Effects of endurance, circuit, and relaxing training on cardiovascular risk factors in hypertensive elderly patients

Abstract

Recommendations for prevention of cardiovascular diseases (CVDs) risk factors among older adults highlighted the importance of exercise-based interventions, including endurance training (ET). However, the evidence of efficacy of other interventions based on short-bouts of exercise (circuit training, CT), and the practice of breath-control and meditation (relaxing training, RT) is growing. The aim of this study was to elucidate if CT or RT are equally effective in CVD risk factors reduction compared to ET. To this purpose, in 40 elderly participants, with clinically diagnosed grade 1 hypertension, resting blood pressure, blood glucose, and cholesterol levels, peak oxygen uptake ([Formula: see text]), mechanical efficiency and quality of life were evaluated before and after 12 weeks of ET, CT, and RT treatments. Resting blood pressure reduced significantly in all groups by ∼11 %. In ET, blood cholesterol levels (-18 %), [Formula: see text] (+8 %), mechanical efficiency (+9 %), and quality of life scores (+36 %) ameliorated. In CT blood glucose levels (-11 %), [Formula: see text] (+7 %) and quality of life scores (+35 %) were bettered. Conversely, in RT, the lower blood pressure went along only with an improvement in the mental component of quality of life (+42 %). ET and CT were both appropriate interventions to reduce CVDs risk factors, because blood pressure reduction was accompanied by decreases in blood glucose and cholesterol levels, increases in [Formula: see text], mechanical efficiency, and quality of life. Although RT influenced only blood pressure and quality of life, this approach would be an attractive alternative for old individuals unable or reluctant to carry out ET or CT.

Keywords: Aging; Blood pressure; Cardiovascular disease; Circuit training; Endurance training; Relaxing training.

Fig. 1

Experimental design: After baseline evaluations (PRE), participants were assigned to four different groups. ET group, endurance exercise training on treadmill, elliptical, and stepper ergometers; CT group, short bouts of dynamic exercises on knee extension (KE), knee flexion (KF), calf rise (CR), and leg press (LP) ergometers; RT group, relaxing training program; CTRL group, no intervention

Fig. 2

Heart rate response: Average heart rate (HR) response, as a percentage of HR reserve (HRR, panel A), in the four groups during interventions at the beginning (1st week) and at the end (12th week) of treatments. Panel B represents the HR response during an intervention session in representative participants of the four groups. The light and dark gray areas represent the exercise time during ET and CT, respectively. * = in-group P < 0.05; † = among groups P < 0.05; ‡ P < 0.05 vs RT and CTRL

Fig. 3

Cardiovascular variables at rest: Average resting systolic (SBP) and diastolic (DBP) blood pressures and heart rate (HR) in the four groups before and after interventions. * = in-group P < 0.05

Fig. 4

Cardiorespiratory response to exercise: average heart rate (HR), expiratory ventilation $\left({\dot{V}}_E\right)$, CO₂ production $\left(\dot{V}c{o}_2\right)$, and oxygen uptake $\left(\dot{V}{o}_2\right)$ during cycle incremental ramp exercise in the four groups, before and after interventions. * = in-group P < 0.05; § = in-group P < 0.05 at maximal exercise

Fig. 5

Mechanical efficiency: Δ mechanical efficiency in the four groups, calculated on the first part of the cycle ramp exercise before and after interventions. * = in-group P < 0.05