Hypertension, Overweight, Sedentary
Conditions
Keywords
cardiovascular risk, obesity, interval training, diet
Brief summary
Obesity and arterial hypertension (HTN) frequently coexist in the same patient. Moreover, the concept that obesity and HTN can be additive in terms of cardiovascular rist is widely accepted. Yet, clinical decision-making in obese patients is complicated by a surprising lack of evidence on the relative importance of obesity and HTN treatment and its efficacy and safety. Lifestyle interventions are the mainstay of obesity management programs and are also advocated in the prevention and treatment of HTN. Physical exercise and diet are recommended to prevent and control obesity and HTN. Aerobic exercise is firmly established as an effective measure for lowering blood pressure and reducing cardiovascular risk. However, there is no agreement about the optimal dose of frequency, intensity, duration and type of exercise. Therefore, the aims of the study are: 1) to assess the changes in selected parameters of blood pressure, cardiorespiratory fitness, body composition and biological markers brought about by a period of 16-week of different aerobic exercise programs with hypocaloric diet for overweight or obesity and primary hypertensive adults, and 2) to examine the effect of six months detraining subsequent to intervention. Secondary objectives are to examine the additional effect of the intervention on physical activity behavior and health-related quality of life.
Detailed description
METHODOLOGY: participants will perform a ramp incremental cardiopulmonary exercise bike test before, after 16-week of follow-up, and after 6-month detraining period (with no intervention only recommendations). After inclusion criteria they will be randomized to four parallel groups: 1) control group with only hypocaloric diet intervention and lifestyle recommendations; 2) Moderate (HR values between VT1 and VT2 or 50-75% of HR reserve) continuous exercise and high volume (from 20 to 45min) group and hypocaloric diet intervention; 3) high intensity (HR values up to VT2 to peak intensity or ≥76% to \<100 % of HR reserve) interval training and high-volume (from 20 to 45min) group alternating high and moderate intensities at different protocols and hypocaloric diet intervention; and 4) high-intensity interval training and low-volume (20min) group alternating high and moderate intensities at different protocolsand hypocaloric diet intervention.
Interventions
Lifestyle intervention through hypocaloric diet
Lifestyle intervention through hypocaloric diet and exercise at moderate intensity (60-80%peakHR) continuous mode, and high volume (45 min).
Lifestyle intervention through hypocaloric diet and exercise at high intensity (80-95%peakHR) interval mode, and high volume (45 min).
Lifestyle intervention through diet and exercise at high intensity (80-95%peakHR) interval mode, and low volume (20 min).
Sponsors
Study design
Eligibility
Inclusion criteria
* older than 18yr old and less than 70yr old * overweight (BMI \>25) * primary hypertension * low-moderate cardiovascular risk * not diet treatment * sedentary behavior * availability to exercise two days a week.
Exclusion criteria
* secondary hypertension * pulmonary disorder * neurological deficit * physical incapacity to exercise * to exercise frequently * pregnancy or breastfeeding * left ventricular hypertrophy * more than three cardiovascular risk factors
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Blood pressure | 16-weeks | Ambulatory Blood Pressure Monitoring- 24 hours-Systolic and diastolic blood pressure |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incremental shuttle walk test (ISWT) | 16-weeks | Field test |
| Ventilatory threshold (VT) | 16-weeks | the VT is the 'point of transition between predominantly aerobic energy production to anaerobic energy production |
| Biochemical variables | 16-weeks | Glucose, Insulin, Leptin, Adiponectin,Total-Cholesterol, HDL-cholesterol, LDL-cholesterol, Triglycerides, C-reactive protein, aspartate transaminase, alanine transaminase, gamma-glutaryl transferase, Fibrinogen Uric acid |
| Health related Quality of life (QoL) | 16-weeks | Questionnaire SF-36 |
| Peak Oxygen Uptake (VO2peak) | 16-weeks | Cardiovascular peak aerobic capacity |
| Anthropometry | 16-weeks | Body mass, body mass index, waist-hip ratio |
| Physical activity and sedentary behavior | 16-weeks | Accelerometry and The International Physical Activity Questionnaires |
Countries
Spain