4>Abnormally elevated exercise blood pressure is associated with an increased risk of cardiovascular disease. Aerobic exercise training has been shown to reduce exercise blood pressure. However, it is unknown whether these improvements occur in a dose-dependent manner. The purpose of the present study was to determine the effect of different doses of aerobic exercise training on exercise blood pressure in obese postmenopausal women.<h4>Methods</h4>Participants (N = 404) were rand ...[more]

PMID: 22547251

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Project description:BackgroundIt has been suggested that exercise training results in compensatory mechanisms that attenuate weight loss. However, this has only been examined with large doses of exercise. The goal of this analysis was to examine actual weight loss compared to predicted weight loss (compensation) across different doses of exercise in a controlled trial of sedentary, overweight or obese postmenopausal women (n = 411).Methodology/principal findingsParticipants were randomized to a non-exercise control (n = 94) or 1 of 3 exercise groups; exercise energy expenditure of 4 (n = 139), 8 (n = 85), or 12 (n = 93) kcal/kg/week (KKW). Training intensity was set at the heart rate associated with 50% of each woman's peak VO(2) and the intervention period was 6 months. All exercise was supervised. The main outcomes were actual weight loss, predicted weight loss (exercise energy expenditure/ 7700 kcal per kg), compensation (actual minus predicted weight loss) and waist circumference. The study sample had a mean (SD) age 57.2 (6.3) years, BMI of 31.7 (3.8) kg/m(2), and was 63.5% Caucasian. The adherence to the intervention was >99% in all exercise groups. The mean (95% CI) weight loss in the 4, 8 and 12 KKW groups was -1.4 (-2.0, -0.8), -2.1 (-2.9, -1.4) and -1.5 (-2.2, -0.8) kg, respectively. In the 4 and 8 KKW groups the actual weight loss closely matched the predicted weight loss of -1.0 and -2.0 kg, respectively, resulting in no significant compensation. In the 12 KKW group the actual weight loss was less than the predicted weight loss (-2.7 kg) resulting in 1.2 (0.5, 1.9) kg of compensation (P<0.05 compared to 4 and 8 KKW groups). All exercise groups had a significant reduction in waist circumference which was independent of changes in weight.ConclusionIn this study of previously sedentary, overweight or obese, postmenopausal women we observed no difference in the actual and predicted weight loss with 4 and 8 KKW of exercise (72 and 136 minutes respectively), while the 12 KKW (194 minutes) produced only about half of the predicted weight loss. However, all exercise groups had a significant reduction in waist circumference which was independent of changes in weight.Trial registration(ClinicalTrials.gov) NCT00011193.

Project description:BackgroundElevated total white blood cell (WBC) count is associated with an increased risk of coronary heart disease and death. Aerobic exercise is associated with lower total WBC, neutrophil, and monocyte counts. However, no studies have evaluated the effect of the amount of aerobic exercise (dose) on total WBC and WBC subfraction counts.PurposeTo examine the effects of 3 different doses of aerobic exercise on changes in total WBC and WBC subfraction counts and independent effects of changes in fitness, adiposity, markers of inflammation (IL-6, TNF-α, C-reactive protein), fasting glucose metabolism, and adiponectin.MethodsData from 390 sedentary, overweight/obese postmenopausal women from the DREW study were used in these analyses. Women were randomized to a non-exercise control group or one of 3 exercise groups: energy expenditure of 4, 8, or 12 kcal kg(-1)⋅week(-1) (KKW) for 6 months at an intensity of 50% VO2peak.ResultsA dose-dependent decrease in total WBC counts (trend P = 0.002) was observed with a significant decrease in the 12KKW group (-163.1±140.0 cells/µL; mean±95%CI) compared with the control (138.6±144.7 cells/µL). A similar response was seen in the neutrophil subfraction (trend P = 0.001) with a significant decrease in the 12KKW group (-152.6±115.1 cells/µL) compared with both the control and 4KKW groups (96.4±119.0 and 21.9±95.3 cells/µL, respectively) and in the 8KKW group (-102.4±125.0 cells/µL) compared with the control. When divided into high/low baseline WBC categories (median split), a dose-dependent decrease in both total WBCs (P = 0.003) and neutrophils (P<0.001) was observed in women with high baseline WBC counts. The effects of exercise dose on total WBC and neutrophil counts persisted after accounting for significant independent effects of change in waist circumference and IL-6.ConclusionAerobic exercise training reduces total WBC and neutrophil counts, in a dose-dependent manner, in overweight/obese postmenopausal women and is especially beneficial for those with systemic low grade inflammation.Clinical trials identifierNCT00011193.

Project description:Background: High blood pressure (BP), particularly systolic BP (SBP), is the major modifiable risk factor for cardiovascular diseases and related disorders of aging. SBP increases markedly with aging in women such that the prevalence of above-normal SBP (i.e., ≥120 mmHg) in postmenopausal women exceeds rates in age-matched men. This increase in SBP is associated with vascular endothelial dysfunction, mediated by excessive reactive oxygen species-induced oxidative stress and consequent reductions in nitric oxide bioavailability. Moderate-intensity aerobic exercise is a recommended lifestyle strategy for reducing SBP. However, adherence to aerobic exercise guidelines among postmenopausal women is low (<30%) and aerobic exercise does not consistently enhance endothelial function in estrogen-deficient postmenopausal women. High-resistance inspiratory muscle strength training (IMST) is a time-efficient, adherable lifestyle intervention that involves inhaling against resistance through a handheld device (30 breaths/day). Here, we present the protocol for a randomized controlled trial investigating the efficacy of 3 months of high-resistance IMST compared to guideline-based, "standard-of-care" aerobic exercise training for decreasing SBP and improving endothelial function in estrogen-deficient postmenopausal women with above-normal SBP (120-159 mmHg) at baseline (ClinicalTrials.gov Identifier: NCT05000515). Methods: A randomized, single-blind, parallel-group design clinical trial will be conducted in 72 (36/group) estrogen-deficient postmenopausal women with above-normal SBP. Participants will complete baseline testing and then be randomized to either 3 months of high-resistance IMST (30 breaths/day, 6 days/week, 75% maximal inspiratory pressure) or moderate-intensity aerobic exercise training (brisk walking 25 min/day, 6 days/week, 40-60% heart rate reserve). Outcome measures will be assessed after 3 months of either intervention. Following end-intervention testing, participants will abstain from their assigned intervention for 6 weeks, after which BP and endothelial function will be assessed to evaluate the potential persistent effects of the intervention on the primary and secondary outcomes. Discussion: This study is designed to compare the effectiveness of time-efficient, high-resistance IMST to guideline-based aerobic exercise training for lowering SBP and improving endothelial function, and interrogating potential mechanisms of action, in estrogen-deficient postmenopausal women. Clinical Trial Registration: ClinicalTrials.gov, Identifier: NCT05000515.

Project description:Background and aimsTo determine the comparative efficacy of resistance, aerobic, and combined resistance plus aerobic exercise on cardiovascular disease (CVD) risk profile.MethodsThis randomized controlled trial enrolled 406 adults aged 35-70 years with overweight or obesity and elevated blood pressure. Participants were randomly assigned to resistance (n = 102), aerobic (n = 101), combined resistance plus aerobic exercise (n = 101), or no-exercise control (n = 102). All exercise participants were prescribed 1 h of time-matched supervised exercise (the combination group with 30 min of each resistance and aerobic exercise) three times per week for 1 year. The primary outcome was the change from baseline to 1 year in the standardized composite Z-score of four well-established CVD risk factors: systolic blood pressure, low-density lipoprotein (LDL) cholesterol, fasting glucose, and per cent body fat.ResultsAmong 406 participants (53% women), 381 (94%) completed 1-year follow-up. Compared with the control group, the composite Z-score decreased at 1 year, which indicates improved CVD risk profile, in the aerobic {mean difference, -0.15 [95% confidence interval (CI): -0.27 to -0.04]; P = .01} and combination [mean difference, -0.16 (95% CI: -0.27 to -0.04); P = .009] groups, but not in the resistance [mean difference, -0.02 (95% CI: -0.14 to 0.09); P = .69] group. Both aerobic and combination groups had greater reductions in the composite Z-score compared with the resistance group (both P = .03), and there was no difference between the aerobic and combination groups (P = .96). Regarding the four individual CVD risk factors, only per cent body fat decreased in all three exercise groups at 1 year, but systolic blood pressure, LDL cholesterol, and fasting glucose did not decrease in any exercise groups, compared with the control group.ConclusionsIn adults with overweight or obesity, aerobic exercise alone or combined resistance plus aerobic exercise, but not resistance exercise alone, improved composite CVD risk profile compared with the control.

Dataset Information

The effect of different doses of aerobic exercise training on exercise blood pressure in overweight and obese postmenopausal women.

Objective

Methods

Results

Conclusions

Publications

The effect of different doses of aerobic exercise training on exercise blood pressure in overweight and obese postmenopausal women.

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