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1. Effect of aerobic exercise training on pulse wave velocity in adults with and without long-term conditions: a systematic review and meta-analysis

Author

Thomas Yates, Michael C Steiner, Gerry P McCann, Amy V Jones, Enya Daynes, Lorna Latimer, Matt Graham-Brown, Pip Divall, Majda Bakali, Thomas CJ Ward, Grace M Hawthorne, and Rachael Andrea Evans

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Rationale There is conflicting evidence whether aerobic exercise training (AET) reduces pulse wave velocity (PWV) in adults with and without long-term conditions (LTCs).Objective To explore whether PWV improves with AET in adults with and without LTC, to quantify the magnitude of any effect and understand the influence of the exercise prescription.Data sources CENTRAL, MEDLINE and EMBASE were among the databases searched.Eligibility criteria We included studies with a PWV measurement before and after supervised AET of at least 3 weeks duration. Exclusion criteria included resistance exercise and alternative measures of arterial stiffness.Design Controlled trials were included in a random effects meta-analysis to explore the effect of AET on PWV. Uncontrolled studies were included in a secondary meta-analysis and meta-regression exploring the effect of patient and programme factors on change in PWV. The relevant risk of bias tool was used for each study design.Results 79 studies (n=3729) were included: 35 controlled studies (21 randomised control trials (RCT) (n=1240) and 12 non-RCT (n=463)) and 44 uncontrolled (n=2026). In the controlled meta- analysis, PWV was significantly reduced following AET (mean (SD) 11 (7) weeks) in adults with and without LTC (mean difference −0.63; 95% CI −0.82 to −0.44; p

Published
2023
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2. Antihypertensive Treatment Fails to Control Blood Pressure During Exercise

Author

Julian F. R. Paton, Emma C. Hart, Angus K Nightingale, Amy E Burchell, Majda Bakali, Benjamin Chant, and Thomas Hinton

Subjects
medicine.medical_specialty, hypertension, Bristol Heart Institute, Ischemia, 030204 cardiovascular system & hematology, CRICBristol, Incremental exercise, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Internal Medicine, medicine, Aerobic exercise, Risk factor, humans, Peak exercise, exercise, business.industry, blood pressure, medicine.disease, Blood pressure, Cardiology, Analysis of variance, business, Body mass index, 030217 neurology & neurosurgery
Abstract

An exaggerated blood pressure (BP) response to maximal exercise is an independent risk factor for cardiovascular events and mortality. It is unclear whether treating BP to guideline recommended levels could normalize the rise in BP during exercise, which is mediated by the metaboreflex. We aimed to assess the BP response to incremental exercise testing and metaboreflex activation in treated–controlled hypertension (n=16), treated–uncontrolled hypertension (n=16), and untreated hypertension (n=11) and 16 control participants with normal BP (n=16). All groups were matched for age and body mass index. BP was measured during an incremental V o 2 peak test on a cycle ergometer and during metaboreflex isolation using postexercise ischemia. Data were analyzed using 2-way ANOVA with Tukey test for multiple comparisons. Aerobic fitness was similar among groups ( P =0.97). The rise in absolute systolic BP from baseline at peak exercise was similar in controlled, uncontrolled, and untreated hypertension but greater compared with normotensive controls (Δ71±3, 81±7, 79±8.5 versus 47±5 mm Hg; P =0.0001). Metaboreflex sensitivity was also similar in controlled, uncontrolled, and untreated hypertension but augmented compared with normotensive controls (Δsystolic BP: 21±2, 28±2, 25±3 versus 12±2 mm Hg; P

Published
2018

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