Eight-week mat Pilates improves blood pressure, vascular, and autonomic function in adults with elevated blood pressure or stage 1 hypertension

Aim: Hypertension and obesity frequently coexist and increase cardiovascular risk through vascular dysfunction, autonomic imbalance, and metabolic dysregulation. This study investigated the effects of an 8-week mat Pilates program on body composition, blood pressure, vascular function, autonomic nervous system activity, and health-related physical fitness in obese men with elevated or stage 1 hypertension. Methods: Twenty-three men with elevated or stage 1 hypertension and a body mass index (BMI) ≥ 25 kg/m2 were initially recruited and randomly assigned to a control group (CON) or an experimental group (EXP). After withdrawal or loss to follow-up, 20 participants completed the study and were included in the final analysis (CON, n = 10; EXP, n = 10). The EXP performed mat Pilates three times per week for eight weeks, while CON maintained their usual lifestyle. Outcomes were assessed before and after the intervention. Results: Significant group × time interaction effects were observed for body weight, BMI, fat mass, hemodynamic variables, vascular indices, selected heart rate variability measures, and health-related physical fitness. Lean body mass and percent body fat improved significantly within the EXP, although the corresponding interaction effects were not significant. Overall, the EXP showed more favorable changes than the CON in several cardiometabolic and fitness-related outcomes. Conclusions: An 8-week mat Pilates program was associated with favorable changes in body composition, blood pressure and vascular function, autonomic nervous system indices, and health-related physical fitness in obese men with elevated or stage 1 hypertension. However, because body weight and fat mass also decreased and the sample size was small, these findings should be interpreted cautiously. This study cannot determine whether the changes resulted from the Pilates intervention itself, concurrent body composition changes, or their combined effects. Trial registration: KCT0010502; https://cris.nih.go.kr/cris/index/index.do.