TY - JOUR
T1 - Neurohumoral and endothelial responses to heated water-based exercise in resistant hypertensive patients
AU - de Barros Cruz, Lais Galvani
AU - Bocchi, Edimar Alcides
AU - Grassi, Guido
AU - Guimaraes, Guilherme Veiga
PY - 2017
Y1 - 2017
N2 - Background: The neurohumoral and endothelial responses to the blood pressure (BP) lowering effects of heated water-based exercise (HEx) in resistant hypertension (HT) patients remain undefined. Methods and Results: We investigated these in 44 true resistant HT patients (age 53.3±0.9 years, mean ± SEM). They were randomized and allocated to 2 groups, 28 to a HEx training protocol, which consisted of callisthenic exercises and walking in a heated pool for 1 h, three times weekly for 12 weeks and 16 patients to a control group maintaining their habitual activities. Measurements made before and after 12 weeks of HEx included clinic and 24-h BP, plasma levels of nitric oxide, endothelin-1, aldosterone, renin, norepinephrine and epinephrine, as well as peak VO2, and endothelial function (reactive hyperemia). After 12 weeks of HEx patients showed a significant decrease in clinic and 24-h systolic and diastolic BPs. Concomitantly, nitric oxide increased significantly (from 25±8 to 75±24 μmol/L, P<0.01), while endothelin-1 (from 41±5 to 26±3 pg/mL), renin (from 35±4 to 3.4±1 ng/mL/h), and norepinephrine (from 720±54 to 306±35 pg/mL) decreased significantly (P<0.01). Plasma aldosterone also tended to decrease, although not significantly (from 101±9 to 76±4 pg/mL, P=NS). Peak VO2 increased significantly after HEx (P<0.01), while endothelial function was unchanged. No significant change was detected in the control group. Conclusions: The BP-lowering effects of HEx in resistant HT patients were accompanied by a significant reduction in the marked neurohumoral activation characterizing this clinical condition.
AB - Background: The neurohumoral and endothelial responses to the blood pressure (BP) lowering effects of heated water-based exercise (HEx) in resistant hypertension (HT) patients remain undefined. Methods and Results: We investigated these in 44 true resistant HT patients (age 53.3±0.9 years, mean ± SEM). They were randomized and allocated to 2 groups, 28 to a HEx training protocol, which consisted of callisthenic exercises and walking in a heated pool for 1 h, three times weekly for 12 weeks and 16 patients to a control group maintaining their habitual activities. Measurements made before and after 12 weeks of HEx included clinic and 24-h BP, plasma levels of nitric oxide, endothelin-1, aldosterone, renin, norepinephrine and epinephrine, as well as peak VO2, and endothelial function (reactive hyperemia). After 12 weeks of HEx patients showed a significant decrease in clinic and 24-h systolic and diastolic BPs. Concomitantly, nitric oxide increased significantly (from 25±8 to 75±24 μmol/L, P<0.01), while endothelin-1 (from 41±5 to 26±3 pg/mL), renin (from 35±4 to 3.4±1 ng/mL/h), and norepinephrine (from 720±54 to 306±35 pg/mL) decreased significantly (P<0.01). Plasma aldosterone also tended to decrease, although not significantly (from 101±9 to 76±4 pg/mL, P=NS). Peak VO2 increased significantly after HEx (P<0.01), while endothelial function was unchanged. No significant change was detected in the control group. Conclusions: The BP-lowering effects of HEx in resistant HT patients were accompanied by a significant reduction in the marked neurohumoral activation characterizing this clinical condition.
KW - Endothelial dysfunction
KW - Heated water-based exercise
KW - Neurohumoral activation
KW - Resistant hypertension
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U2 - 10.1253/circj.CJ-16-0870
DO - 10.1253/circj.CJ-16-0870
M3 - Article
C2 - 28049937
AN - SCOPUS:85013901896
VL - 81
SP - 339
EP - 345
JO - Circulation Journal
JF - Circulation Journal
SN - 1346-9843
IS - 3
ER -