Individuals with controlled hypertension show endothelial integrity following a bout of moderate-intensity exercise: randomized clinical trial

Abstract

To examine the acute effects of aerobic exercise (AE), resistance exercise (RE) or combined exercise (CE) on flow-mediated dilation (FMD), progenitor cells (PCs), endothelial progenitor cells (EPCs), oxidative stress markers and endothelial-cell derived microvesicles (EMVs) in patients with hypertension. This is a randomized, parallel-group clinical trial involving an intervention of one session of three different modalities of exercise. Thirty-three males (43 ± 2y) were randomly divided into three groups: a session of AE (n = 11, 40 min, cycle ergometer, 60% HRR); a session of RE (n = 11, 40 min, 4 × 12 lower limb repetitions, 60% 1-RM); or a session of CE (n = 11, 20-min RE + 20-min AE). FMD was assessed 10 min before and 10, 40 and 70 min post-intervention. Blood samples were collected at the same time points (except 40 min). FMD were similar in all groups and from baseline (within each group) after a single exercise bout (AE, RE or CE). At 70 min, RE group showed higher levels of PCs compared to the AE (81%) and CE group (60%). PC levels were reduced from baseline in all groups (AE: 32%, p = 0.037; RE: 15%, p = 0.003; CE: 17%, p = 0.048). The levels of EPCs, EMVs and oxidative stress were unchanged. There were no acute effects of moderate-intensity exercise on FMD, EPCs, EMVs and oxidative stress, but PCs decreased regardless of the exercise modality. Individuals with controlled hypertension do not seem to have impaired vascular function in response to a single exercise bout.

Figure 1

Study design. IPAQ, International Questionnaire of Physical Activity; FMD, flow-mediated dilation; PCs, progenitor cells, EPCs, endothelial progenitor cells, EMVs, endothelial microvesicles; AE, aerobic exercise session; RE, resistance exercise session; CE, combined exercise session.

Figure 2

Flow-mediated dilation of the brachial artery at baseline and after the exercise intervention in participants with hypertension. AE: aerobic exercise session (n = 11); RE: resistance exercise session (n = 11); and CE: combined exercise session (n = 10). Values are expressed as mean ± standard error. GEE with Bonferroni post-hoc test was used (p < 0.05) and no difference was observed within each group and among the groups; p (group) = 0.114, p (time) = 0.263, and p (interaction) = 0.157.

Figure 3

Blood flow response (A), vascular resistance (B) of the arm at baseline and after exercise intervention in participants with hypertension. AE: aerobic exercise session (n = 11); RE: resistance exercise session (n = 11); CE: combined exercise session (n = 10). Values are expressed as mean ± standard error. GEE with Bonferroni post-hoc test was used and considered differences for p < 0.05. Panel A: p (group) = 0.543, p (time) < 0.001, and p (interaction) < 0.001; Panel B: p (group) = 0.890, p (time) < 0.001, and p (interaction) = 0.024; * versus AE at the same time point.

Figure 4

Response of PCs: CD45 + dim/CD34 + (A), EPCs—CD45 + dim/CD34+/CD309 + (B) and EMVs—CD45−/CD42b−/CD31 + (C) at baseline and after exercise interventions in participants with hypertension. AE: aerobic exercise session (n = 11); RE: resistance exercise session (n = 11); CE: combined exercise session (n = 11). Values are expressed as mean ± standard error. GEE followed by Bonferroni post-hoc test was used and considered differences for p < 0.05. Panel A: p (group) = 0.034, p (time) < 0.001, and p (interaction) = 0.025; Panel B: p (group) = 0.033, p (time) = 0.186, and p (interaction) = 0.111; Panel C: p (group) = 0.638, p (time) = 0.149, and p (interaction) = 0.840; * versus AE at the same time point; † versus CE at the same time point.