Key result
Six months of supervised exercise training had no significant effect on cardiac size (LVMI 65.1 vs 65.0 g/m2, p=0.63) or LV diastolic function compared with usual care in older adults with mild hypertension.
Why the study?
Does a 6-month supervised aerobic and resistance exercise training program alter cardiac size and improve left ventricular diastolic function compared with usual care in older adults with untreated mild hypertension?
RCT (n=104)
Randomised
No
Does a 6-month supervised aerobic and resistance exercise training program alter cardiac size and improve left ventricular diastolic function compared with usual care in older adults with untreated mild hypertension?
In older adults with untreated mild hypertension, 6 months of combined aerobic and resistance exercise significantly improved fitness, body fatness, diastolic blood pressure, and insulin resistance without causing adverse cardiac remodelling, while individual reductions in abdominal fat correlated modestly with improved LV diastolic function.
Answers are grounded in this paper and cite their sources.
Exercise training does not alter cardiac size or diastolic function in mild hypertension; confirms neutral cardiac effects despite cardiometabolic gains.
OBJECTIVES: To determine exercise training effects on cardiac size and left ventricular (LV) diastolic function and relationships of exercise induced changes in physiological and body composition parameters with cardiac parameters. DESIGN: Prospective, randomised controlled trial. SUBJECTS: Men and women (63.6 (5.7) years, body mass index 29.5 (4.4) kg/m(2)) with untreated hypertension (systolic blood pressure (BP) 130-159 or diastolic BP 85-99 mm Hg). MAIN OUTCOME MEASURES: Cardiac size and LV diastolic function, peak oxygen uptake (Vo(2)), muscle strength, general and abdominal fatness, and insulin resistance. INTERVENTIONS: 6 months of exercise training versus usual care. RESULTS: When analysed by group at six months, cardiac size and LV diastolic function did not differ between exercisers (n = 51) and controls (n = 53), whereas exercisers had significantly higher peak Vo(2) (28 v 24 ml/kg/min) and strength (383 v 329 kg), and lower fatness (34% v 37%), diastolic BP (73 v 75 mm Hg) and insulin resistance (quantitative insulin sensitivity check index 0.35 v 0.34) versus controls (all p <or= 0.05). By regression analysis, among six month changes, increased peak Vo(2) and reduced abdominal fat were associated with increased cardiac size. Increased peak Vo(2) and reduced abdominal fat, BP and insulin resistance were associated with improved LV diastolic function. r Values ranged from 0.20 to 0.32 (p <or= 0.05). CONCLUSIONS: When examined by group assignment, exercise had no effect on cardiac size or LV diastolic function. When individual variations in six month changes were examined, participants attaining the greatest increases in fitness and reductions in abdominal fatness, insulin resistance and BP showed a modest trend towards physiological hypertrophy characterised by increased cardiac size and improved LV diastolic function. These results suggest that decreased abdominal fatness may have a role in improving cardiovascular health.
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Stewart et al. (2005) conducted an RCT in Untreated mild hypertension (n=104). Supervised aerobic and resistance exercise training vs. Usual care (National Institute of Aging Guidelines for Exercise and AHA Step I Diet recommendations) was evaluated on Left ventricular mass index (LVMI, g/m2) by MRI at 6 months (p=0.63). Six months of supervised exercise training had no significant effect on cardiac size (LVMI 65.1 vs 65.0 g/m2, p=0.63) or LV diastolic function compared with usual care in older adults with mild hypertension.
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