Key result
Antihypertensive medication and high-intensity interval training independently reduced 24-h mean arterial pressure by 5.7 mmHg (P<0.001) and 2.3 mmHg (P=0.007), respectively, with no interaction.
Why the study?
It was unknown whether interactions between antihypertensive medication and lifestyle interventions, such as exercise training, result in better ambulatory blood pressure control in hypertensive individuals with metabolic syndrome.
Does the combination of antihypertensive medication and high-intensity interval training reduce 24-h mean arterial pressure in hypertensive individuals with metabolic syndrome?
RCT (n=36)
Double-blind
randomized
Does the combination of antihypertensive medication and high-intensity interval training reduce 24-h mean arterial pressure in hypertensive individuals with metabolic syndrome?
Mean Difference: -5.7
p-value: p=<0.001
Antihypertensive medication and high-intensity interval training have independent and additive effects in lowering ambulatory blood pressure in patients with metabolic syndrome.
Supports combined antihypertensives and HIIT for additive ambulatory BP reduction; extends evidence of independent effects to metabolic syndrome.
Pharmacological and non-pharmacological therapies are simultaneously prescribed when treating hypertensive individuals with elevated cardiovascular risk (ie, metabolic syndrome individuals). However, it is unknown if the interactions between antihypertensive medication (AHM) and lifestyle interventions (ie, exercise training) may result in a better ambulatory blood pressure (ABP) control. To test this hypothesis, 36 hypertensive individuals with metabolic syndrome (MetS) under long-term prescription with AHM targeting the renin-angiotensin-aldosterone system (RAAS) were recruited. Before and after 4 months of high-intensity interval training (HIIT), participants completed two trials in a double-blind, randomized order: (a) placebo trial consisting of AHM withdrawal for 3 days and (b) AHM trial where individuals held their habitual dose of AHM. In each trial, 24-h mean arterial pressure (MAP) was monitored and considered the primary study outcome. Secondary outcomes included plasma renin activity (PRA) and aldosterone concentration to confirm withdrawal effects on RAAS, along with the analysis of urine albumin-to-creatinine ratio (UACR) to assess kidney function. The results showed main effects from AHM and HIIT reducing 24-h MAP (-5.7 mmHg, p < 0.001 and -2.3 mmHg, p = 0.007, respectively). However, there was not interaction between AHM and HIIT on 24-h MAP (p = 0.240). There was a main effect of AHM increasing PRA (p < 0.001) but no effect on plasma aldosterone concentration (p = 0.368). HIIT did not significantly improve RAAS hormones or the UACR. In conclusion, AHM and HIIT have independent and additive effects in lowering ABP. These findings support the combination of habitual AHM with exercise training with the goal to reduce ABP in hypertensive MetS individuals.
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Ramírez-Jiménez et al. (2021) conducted an RCT in Hypertensive metabolic syndrome (n=36). High-intensity interval training (HIIT) and antihypertensive medication (AHM) vs. AHM withdrawal (placebo) and pre-HIIT was evaluated on 24-h mean arterial pressure (MAP) (MD -5.7 mmHg (AHM) and -2.3 mmHg (HIIT), p=<0.001). Antihypertensive medication and high-intensity interval training independently reduced 24-h mean arterial pressure by 5.7 mmHg (P<0.001) and 2.3 mmHg (P=0.007), respectively, with no interaction.
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