Key result
Interval hypoxic training added to an aerobic rehabilitation program did not significantly reduce systolic blood pressure compared to aerobic training alone (MD -2.4 mm Hg), although more patients in the hypoxic group achieved targeted systolic blood pressure.
Why the study?
New rehabilitation strategies are needed for adolescents with obesity and comorbid arterial hypertension before significant cardiovascular pathological changes develop.
Does interval hypoxic training added to aerobic exercise and diet reduce blood pressure in adolescents with overweight/obesity and comorbid arterial hypertension?
RCT (n=85)
Open-label
Random number table
No
Does interval hypoxic training added to aerobic exercise and diet reduce blood pressure in adolescents with overweight/obesity and comorbid arterial hypertension?
Mean Difference: -2.4 (95% CI -6.6–1.8)
Absolute Event Rate: 119.6% vs 122%
p-value: p=0.279
Interval hypoxic training did not provide additional absolute blood pressure reduction over aerobic exercise and diet in hypertensive adolescents with obesity, though it increased the rate of achieving target systolic blood pressure.
IHT adds no absolute BP reduction beyond exercise and diet in hypertensive obese adolescents; confirms lack of primary-endpoint benefit while leaving target-rate findings open.
Background . Searching for new strategies for the rehabilitation of adolescents with obesity and comorbid arterial hypertension (AHT) before significant pathological changes development in the cardiovascular system remains the urgent challenge. Objective . The aim of the study was to examine the effect of interval hypoxic training (IHT) on blood pressure (BP) levels in adolescents with overweight / obesity and comorbid AHT. Methods . Adolescents aged 14-17 years with body mass index SDS ≥ 1 and grade I AHT (mean level of systolic and/or diastolic BP ≥ 95th percentile for population of corresponding age, sex and height) have been randomized to the group «aerobic training» (treadmill walking) and “aerobic training + IHT” (usage of hypoxicator in intermittent operation cycles). All patients were on subcaloric diet (10% reduction in caloric intake for given age). Primary outcome measure was the difference between groups on systolic/diastolic BP levels according to 24-hour BP monitoring after completion of training program (10 classes each). The effects of IHT on body composition (bioelectrical impedance analysis), heart rate variability and psychoemotional state (Spielberger scale, assessment of health, activity and mood) were further estimated. Results . 43 patients were assigned to the index group, and 42 — to the control group. 67 patients have completed the research program. 5 patients (12%) from the IHT group and 13 patients (31%; p = 0.029) from the control group prematurely discontinued participation in the trial due to poor exercise tolerance. The groups were comparable in baseline systolic and diastolic BP. Decrease in BP occurred in both groups after 10 workouts. There were no differences in decrease value: mean difference for SBP was 2.4 mm Hg (95% CI -6.6 ... 1.8), for DBP — 0.2 mm Hg (-3.6 ... 4.0). However, the incidence of reaching the targeted SBP (< 95th percentile for the corresponding age and sex) after completion of the treatment was recorded in 66% patients in the experimental group and in 42% patients in the control group (p = 0,047). Positive dynamics in several indicators of heart rate variability and psychoemotional state were mentioned in the IHT group. Conclusion . The IHT implementation in the complex of rehabilitation program for adolescents with overweight / obesity and AHT has no additional positive effect on BP levels. However, the incidence of reaching the targeted SBP (< 95th percentile for the corresponding age and sex) after completion of the treatment was recorded in 66% patients in the experimental group and in 42% patients in the control group (p = 0,054).
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Mashanskaya et al. (2021) conducted an RCT in Overweight/obesity and comorbid arterial hypertension (n=85). Interval hypoxic training vs. Aerobic training (treadmill walking) alone was evaluated on Difference in systolic blood pressure after 10 training sessions (MD -2.4 mm Hg, 95% CI -6.6 to 1.8, p=0.279). Interval hypoxic training added to an aerobic rehabilitation program did not significantly reduce systolic blood pressure compared to aerobic training alone (MD -2.4 mm Hg), although more patients in the hypoxic group achieved targeted systolic blood pressure.
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