Lifestyle Change Diminishes a Hypertensive Response to Exercise in Type 2 Diabetes
Open accessAbstract
Purpose A hypertensive response to exercise (HRE) is common in patients with type 2 diabetes and is associated with increased left ventricular (LV) mass and mortality. This study aimed to determine whether lifestyle modification would improve exercise blood pressure (BP) and reduce LV mass in patients with type 2 diabetes. Methods One hundred and eighty-five patients with type 2 diabetes were randomized to 1 yr of lifestyle intervention (n=97, mean ± SD age=54.7 ± 11.3 yr, 51% men) or usual care (control; n=88, age=53.8 ± 8.1 yr, 61% men). Brachial BP was measured at rest and during a graded maximal exercise test at baseline and 1 yr. Patients also underwent two-dimensional echocardiography to determine LV dimensions. A subgroup of 61 patients had resting and exercise central BP estimated from radial tonometry. An HRE was defined as a maximal exercise systolic BP of ≥210 mm Hg for men and ≥190 mm Hg for women. Results At study entry, there were 101 patients (55%) with an HRE (n=51 controls). Compared with controls, lifestyle intervention significantly reduced the propensity to develop an HRE in those participants who did not have HRE at baseline (29.8% vs 59.5%, P=0.006). However, absolute values of exercise and resting (brachial and central) BP and LV mass were not significantly changed (all P values >0.05). There were significant (all P values Conclusions Lifestyle intervention significantly attenuates the development of an HRE but does not reduce cardiac size after 1 yr in…
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The effect of lifestyle interventions on maximal exercise SBP varies, perhaps attributable to training-induced improvements in cardiorespiratory fitness that mask the full treatment effects.
“The effect of lifestyle interventions on maximal exercise SBP also varies (41,42), perhaps attributable to training-induced improvements in cardiorespiratory fitness that mask the full treatment effects.”
From Cardiorespiratory Fitness, Workload, and the Blood Pressure Response to Exercise Testing (2022) · cites this paper as [41]
Indexing the exercise systolic blood pressure response to a workload (METs or watt) has the ability to partially remove the influence of relative workload differences, aiding clinical interpretation in light of cardiorespiratory fitness level.
“Indexing the exercise SBP response to a workload has the ability to partially remove the influence of relative workload differences, aiding clinical interpretation in light of cardiorespiratory fitness level.”
From Cardiorespiratory Fitness, Workload, and the Blood Pressure Response to Exercise Testing (2022) · cites this paper as [40]
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References 26 · Cited by 28
- Authors
- SCHULTZ, M. G., HORDERN, M. D., LEANO, R., COOMBES, J. S., MARWICK, T. H., & SHARMAN, J. E.
- Affiliations
- The University of Queensland (AU)
- Venue
- Medicine & Science in Sports & Exercise
- Published
- 2011-05
- Volume
- 43
- Issue
- 5
- Pages
- 764-769
- ISSN
- 0195-9131 (ISSN-L)
- OpenAlex
- W2018217205
- Cited by
- 28
- References
- 26
- Citations by year
- 2026: 1 · 2024: 6 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 3 · 2016: 1 · 2015: 1 · 2014: 4 · 2013: 2 · 2012: 1
- FWCI
- 2.57
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Licence
- cc-by
- Locations
- Medicine & Science in Sports & Exercise (publishedVersion)
- PubMed (publishedVersion)
- eCite Digital Repository (University of Tasmania) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- hypertensive response to exercise, type 2 diabetes, lifestyle intervention, left ventricular mass, blood pressure response to exercise, central blood pressure, radial tonometry, insulin resistance, VO2max, body mass index, HDL cholesterol
- MeSH terms
- Adult, Aged, Diabetes Mellitus, Type 2, Echocardiography, Female, Hemodynamics, Humans, Hypertension, Male, Middle Aged, Exercise, Risk Reduction Behavior, Young Adult
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