Effects of short-term exercise-training on aortic systolic pressure augmentation in overweight and obese individuals

Patient preference and timing for exercise in breast cancer care

Exercise is recommended following cancer diagnosis and may be particularly valuable for women receiving cardiotoxic chemotherapy treatments. We investigated breast cancer patient preference on exercise programming in a prospective manner and retrospectively assessed length of time between diagnosis and chemotherapy initiation. Sixty-seven newly diagnosed breast cancer patients responded to questions regarding exercise programming related to cancer treatment and surveys on current activity level. Additionally, a retrospective chart review was conducted on 500 random breast cancer patients. Age, cancer stage, treatment, and treatment dates were extracted. Women were interested in, or, absolutely wanted to, participate in an exercise program before treatment (76.2%). There was uncertainty regarding willingness to delay treatment; 49.2% were willing to delay their treatment if the program was recommended by their doctors, 41.8% would not, and 9.0% were too unsure to respond. However, women would like to hear information about an exercise program for cancer patients when they are first diagnosed (61.9%). We observed that 64.6% of women were below recommended levels of physical activity; yet, current activity was not associated with an interest in an exercise program or willingness to delay treatment. Retrospectively, we observed an average interval of 72.6 ± 34.6 days between cancer diagnosis and initiation of anthracycline-based chemotherapy treatment, with younger women with more advanced cancer receiving anthracycline-based chemotherapy. Based on patient preference and length of time to chemotherapy initiation, a reasonable next step to promote the current recommendations for exercise could be to integrate exercise into breast cancer care earlier in treatment.

The training and detraining effect of high-intensity interval training on post-exercise hypotension in young overweight/obese women

PURPOSE

Studies evaluating the response in blood pressure (BP) following high-intensity interval training (HIIT) are scant even though there has been extensive work done on the BP response following acute and chronic low- to moderate-intensity aerobic and resistance exercise in both hypertensive and normotensive individuals. The present study sought to investigate the training and detraining effects of short-term HIIT on the post-exercise hypotension (PEH) response in overweight/obese young women.

METHOD

Twenty young untrained women volunteered for the study. Participants performed six HIIT sessions on a treadmill within 2 weeks (week 1: 10 × 1 min and week 2: 15 × 1 min intervals at 90-95% HRmax, separated by 1 min active recovery at 70% HRmax each session) and detrained for 2 weeks. Post-exercise BP was measured for 1 h following the first and last HIIT sessions.

RESULTS

Participants were normotensive (SBP: 119.2 ± 5.60 mmHg; DBP: 78.8 ± 4.12 mmHg) and had a BMI greater than 25 kg m(-2). The magnitude of the systolic hypotensive response was slightly greater after the six sessions HIIT compared to pre-training (5.04 and 4.28 mmHg, respectively), and both would be considered clinically significant (>3 mmHg decrease). After 2 weeks, detraining the PEH response was not clinically significant (1.08 mmHg decrease). The magnitude of the DBP response was only clinically significant following post- and detraining (4.26 and 3.87 mmHg, respectively).

CONCLUSION

The findings suggest that six HIIT sessions is sufficient to affect clinically significant PEH responses in young, overweight/obese women; however, the training effects are lost within 2 weeks of detraining.

Effect of weight loss on central systolic blood pressure in elderly community-dwelling persons

Central blood pressure (BP) has been shown to strongly associate with cardiovascular disease and outcome. Recent studies have demonstrated a relationship between changes in body size by exercise training and peripheral BP; however, the effect on changes in central BP is unknown. The aim of this study was to assess whether changes in body size are independently related to changes in central BP in the elderly. The subjects were 11 men (mean age, 68±6 years) and 84 women (68±7 years) from a rural village. Before and at the end of the 12-week training program, metabolic variables, and first peak radial systolic BP (SBP1) and second peak radial SBP (SBP2) as estimates of central SBP, were obtained. Radial augmentation index (AI) was calculated as follows: ((SBP2-diastolic BP (DBP))/(SBP1-DBP)) × 100 (%) and we used AI corrected at heart rate 75 per min (AI@75). After the 12-week training program, weight loss correlated strongly with reduction in brachial mean arterial pressure (MAP), radial SBP1, SBP2 and AI@75. After adjusting for confounding factors, weight loss was significantly and independently associated with each reduction in brachial MAP (β=0.34, P=0.001), radial SBP1 (β=0.31, P=0.002), SBP2 (β=0.37, P<0.001) and AI@75 (β=0.36, P=0.001). These findings suggest that weight loss by a 12-week training program may be an effective strategy to improve central BP parameters among Japanese elderly persons.

The impact of aerobic exercise training on arterial stiffness in pre- and hypertensive subjects: a systematic review and meta-analysis

BACKGROUND

Debate concerning aerobic exercise decreasing arterial stiffness in pre- and hypertensive individuals still exists. We sought to systematically review and quantify the effect of aerobic exercise training on arterial stiffness in pre- and hypertensive subjects.

METHODS

MEDLINE, Cochrane, Scopus and Web of Science were searched up until August 2013 for trials assessing the effect of aerobic exercise interventions lasting 4 or more weeks on arterial stiffness in (pre)hypertensive subjects. Standardized mean difference (SMD) in arterial stiffness parameters (PWV, B-stiffness, Compliance, AIx) was calculated using a random-effects model. Subgroup and meta-regression analyses were used to study potential moderating factors.

RESULTS

Fourteen trials comprising a total of 472 (pre)hypertensive subjects met the inclusion criteria. Arterial stiffness was not significantly reduced by aerobic training in (pre)hypertensive subjects (14 trials, SMD=-0.19; P=.06). Likewise, post-intervention arterial stiffness was similar between the aerobic exercise-trained and control (pre)hypertensive subjects (8 trials, SMD=-0.10; P=.43). Neither heterogeneity nor publication bias was detected in either of these analyses. In the subgroup analyses, arterial stiffness was significantly reduced in aerobic exercise-trained (pre)hypertensive subgroups below the median value in post minus pre-intervention systolic blood pressure (SBP) (SMD=-0.38, P=.04) and in subgroups above the median value in the duration of the intervention (SMD=-0.28, P=.03). Similar results were obtained in the meta-regression analysis.

CONCLUSIONS

Arterial stiffness is not reduced in (pre)hypertensive subjects in response to aerobic training unless associated with a substantial reduction in SBP and/or prolonged duration.

Eight weeks of stretching training reduces aortic wave reflection magnitude and blood pressure in obese postmenopausal women

The augmentation index (AIx, a marker of wave reflection) is reduced and peripheral artery vasodilation increased following acute stretching exercise. We examined the effects of stretching training (ST) on arterial function, blood pressure (BP) and sympathetic vasomotor modulation. Twenty-eight obese postmenopausal women (57±1 years) were randomized to a ST (n=14) or no-exercise control (CON) group ( n=14). ST included stretching exercises 3 days week(-1) for 8 weeks. Brachial (b) and aortic (a) systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), heart rate (HR), brachial-ankle pulse wave velocity (baPWV), carotid-femoral PWV (aPWV), femoral-ankle PWV (faPWV), AIx, low-frequency component of SBP (LFSBP) and sit/reach score (SRS) were measured before and after interventions. There were significant decreases in bSBP (P<0.05), aSBP (P<0.01), aDBP (P<0.05), aMAP (P<0.01), aAIx (P<0.05) and LFSBP (P<0.05) after ST compared with CON. SRS significantly (P<0.01) increased after ST but not after CON. There were no significant effects (P>0.05) on HR, baPWV, aPWV and faPWV after ST or CON. Eight weeks of ST decreases BP, AIx and LFSBP in obese postmenopausal women. Our findings show that ST reduces peripheral and central BP, wave reflection magnitude and vascular sympathetic activity in obese postmenopausal women with prehypertension and hypertension.