High-intensity exercise improves BP, body composition of hypertensive patients

The inclusion of a moderate- (MT) or high-intensity training (HIT) program as adjuvant therapy in hypertensive patients appears beneficial in reducing certain cardiovascular risks, but only HIT is effective at lowering blood pressure (BP) and losing body mass and fat, reports a study.

“Moreover, both MT and HIT improve the lipid profile and cardiorespiratory fitness, but only after 7 weeks of detraining, these variables return to baseline values,” the researchers said.

The study included 34 patients. Participants in the HIT group (n=15) underwent intensity training at 80 percent to 90 percent of maximum heart rate, while those in the MT group (n=19) had training at 50 percent to 70 percent of maximum heart rate.

The researchers then analysed the participants’ BP, body composition, lipid profile, fasting glucose, strength, and cardiovascular fitness.

BP did not decrease during the first training period, but the HIT group had significant BP reduction during the second training period. [J Hypertens 2023;41:411-419]

At 12 weeks, both the MT and HIT group showed no decrease in body mass, body mass index, or fat mass, but after 7 weeks of detraining, the latter saw improvements in these body composition variables during the second training period.

Both training periods and intensities led to improvements in high- and low-density lipoproteins, but only HIT successfully reduced total cholesterol levels. However, the lipid profile variables returned to baseline values after 7 weeks of detraining.

Notably, blood glucose decreased significantly after 16 weeks of retraining with MT or HIT. The two intensity programs in both periods also improved cardiorespiratory fitness, but it likewise returned to baseline values after 7 weeks of detraining.

In a previous review, at least 3 months of MT or HIT are needed to improve BP parameters. Such beneficial effects only appeared in participants not taking antihypertensive medication. [Sport Med 2012;42:489-509]

“This fact could explain our results because all the participants of the present study were hypertensive and they were treated with antihypertensive pharmacological therapy during the study,” according to the researchers, noting that only 3 months of training were not enough to reduce BP levels, but that a second retraining period of HIT for 16 weeks could effectively improve BP levels.

“Thus, the training programs proposed to decrease BP must include HIT and a longer duration, and they should be repeated along the time in a longitudinal way and with retraining periods, specifically in patients with pharmacological antihypertensive therapy,” they said.

High-intensity training

Factors affecting the lipid profile and body composition include energy expenditure and postexercise oxygen consumption. The current findings suggest that HIT promotes both higher postexercise oxygen consumption and energy expenditure than low-intensity exercise. [Metabolism 1991;40:836-841]

In addition, earlier studies have shown that HIT, compared to low-intensity training, reduces energy intake more substantially, yields greater mobilization of lipids, and enhances the potential of skeletal muscles to utilize lipids. [Br J Nutr 1997;77:511-521; Metabolism 1994;43:814-818]

“Therefore, evidence suggests that HIT has the potential to chronically influence lipid balance and body composition, and it would explain the data reported in the present study,” the researchers said.