TY - JOUR
T1 - Effect of exercise on blood pressure in type 2 diabetes
T2 - A randomized controlled trial
AU - Dobrosielski, Devon A.
AU - Gibbs, Bethany Barone
AU - Ouyang, Pamela
AU - Bonekamp, Susanne
AU - Clark, Jeanne M.
AU - Wang, Nae Yuh
AU - Silber, Harry A.
AU - Shapiro, Edward P.
AU - Stewart, Kerry J.
N1 - Funding Information:
Acknowledgements: Funding Support: This study was supported by grant R01DK62368 from the National Institute of Diabetes and Digestive and Kidney Diseases (Dr. Stewart); and by Grant Number UL1 RR 025005 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. Information on NCRR is available at http://www.ncrr.nih.gov/. Information on Re-engineering the Clinical Research Enterprise can be obtained from http://nihroadmap.nih.gov/clinicalresearch/ overview-translational.asp." Prior Presentations: American Heart Association Annual Meeting 2011, Orlando FL.
PY - 2012/11
Y1 - 2012/11
N2 - BACKGROUND: Increased blood pressure (BP) in type 2 diabetes (T2DM) markedly increases cardiovascular disease morbidity and mortality risk compared to having increased BP alone. OBJECTIVE: To investigate whether exercise reduces suboptimal levels of untreated suboptimal BP or treated hypertension. DESIGN: Prospective, randomized controlled trial for 6 months. SETTING: Single center in Baltimore, MD, USA. PATIENTS: 140 participants with T2DM not requiring insulin and untreated SBP of 120-159 or DBP of 85-99 mmHg, or, if being treated for hypertension, any SBP <159 mmHg or DBP<99 mmHg; 114 completed the study. INTERVENTION: Supervised exercise, 3 times per week for 6 months compared with general advice about physical activity. MEASUREMENTS: Resting SBP and DBP (primary outcome); diabetes status, arterial stiffness assessed as carotid-femoral pulse-wave velocity (PWV), body composition and fitness (secondary outcomes). RESULTS: Overall baseline BP was 126.8±13.5/71. 7±9.0 mmHg, with no group differences. At 6 months, BP was unchanged from baseline in either group, BP 125.8±13.2/70.7±8.8 mmHg in controls; and 126.0±14.2/70.3±9.0 mmHg in exercisers, despite attaining a training effects as evidenced by increased aerobic and strength fitness and lean mass and reduced fat mass (all p<0.05), Overall baseline PWV was 959.9±333.1 cm/s, with no group difference. At 6-months, PWV did not change and was not different between group; exercisers, 923.7±319.8 cm/s, 905.5± 344.7, controls. LIMITATIONS: A completion rate of 81 %. CONCLUSIONS: Though exercisers improve fitness and body composition, there were no reductions in BP. The lack of change in arterial stiffness suggests a resistance to exercise-induced BP reduction in persons with T2DM.
AB - BACKGROUND: Increased blood pressure (BP) in type 2 diabetes (T2DM) markedly increases cardiovascular disease morbidity and mortality risk compared to having increased BP alone. OBJECTIVE: To investigate whether exercise reduces suboptimal levels of untreated suboptimal BP or treated hypertension. DESIGN: Prospective, randomized controlled trial for 6 months. SETTING: Single center in Baltimore, MD, USA. PATIENTS: 140 participants with T2DM not requiring insulin and untreated SBP of 120-159 or DBP of 85-99 mmHg, or, if being treated for hypertension, any SBP <159 mmHg or DBP<99 mmHg; 114 completed the study. INTERVENTION: Supervised exercise, 3 times per week for 6 months compared with general advice about physical activity. MEASUREMENTS: Resting SBP and DBP (primary outcome); diabetes status, arterial stiffness assessed as carotid-femoral pulse-wave velocity (PWV), body composition and fitness (secondary outcomes). RESULTS: Overall baseline BP was 126.8±13.5/71. 7±9.0 mmHg, with no group differences. At 6 months, BP was unchanged from baseline in either group, BP 125.8±13.2/70.7±8.8 mmHg in controls; and 126.0±14.2/70.3±9.0 mmHg in exercisers, despite attaining a training effects as evidenced by increased aerobic and strength fitness and lean mass and reduced fat mass (all p<0.05), Overall baseline PWV was 959.9±333.1 cm/s, with no group difference. At 6-months, PWV did not change and was not different between group; exercisers, 923.7±319.8 cm/s, 905.5± 344.7, controls. LIMITATIONS: A completion rate of 81 %. CONCLUSIONS: Though exercisers improve fitness and body composition, there were no reductions in BP. The lack of change in arterial stiffness suggests a resistance to exercise-induced BP reduction in persons with T2DM.
KW - Diabetes
KW - Exercise training
KW - High blood pressure
KW - Randomized trial
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U2 - 10.1007/s11606-012-2103-8
DO - 10.1007/s11606-012-2103-8
M3 - Article
C2 - 22610907
AN - SCOPUS:84867845044
SN - 0884-8734
VL - 27
SP - 1453
EP - 1459
JO - Journal of general internal medicine
JF - Journal of general internal medicine
IS - 11
ER -