Acute resistance exercise is more effective than aerobic exercise for 24h blood pressure control in type 2 diabetics

Usefulness of Aerobic Exercise for Home Blood Pressure Control in Patients with Diabetes: Randomized Crossover Trial

Hypertension usually coexists with diabetes mellitus and significantly increases the risk of macrovascular complications. Blood pressure measured at home, especially nocturnal blood pressure, is particularly important because it is more strongly associated with target organ damage than clinical blood pressure measurements. Regular moderate aerobic exercise has been shown to have anti-hypertensive effects. This study aimed to investigate the effects of aerobic exercise on home blood pressure in patients with diabetes. This randomized crossover trial was based on outpatient treatment at a university hospital. In this randomized crossover trial, 124 patients with type 2 diabetes were randomly assigned to two groups over 56 days: an exercise preceding group (exercise intervention for 28 days and then no exercise intervention for the following 28 days) and an exercise lagging group (no exercise intervention for 28 days and then exercise intervention for the following 28 days). The associations between the nocturnal blood pressure and exercise intervention were assessed accordingly. A decrease in blood pressure was observed in the morning and evening, at 2 a.m. and 3 a.m. after exercise intervention; however, there was no significant difference between groups. Moderate exercise was not effective in lowering nocturnal blood pressure in this study.

A 16-Week Home-Based Progressive Resistance Tube Training Among Older Adults With Type-2 Diabetes Mellitus: Effect on Glycemic Control

Research has proven that aerobic exercise improves glucose homeostasis among patients with type 2 diabetes mellitus (T2DM). Elastic resistance (tube or band) is suggested as a good alternative for home-based strength training among older adults including those with T2DM due to its low cost, simplicity, portability, and versatility. This study aimed to measure the effects of 16-week home-based progressive resistance training (PRT), using a resistance tube on glucose homeostasis and cardiovascular risk factors among older adults with T2DM. A total of 70 participants aged 61.68 (5.50) years with T2DM were assigned to the intervention (n = 35) and control (n = 35) groups in this quasi-experimental trial. The intervention group underwent 16 weeks of home-based PRT using a resistance tube. Significant improvements in HbA1c (-1.34% point, p < 0.001), fasting blood glucose (-1.30 mmol/L, p < 0.001), and systolic blood pressure (-1.42 mmHg, p < 0.05) were observed after 16 weeks of intervention. However, no significant changes were observed in lipid profile, diastolic blood pressure, resting heart rate, and ankle-brachial index. The finding suggests that 16 weeks of home-based PRT using a resistance tube has the potential to improve glycemic control and reduce systolic blood pressure among older adults with T2DM and caused no adverse events.

Cardiovascular and Autonomic Responses after a Single Bout of Resistance Exercise in Men with Untreated Stage 2 Hypertension

The aim of this paper is to assess the integrated responses of ambulatory blood pressure (BP), cardiac autonomic modulation, spontaneous baroreflex sensitivity (BRS), and vascular reactivity after a single bout of resistance exercise (RE) in men with stage 2 hypertension who have never been treated before. Ten hypertensive men were subjected to a RE session of three sets of 20 repetitions and an intensity of 40% of the 1-repetition maximum (RM) test in seven different exercises. For the control (CTR) session, the volunteers were positioned on the exercise machines but did not perform any exercise. Forearm blood flow was measured by venous occlusion plethysmography. We also analyzed the heart rate variability (HRV), ambulatory BP, blood pressure variability (BPV), and BRS. All measurements were performed at different timepoints: baseline, 20 min, 80 min, and 24 h after both RE and CTR sessions. There were no differences in ambulatory BP over the 24 h between the RE and CTR sessions. However, the area under the curve of diastolic BP decreased after the RE session. Heart rate (HR) and cardiac output increased for up to 80 and 20 min after RE, respectively. Similarly, forearm blood flow, conductance, and vascular reactivity increased 20 min after RE (p < 0.05). In contrast, HRV and BRS decreased immediately after exercise and remained lower for 20 min after RE. We conclude that a single bout of RE induced an increase in vascular reactivity and reduced the pressure load by attenuating AUC of DBP in hypertensive individuals who had never been treated with antihypertensive medications.

Effects of single bout resistance exercise on glucose levels, insulin action, and cardiovascular risk in type 2 diabetes: A narrative review

AIMS

Previous studies have reported beneficial effects of chronic resistance exercise in the prevention and treatment of type 2 diabetes. To clarify potential modulators of acute responses to resistance exercise, we reviewed the literature to determine the effects of a single bout of resistance exercise on cardiometabolic risk factors in type 2 diabetes.

METHODS

Pubmed and Embase were searched for studies investigating the effects of single bouts of resistance exercise on glucose and insulin levels, and cardiovascular disease risk in people with diabetes. Fourteen reports were identified and reviewed to formulate evidence-based resistance exercise prescription recommendations.

RESULTS

Glucose and insulin levels appear to decrease with resistance exercise with effects lasting up to 24 and 18 h, respectively. Bouts of resistance exercise may outperform aerobic exercise in reducing ambulatory blood pressure, with effects lasting up to 24 h. Moreover, resistance exercise after rather than before a meal may be more effective in reducing glucose, insulin, and triacylglycerol levels. However, reducing injectable insulin dosage prior to resistance exercise may blunt its favorable effects on glucose levels.

CONCLUSIONS

This review suggests that a single bout of resistance exercise may be effective for acutely improving cardiometabolic markers in people with diabetes.

Resistance Exercise Training Is More Effective than Interval Aerobic Training in Reducing Blood Pressure During Sleep in Hypertensive Elderly Patients

Bertani, RF, Campos, GO, Perseguin, DM, Bonardi, JMT, Ferriolli, E, Moriguti, JC, and Lima, NKC. Resistance exercise training is more effective than interval aerobic training in reducing blood pressure during sleep in hypertensive elderly patients. J Strength Cond Res 32(7): 2085-2090, 2018-An appropriate fall in blood pressure (BP) during sleep is known to be related to a lower cardiovascular risk. The objective of this study was to compare the effect of different types of training on hypertensive elderly patients under treatment in terms of pressure variability assessed by the nocturnal decline in BP. Hypertensive elderly subjects under pharmacological treatment were randomly assigned to the following groups: 12 weeks of continuous aerobic training, interval aerobic training (IA), resistance training (R), or control (C). All subjects underwent ambulatory BP monitoring before and 24 hours after the last exercise session. The results were assessed using the mixed effects model. A greater nocturnal decline in diastolic BP compared with the wakefulness period was observed in R in comparison with C (11.0 ± 4.1 vs. 6.0 ± 5.7 mm Hg and p = 0.01) and with IA (11.0 ± 4. vs. 6.5 ± 5.1 mm Hg and p = 0.02). No fall in BP during a 24-hour period was observed in training groups compared with C, perhaps because the subjects were mostly nondippers, for whom the effect of training on BP is found to be lower. In conclusion, resistance training promoted a greater nocturnal fall in BP among hypertensive elderly subjects under treatment compared with IA subjects.

Optimization of Aerobic Exercise Protocols in Diabetes Mellitus: A Randomized Trial

Background and Aims: diabetes mellitus one of the non-communicable disorders which is spreading globally irrespective of nation being developed or developing. The aim of this study was to optimize the exercise protocols and to find the efficacy of these protocols on glucose control, balance, gait and proprioception in patients suffering from type 2 diabetes mellitus.

Material and Methods: 40 individuals with type 2 DM with age 35 to 60 were randomly allotted to four groups with 10 subjects in each. Cycle ergometer based aerobic exercises were given with duration of 20 or 30 minutes twice or thrice weekly for 6 weeks. Pre and post intervention was collected using Fullerton Advanced Balance scale for balance, spatiotemporal gait parameters for gait, Continuous passive motion for Proprioception and High Performance Liquid Chromatography in the laboratory.

Results: data was analysed using Design Expert software. Full factorial design was used to compare role of duration and frequency of exercise on each patient. The results showed significant effect of exercises on balance, gait, proprioception and glycated haemoglobin (HbA1c).

Conclusion: Aerobic exercises if given for 30 minutes and thrice weekly can show a significant improvement in complications in Diabetics.

An integrative perspective of the anaerobic threshold

The concept of anaerobic threshold (AT) was introduced during the nineteen sixties. Since then, several methods to identify the anaerobic threshold (AT) have been studied and suggested as novel 'thresholds' based upon the variable used for its detection (i.e. lactate threshold, ventilatory threshold, glucose threshold). These different techniques have brought some confusion about how we should name this parameter, for instance, anaerobic threshold or the physiological measure used (i.e. lactate, ventilation). On the other hand, the modernization of scientific methods and apparatus to detect AT, as well as the body of literature formed in the past decades, could provide a more cohesive understanding over the AT and the multiple physiological systems involved. Thus, the purpose of this review was to provide an integrative perspective of the methods to determine AT.

Double product break point estimates ventilatory threshold in individuals with type 2 diabetes

[Purpose] To verify the identification of the anaerobic threshold through the double product breakpoint (DPBP) method for individuals with type 2 diabetes. [Subjects and Methods] Nine individuals with T2D (7 females; age=63.2 ± 8.9 y) and 10 non-diabetic (ND) (7 females; age=58.3 ± 7.8 y) performed an incremental exercise test on a cycle ergometer. Heart rate (HR), blood pressure (BP) and expired gas were measured at the end of each stage. The ventilatory threshold (VT) and DPBP were considered as the exercise intensities above which an over proportional increases in VE and DP were observed in relation to increasing workload. [Results] No differences were observed between the workloads, HR and VO2 corresponding to the AT identified respectively by VT and DPBP. For the T2D, strong correlations between VT and DBPB workloads (r=0.853), HR (r=0.714), and VO2 (r=0.863) were found. These relationships were similar to those found for the control group (r=0.923; r=0.881; and r=0.863, respectively). [Conclusion] These results demonstrate that the DPBP enables for the prediction of AT and correlated well the VT in both the T2D and ND participants.

Caloric expenditure of aerobic, resistance, or combined high-intensity interval training using a hydraulic resistance system in healthy men

Although exercise regimens vary in content and duration, few studies have compared the caloric expenditure of multiple exercise modalities with the same duration. The purpose of this study was to compare the energy expenditure of single sessions of resistance, aerobic, and combined exercise with the same duration. Nine recreationally active men (age: 25 ± 7 years; height: 181.6 ± 7.6 cm; weight: 86.6 ± 7.5 kg) performed the following 4 exercises for 30 minutes: a resistance training session using 75% of their 1-repetition maximum (1RM), an endurance cycling session at 70% maximum heart rate (HRmax), an endurance treadmill session at 70% HRmax, and a high-intensity interval training (HIIT) session on a hydraulic resistance system (HRS) that included repeating intervals of 20 seconds at maximum effort followed by 40 seconds of rest. Total caloric expenditure, substrate use, heart rate (HR), and rating of perceived exertion (RPE) were recorded. Caloric expenditure was significantly (p ≤ 0.05) greater when exercising with the HRS (12.62 ± 2.36 kcal·min), compared with when exercising with weights (8.83 ± 1.55 kcal·min), treadmill (9.48 ± 1.30 kcal·min), and cycling (9.23 ± 1.25 kcal·min). The average HR was significantly (p ≤ 0.05) greater with the HRS (156 ± 9 b·min), compared with that using weights (138 ± 16 b·min), treadmill (137 ± 5 b·min), and cycle (138 ± 6 b·min). Similarly, the average RPE was significantly (p ≤ 0.05) higher with the HRS (16 ± 2), compared with that using weights (13 ± 2), treadmill (10 ± 2), and cycle (11 ± 1). These data suggest that individuals can burn more calories performing an HIIT session with an HRS than spending the same amount of time performing a steady-state exercise session. This form of exercise intervention may be beneficial to individuals who want to gain the benefits of both resistance and cardiovascular training but have limited time to dedicate to exercise.

The period of the day affects the twenty-four hour blood pressure response to an acute combined exercise session in Brazilian jiu jitsu athletes

AbstractThe purpose of this study was to compare the effect of a combined exercise session performed at different periods of the day on the 24h blood pressure (BP) response. Anaerobic threshold (AT) and 12 repetition maximum (12RM) tests were evaluated in nine Brazilian jiu-jitsu athletes (male) (22±3.7 y; 176±5.0 cm; 73.4±9.7 kg; 6.8±2.1 % body fat). Four experimental sessions were performed: resistance exercise followed by aerobic exercise [Morning (MornS) and Afternoon (AfternS)] and Control (C) [Morning and Afternoon]. The morning sessions were conducted at 09:00 a.m. and the afternoon sessions were conducted at 3:00 p.m. The resistance exercise consisted of three sets at 90% of a 12RM for six resistance exercises. The aerobic exercise consisted of 15min at 90% of the AT. Blood pressure (BP) was measured before, during and 1h (Microlife(r) BP3A1C) after the performance of exercises in laboratory, and then during daily activities for the succeeding 23h by ambulatory BP monitoring (Dyna-MAPA(r)). Analysis of the area under the curve (AUC) indicated significant reductions in blood pressure parameters at various time points during the 24h monitoring period. For systolic BP (SBP), significantly lower values were shown following the morning session versus the control (MornS: 1756.2±100.8 vs. C: 1818.2±84.3 mmHg*15h; p < .05) and total-24h (MornS: 2695.8±143.3 vs. C: 2784.1±143.2 mmHg*24h; p < .05). The total-24h mean BP (MAP) was also significantly lower following the morning session versus the control (MornS: 2015.7±121.2 vs. C: 2087.3±153.8 mmHg*24h; p < .05). There were significant differences in the sleeping AUC of SBP (AfternS: 883.6±27.0 vs. C: 965.2±67.9 mmHg*9h; p< .05), diastolic BP (DBP) (AfternS: 481.4±30.9 vs. MornS: 552.9±34.2 and C: 562.1±52.3 mmHg*9h; p < .01) and MBP (AfternS: 651.9±22.4 vs. MornS: 708.7±43.1 and C: 726.9±64.7 mmHg*9h; p < .01). The combined exercise performed at different periods of the day contributed distinctly to the reduction of BP. The morning session was important in reducing SBP and MBP in the total-24h monitoring, while the afternoon session reduced SBP, DBP and MBP during sleeping in jiu-Jitsu athletes.

Post-Exercise Hypotension and Its Mechanisms Differ after Morning and Evening Exercise: A Randomized Crossover Study

Post-exercise hypotension (PEH), calculated by the difference between post and pre-exercise values, it is greater after exercise performed in the evening than the morning. However, the hypotensive effect of morning exercise may be masked by the morning circadian increase in blood pressure. This study investigated PEH and its hemodynamic and autonomic mechanisms after sessions of aerobic exercise performed in the morning and evening, controlling for responses observed after control sessions performed at the same times of day. Sixteen pre-hypertensive men underwent four sessions (random order): two conducted in the morning (7:30am) and two in the evening (5pm). At each time of day, subjects underwent an exercise (cycling, 45 min, 50%VO₂peak) and a control (sitting rest) session. Measurements were taken pre- and post-interventions in all the sessions. The net effects of exercise were calculated for each time of day by [(post-pre exercise)-(post-pre control)] and were compared by paired t-test (P<0.05). Exercise hypotensive net effects (e.g., decreasing systolic, diastolic and mean blood pressure) occurred at both times of day, but systolic blood pressure reductions were greater after morning exercise (-7±3 vs. -3±4 mmHg, P<0.05). Exercise decreased cardiac output only in the morning (-460±771 ml/min, P<0.05), while it decreased stroke volume similarly at both times of day and increased heart rate less in the morning than in the evening (+7±5 vs. +10±5 bpm, P<0.05). Only evening exercise increased sympathovagal balance (+1.5±1.6, P<0.05) and calf blood flow responses to reactive hyperemia (+120±179 vs. -70±188 U, P<0.05). In conclusion, PEH occurs after exercise conducted at both times of day, but the systolic hypotensive effect is greater after morning exercise when circadian variations are considered. This greater effect is accompanied by a reduction of cardiac output due to a smaller increase in heart rate and cardiac sympathovagal balance.

Effects of aerobic exercise intensity on 24-h ambulatory blood pressure in individuals with type 2 diabetes and prehypertension

[Purpose] To verify the effects of different intensities of aerobic exercise on 24-hour ambulatory blood pressure (BP) responses in individuals with type 2 diabetes mellitus (T2D) and prehypertension. [Subjects and Methods] Ten individuals with T2D and prehypertension (55.8 ± 7.7 years old; blood glucose 133.0 ± 36.7 mg·dL⁻¹ and awake BP 130.6 ± 1.6/ 80.5 ± 1.8 mmHg) completed three randomly assigned experiments: non-exercise control (CON) and exercise at moderate (MOD) and maximal (MAX) intensities. Heart rate (HR), BP, blood lactate concentrations ([Lac]), oxygen uptake (VO₂), and rate of perceived exertion (RPE) were measured at rest, during the experimental sessions, and during the 60 min recovery period. After this period, ambulatory blood pressure was monitored for 24 h. [Results] The results indicate that [Lac] (MAX: 6.7±2.0 vs. MOD: 3.8±1.2 mM), RPE (MAX: 19±1.3 vs. MOD: 11±2.3) and VO₂peak (MAX: 20.2±4.1 vs. MOD: 14.0±3.0 mL·kg⁻¹·min⁻¹) were highest following the MAX session. Compared with CON, only MAX elicited post-exercise BP reduction that lasted for 8 h after exercise and during sleep. [Conclusion] A single session of aerobic exercise resulted in 24 h BP reductions in individuals with T2D, especially while sleeping, and this reduction seems to be dependent on the intensity of the exercise performed.

Can a single session of a community-based group exercise program combining step aerobics and bodyweight resistance exercise acutely reduce blood pressure?

This study aimed to analyze the acute effects of a single session of a community-based group exercise program combining step aerobics and bodyweight resistance exercise on blood pressure in healthy young adult women. Twenty-three healthy young adult women (aged 31.57 ± 7.87 years) participated in two experimental sessions (exercise and control) in a crossover study design. Blood pressure was monitored before, immediately after and at 10, 20 and 30 min of recovery. The exercise session consisted of four phases: 1) a warm-up (5 min of dance aerobics); 2) aerobic exercise training (30 min of step aerobics); 3) resistance exercise training (six sets of 12 repetitions of three bodyweight exercises in a circuit mode, 10 min); and 4) a cool-down (5 min of breathing and flexibility exercises); totaling 50 min of duration. Systolic blood pressure after exercise was significantly lower compared to control at the 10th min (−10.83 ± 2.13 vs. −2.6 ± 2.13 mmHg; p = 0.009), 20th min (−11.26 ± 2.13 vs. −3.04 ± 2.13 mmHg; p = 0.009) and 30th min of recovery (−10.87 ± 2.39 vs. −0.48 ± 2.39 mmHg; p = 0.004). A single session of a community-based group exercise program combining step aerobics and bodyweight resistance exercise was effective in inducing significant post-exercise hypotension in healthy young adult women. This type of low-cost exercise interventions may have an important role in the prevention of cardiovascular diseases and in community health promotion.

Traditional games resulted in post-exercise hypotension and a lower cardiovascular response to the cold pressor test in healthy children

The present study aimed to verify if blood pressure (BP) reactivity could be reduced through a previous single session of active playing when compared to sedentary leisure. Sixteen pre-pubertal healthy children participated in this study. After familiarization with procedures and anthropometric evaluation, participants performed three sessions in randomized order: (1) 30 min of traditional Brazilian games (PLAY); (2) 30 min of video game playing (DDR); and (3) 30 min of watching TV (TV). Each session lasted 80 min, being 10 min of rest; 30 min of intervention activity; and 40 min of recovery. After recovery, the Cold Pressor Test (CPT) was used for the assessment of acute cardiovascular reactivity. BP was recorded at 30 s and 1 min during the CPT. Analysis of variance showed post-exercise hypotension (PEH) only after PLAY, and that systolic and diastolic BP were significantly increased in all conditions during CPT. However, the magnitude of the CPT-induced BP response was significantly less in PLAY compared to DDR and TV. The PEH observed during recovery and the reduced BP response to CPT following playing traditional games may be due its higher cardiovascular and metabolic demand as was indicated by the increased heart rate, oxygen consumption, and BP. It was concluded that BP reactivity to stress may be reduced through a previous single session of traditional games and that PEH was recorded only after this exercise form. This benefit indicates a potential role of playing strategies for cardiovascular health in childhood.

Combined exercise circuit session acutely attenuates stress-induced blood pressure reactivity in healthy adults

Objective

To investigate the blood pressure (BP) responses to cardiovascular stress test after a combined exercise circuit session at moderate intensity.

Method

Twenty individuals (10 male/10 fem; 33.4± 6.9 years; 70.2± 15.8 kg; 170.4± 11.5 cm; 22.3± 6.8% body fat) were randomized in a different days to control session with no exercise or exercise session consisting of 3 laps of the following circuit: knee extension, bench press, knee flexion, rowing in the prone position, squats, shoulder press, and 5 min of aerobic exercise at 75-85% of age-predicted maximum heart rate and/or 13 on the Borg Rating of Perceived Exertion [scale of 6 to 20]. The sets of resistance exercise consisted of 15 repetitions at ~50% of the estimated 1 repetition maximum test. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured at rest and during 1h of recovery in both experimental sessions. After that, blood pressure reactivity (BP_R) was evaluated using the Cold Pressor Test.

Results

During 1h of exercise recovery, there was a reduction in SBP (3-6 mmHg) and DBP (2-5 mmHg) in relation to pre-session rest (p<0.01), while this reduction was not observed in the control session. A decline in BP_R (4-7 mmHg; p<0.01) was observed 1h post-exercise session, but not in the control session. Post-exercise reductions in SBP and DBP were significantly correlated with BP_R reductions (r=0.50-0.45; p<0.05).

Conclusion

A combined exercise circuit session at moderate intensity promoted subsequent post-exercise hypotension and acutely attenuated BP_R in response to a cardiovascular stress test. In addition, the post-exercise BP reduction was correlated with BP_R attenuation in healthy adults of both genders.

Role of exercise in the management of diabetes mellitus: the global scenario

Background

Exercise training programs have emerged as a useful therapeutic regimen for the management of type 2 diabetes mellitus (T2DM). Majority of the Western studies highlighted the effective role of exercise in T2DM. Therefore, the main aim was to focus on the extent, type of exercise and its clinical significance in T2DM in order to educate the clinicians from developing countries, especially in Asians.

Methods

Pubmed, Science Direct, Scopus, ISI Web of Knowledge and Google scholar were searched using the terms “type 2 diabetes mellitus,” “type 2 DM,” “exercise,” and/or “physical activity,” and “type 2 diabetes mellitus with exercise.” Only clinical or human studies published in English language between 2000 and 2012 were included. Certain criteria were assigned to achieve appropriate results.

Results

Twenty five studies met the selected criteria. The majority of the studies were randomized controlled trial study design (65%). Most of the aerobic exercise based studies showed a beneficial effect in T2DM. Resistance exercise also proved to have positive effect on T2DM patients. Minimal studies related to other types of exercises such as yoga classes, joba riding and endurance-type exercise were found. On the other hand, United States of America (USA) showed strong interest of exercise management towards T2DM.

Conclusion

Aerobic exercise is more common in clinical practice compared to resistance exercise in managing T2DM. Treatment of T2DM with exercise training showed promising role in USA. A large number of researches are mandatory in the developing countries for incorporating exercise in the effective management of T2DM.

Type 2 diabetes elicits lower nitric oxide, bradykinin concentration and kallikrein activity together with higher DesArg(9)-BK and reduced post-exercise hypotension compared to non-diabetic condition

This study compared the plasma kallikrein activity (PKA), bradykinin concentration (BK), DesArg(9)-BK production, nitric oxide release (NO) and blood pressure (BP) response after moderate-intensity aerobic exercise performed by individuals with and without type 2 diabetes. Ten subjects with type 2 diabetes (T2D) and 10 without type 2 diabetes (ND) underwent three sessions: 1) maximal incremental test on cycle ergometer to determine lactate threshold (LT); 2) 20-min of constant-load exercise on cycle ergometer, at 90% LT and; 3) control session. BP and oxygen uptake were measured at rest and at 15, 30 and 45 min post-exercise. Venous blood samples were collected at 15 and 45 minutes of the recovery period for further analysis of PKA, BK and DesArg(9)-BK. Nitrite plus nitrate (NOx) was analyzed at 15 minutes post exercise. The ND group presented post-exercise hypotension (PEH) of systolic blood pressure and mean arterial pressure on the 90% LT session but T2D group did not. Plasma NOx increased ~24.4% for ND and ~13.8% for T2D group 15 min after the exercise session. Additionally, only ND individuals showed increases in PKA and BK in response to exercise and only T2D group showed increased DesArg(9)-BK production. It was concluded that T2D individuals presented lower PKA, BK and NOx release as well as higher DesArg(9)-BK production and reduced PEH in relation to ND participants after a single exercise session.

Cycling above rather than below lactate threshold is more effective for nitric oxide release and post-exercise blood pressure reduction in individuals with type-2 diabetes

The purposes of this study were to analyze and compare the effects of exercise performed in different intensities, above and below lactate threshold (LT) on post-exercise blood pressure (BP) and nitric oxide (NO) responses in individuals with type 2 diabetes (T2D). For this, 11 T2D underwent the following sessions: 1) control session; 2) 20-min of moderate cycling (80% LT); and 3) 20-min of high intensity cycling (120%LT) on a cycle ergometer. Plasma NO and BP measurements were carried out at rest and at 15 and 45 min of post-sessions. When compared to rest, only the exercise session performed at 120%LT elicited an increase of NO (from 7.2 to 9.5 µM, p<0.05), as well as a decrease in systolic BP (from 126.6±7.9 to 118.7±3.9 mmHg, p<0.05) during the post-exercise period. In conclusion, the results suggest that NO release and post-exercise BP decrease are intensity-dependent for individuals with T2D.

Exercise and diabetes-related cardiovascular disease: systematic review of published evidence from observational studies and clinical trials

The cost of treating cardiovascular disease (CVD) and diabetes is enormous and is set to rise in the coming years. Physical inactivity and sedentary behaviors are major risk factors for these diseases and are estimated to account for several million global deaths annually. Lifestyle interventions, particularly those aimed at enhancing physical activity levels, have a substantial favorable impact on diabetes progression in people at high risk of the disease. Although observational studies and small intervention studies suggest that physical activity might also prevent CVD in people with diabetes, this is not supported by the results of larger randomized controlled trials of lifestyle intervention. The purpose of this review is to provide an overview of the published studies focused on the role of physical activity in CVD prevention in persons with diabetes, and to discuss the implications of these studies' findings. Our review identified almost 100 studies published in the past decade relevant to this topic.

Women with metabolic syndrome present different autonomic modulation and blood pressure response to an acute resistance exercise session compared with women without metabolic syndrome

Metabolic syndrome (MetS) is a cluster of risk factors in individuals with high risk of diabetes and heart disease. Resistance training (RT) has been proposed to be a safe, effective and worthwhile method for the prevention and treatment of metabolic and cardiovascular diseases. However, no study has analysed the acute response of blood pressure (BP) and autonomic control of heart rate (HR) after a RT session in female patients with MetS. The aim of the present study was to analyse the response of laboratory assessed and ambulatory BP and cardiac autonomic modulation after a RT session in women with MetS. Nine women without MetS (35.0 ± 6.7 years) and 10 women with MetS (34.1 ± 9.4 years) completed one experimental exercise session and a control session. Laboratory BP, heart rate variability (HRV) and ambulatory BP of each subject were measured at rest, over 60 min, and for 24 h after the end of the sessions, respectively. There was a significant reduction in systolic blood pressure (SBP), night time diastolic blood pressure (DBP) and mean blood pressure (MBP) only for women with MetS, for all periods after the RT session when compared with the control session (P<0.05). Significantly lower laboratory values of SBP and DBP (10, 30 and 40 min postexercise) and MBP (10, 40 and 50 min postexercise) were observed in women with MetS (P<0.05). Patients with MetS exhibited significant lower basal HRV and a lower autonomic responsiveness during the 60 min of acute recovery. These results confirmed that an acute session of resistance exercise induced a lower BP during day time and sleeping hours in women with MetS that may offer a cardio-protective effect. Women with MetS exhibited an impaired autonomic modulation at rest and a lower acute autonomic responsiveness to a RT session. The dissociation between BP and HRV responses suggests that other factors than autonomic control could be involved in the hypotensive effect of a RT session in MetS patients.

Blood glucose control for individuals with type-2 diabetes: acute effects of resistance exercise of lower cardiovascular-metabolic stress

This study compared the effects of resistance exercise (RE) intensities on blood glucose (GLUC) of individuals without (ND) and with type-2 diabetes (T2D). Nine individuals with T2D and 10 ND performed: (a) RE circuit at 23% of 1 maximal repetition (1RM) (RE_L); (b) RE circuit at 43% 1RM (RE_M); and (c) control (CON) session. Blood lactate (LAC) and GLUC were measured before, during, and postinterventions. Double product (DP) and rate of perceived exertion (RPE) were recorded. The area under the curve (AUC) revealed the effects of RE circuits in reducing GLUC in individuals with T2D (RE_L: 12,556 ± 3,269 vs. RE_M: 13,433 ± 3,054 vs. CON: 14,576 ± 3,922 mg.dl(-1).145 minutes; p < 0.05) with a lower AUC of GLUC in RE_L in comparison to RE_M. Similarly, for ND the RE_L reduced the AUC of GLUC when compared with RE_M and CON (RE_L: 10,943 ± 956 vs. RE_M: 12,156 ± 1,062 vs. CON: 11,498 ± 882 mg.dl(-1).145 minutes; p < 0.05). The AUC of GLUC was higher for T2D compared with ND on CON condition (p = 0.02). However, after RE circuits the difference between groups for AUC of GLUC was abolished. The RE_M for T2D was more stressful when compared with RE_L for LAC (CON: 1.3 ± 0.5 vs. RE_L: 5.5 ± 1.5 vs. RE_M: 6.8 ± 1.3 mmol·L(-1); p < 0.05), DP (CON: 8,415 ± 1,223 vs. RE_L: 15,980 ± 2,007 vs. RE_M: 18,047 ± 3,693 mmHg.bpm(-1); p < 0.05), and RPE (RE_L: 11 ± 2 vs. RE_M: 13 ± 2 Borg Scale; p < 0.05). We concluded that RE_L and RE_M were effective in reducing GLUC for individuals with T2D, with lower cardiovascular-metabolic and perceptual stress being observed for RE_L. These data suggest that acute RE sessions at light or moderate intensities are effective for controlling GLUC in individuals with T2D.

Association of cardiovascular response to an acute resistance training session with the ACE gene polymorphism in sedentary women: a randomized trial

Background

The aim of the present study was to verify the effects of an acute resistance training (RT) session and insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) on systolic (SBP), diastolic (DBP) and mean blood pressure (MBP), and heart rate (HR).

Methods

The sample consisted of 27 sedentary women (33.3 ± 8.2 yrs; 69.1 ± 13.8 kg; 1.57 ± 0.05 m; 27.6 ± 5.1 kg/m²) divided into two groups according to their polymorphism I/D (DD = 9; II + ID = 18). Volunteers underwent two experimental sessions: RT – an acute session performed with three sets at 60% of one-repetition maximum (1RM) interspersed with 1 minute rest interval between exercises and sets, and a control session (CON) in which they remained seated for 30 minutes in the laboratory. SBP, DBP, MBP and HR were measured before exercise and during one hour every 10 minutes after sessions, in the seated position. A two-way ANOVA for repeated measures with Tukey’s post hoc test was used for the intra and inter-group comparisons.

Results

There were no statistically significant differences on SBP, DBP and MBP after the experimental protocols, and no effect of ACE polymorphism (P > 0.05). However, comparing CON versus exercise effect size values (ES), homozygotic carriers of the allele D presented a drop in SBP which was considered moderate, while in allele I carriers it was small, 30 minutes after exercise. In MBP, homozygotic D carriers exhibited a large ES 20 minutes post-exercise. HR was higher at 10, 20 and 30 minutes after exercise as compared to pre-exercise only for carriers of the I allele (P < 0.05).

Conclusions

Therefore, an acute RT session reduces clinical BP. In addition to this; it seems that ACE polymorphism had some influence on cardiovascular response to exercise.

Trial Registration

RBR-6GDYVZ

Assessment of maximal lactate steady state during treadmill exercise in SHR

Background

Spontaneously hypertensive rats (SHR) are one of the main animal models used for studying the effects of exercise on hypertension. Therefore, the determination of adequate intensity has been essential for secure and optimized exercise prescriptions concerning hypertensive subjects. This study aimed to identify the MLSS in SHR by using a treadmill test to improve the protocols and further prescriptions of exercise intensity.

Findings

In order to carry out this determination, SHR (n = 10) animals (~17.5 weeks; 227.4 ± 29.3 g; 172.4 ± 8.1 mmHg systolic blood pressure) were divided into two groups (G1 n = 5; G2 n = 5). Rats underwent a test with three different velocities to determine the MLSS. The MLSS was considered as the highest effort intensity where the blood lactate did not vary more than 1 mmol.L^-1 from the 10^th to the 25^th minute. The MLSS was reached at a velocity of 20 m.min^-1 with 3.8 ± 0.5 mmol.L^-1 of lactate for G1. Additionally, the results were validated in G2. However, when the test was applied at 25 m.min^-1, there was no stabilization of BLC in G1 and G2.

Conclusions

In this study it was possible to identify the MLSS in SHR rats, which is an excellent evaluation tool to control exercise intensity. These data are of considerable importance in studies using physical exercise as a means of research in hypertension and may lead to the intensity of exercise being prescribed more appropriately.

The effect of different training programs on antioxidant status, oxidative stress, and metabolic control in type 2 diabetes

We compared the effects of 12 weeks of 3 different exercise types on type 2 diabetic (T2DM) male and female human subjects, randomly divided into 4 groups: aerobic training (AT; n = 11), strength training (ST; n = 10), combined training (CBT; n = 10), and no training (NT; n = 12). Metabolic control, anthropometric parameters, lipid and hematological profiles, kidney and liver function markers, hormones, antioxidant enzymes, and oxidative stress markers were assessed prior to and after the training programs. At baseline, fasting blood glucose and hemoglobin A(1c) in the ST group were higher than in the NT group; after the training, we no longer observed differences in these groups, suggesting an improvement on these parameters. In the AT group, catalase and superoxide dismutase activity, nitrite concentration, levels of sulfhydryl groups, and peak rate of oxygen consumption were elevated after the training (p < 0.05). No changes were observed in antioxidant enzymes or oxidative stress markers in the ST group. The levels of sulfhydryl groups diminished in the NT group (p < 0.01) and increased in the CBT group (p < 0.05). These data demonstrate that the AT program for the T2DM subjects provided important upregulation in antioxidant enzymes and increased nitric oxide bioavailability, which may help minimize oxidative stress and the development of the chronic complications of diabetes. We propose that the beneficial effects observed in the metabolic parameters of the ST group occurred in response to the poor baseline metabolic health n this group, and not necessarily in response to the training itself.

Exercise lowers blood pressure in university professors during subsequent teaching and sleeping hours

BACKGROUND

University professors are subjected to psychological stress that contributes to blood pressure (BP) reactivity and development of hypertension. The purpose of this study was to investigate the effects of exercise on BP in university professors during teaching and sleeping hours.

METHODS

Twelve normotensive professors (42.2 ± 10.8 years, 74.2 ± 11.2 kg, 172.8 ± 10.4 cm, 20.1% ± 6.7% body fat) randomly underwent control (CONT) and exercise (EX30) sessions before initiating their daily activities. EX30 consisted of 30 minutes of cycling at 80%-85% of heart rate reserve. Ambulatory BP was monitored for 24 hours following both sessions.

RESULTS

BP increased in comparison with pre-session resting values during teaching after CONT (P < 0.05) but not after EX30. Systolic, diastolic, and mean arterial BP showed a more pronounced nocturnal dip following EX30 (approximately -14.7, -12.7, and -9.6 mmHg, respectively) when compared with CONT (approximately -6, -5 and -3 mmHg).

CONCLUSION

Exercise induced a BP reduction in university professors, with the main effects being observed during subsequent teaching and sleeping hours.