Acute And Chronic Effects Of Combined Strength Training On Regulatory Variables Of Ambulatory Blood Pressure In Medicated Hypertensive Patients
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- 24-hour Ambulatory Blood Pressure (Systolic, Diastolic, and Mean)
Study Overview
Brief Summary
Dynamic strength training (DST) is widely recognized for promoting neuromuscular adaptations such as increased strength and hypertrophy. It is currently endorsed by treatment and prevention guidelines for systemic arterial hypertension (SAH) due to its significant effect on lowering blood pressure (BP). However, when comparing BP reduction values, isometric strength training (IST) stands out with greater magnitudes of BP reduction, although without the neuromuscular adaptations seen in DST. Given their similarities, a combination of these strategies through combined strength training (CST) is possible but has not yet been evaluated. The researchers hypothesized that CST may have an additive effect compared with DST and IST alone in reducing ambulatory BP. Therefore, the objective of the present thesis was to evaluate and compare the effects of CST, DST, and IST on regulatory variables of ambulatory BP in medicated middle-aged hypertensive patients. This thesis is structured in two parts: (1) a crossover study with medicated middle-aged hypertensive patients to identify autonomic, endothelial, and vascular responses related to ambulatory BP after a single session of CST, DST, and IST; and (2) a randomized clinical trial to assess the chronic effects of CST, DST, and IST on regulatory variables of ambulatory BP in medicated middle-aged hypertensive patients.
Detailed Description
"This thesis is structured in two sequential stages:
A randomized crossover trial involving medicated middle-aged hypertensive patients to identify autonomic, endothelial, and vascular responses on ambulatory blood pressure following a single session of Combined Strength Training (CST), Dynamic Strength Training (DST), and Isometric Strength Training (IST), compared to a control session.
A randomized controlled trial to assess the chronic effects (8 weeks) of CST and DST on the regulatory variables of ambulatory blood pressure in medicated middle-aged hypertensive patients, compared to a non-exercising control group."
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Sequential
- Primary Purpose
- Treatment
- Masking
- Single (Outcomes Assessor)
Masking Description
While it was not possible to mask the participants and the exercise instructors due to the nature of the training sessions, a clear separation was maintained between the team supervising the exercises and the team responsible for data collection and analysis. Specifically, the outcomes assessors responsible for the Ambulatory Blood Pressure Monitoring (ABPM) and Flow-Mediated Dilation (FMD) measurements were completely blinded to the participants' group allocation and had no involvement in the training protocols.
Eligibility Criteria
- Ages
- 30 Years to 60 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Clinical diagnosis of stage 1 or stage 2 hypertension, according to current guidelines.
- •Sedentary lifestyle (no participation in structured exercise training for at least 6 months).
- •Age between 18 and 60 years. Stable antihypertensive pharmacological treatment for at least 4 weeks before enrollment.
- •Ability to perform resistance exercise.
Exclusion Criteria
- •Symptomatic cardiovascular disease. Heart failure. Unstable angina. Uncontrolled diabetes mellitus (HbA1c > 8%). Renal insufficiency. Musculoskeletal disorders or physical limitations that contraindicate resistance exercise.
- •Changes in antihypertensive medication within the 4 weeks prior to enrollment or during the study protocol.
- •Current smoking. Excessive alcohol consumption.
Arms & Interventions
Isometric strength training
8 isometric strength exercises. 10 seconds of isometric strength. 3 sets, 1 second concentric and 2 eccentric. 30 seconds rest between sets and 1 minute and 30 seconds rest between exercises.
Intervention: Acute Isometric Exercise Session. (Other)
Control group
The control group consists of maintaining their habits for 8 weeks, without strength exercises.
Intervention: Control Session and Follow-up (Other)
Combined strength training
8 resistance exercises combining dynamic repetitions with isometric components. Protocol: 3 sets of 11 repetitions, with a concentric phase of 1 second and an eccentric phase of 2 seconds combined with 10 seconds of isometric hold at the end of each set. Includes 30 seconds of rest between sets and 90 seconds between exercises.
Intervention: Combined strength training (Other)
Dynamic strength training
8 dynamic strength exercises, with 14 repetitions, 3 sets, 1 second concentric phase and 2 seconds eccentric phase. 30 seconds of rest between sets and 1 minute and 30 seconds of rest between exercises.
Intervention: Dynamic strength training (Other)
Outcomes
Primary Outcomes
24-hour Ambulatory Blood Pressure (Systolic, Diastolic, and Mean)
Time Frame: Baseline and 8 weeks
Average systolic blood pressure measured over a 24-hour period using an automated ambulatory monitor (ABPM). This measure assesses the chronic effect of the 8-week training protocols compared to baseline.
Secondary Outcomes
- Acute 24-hour Ambulatory Blood Pressure (Systolic, Diastolic, and Mean)(24 hours post-intervention)
- Acute Post-Exercise Blood Pressure Response(Baseline, 30 minutes, and 60 minutes post-exercise.)
- Vascular Endothelial Function - Chronic (Flow-Mediated Dilation)(Baseline and 8 weeks)
- Vascular Endothelial Function - Acute Response (Flow-Mediated Dilation)(Baseline, 30 minutes, and 60 minutes post-exercise.)
- Cardiac Autonomic Modulation - Chronic (Heart Rate Variability)(Baseline and 8 weeks.)
- Cardiac Autonomic Modulation - Acute Response (Heart Rate Variability)(Baseline, 30 minutes, and 60 minutes post-exercise.)
- Office Blood Pressure Adaptation (Weekly Progression)(Baseline and weekly for 8 weeks.)
- Blood-based Biomarkers of Cardiovascular Health(Baseline and 8 weeks)
- Acute Blood-based Biomarkers Response(Baseline, 30 minutes, and 60 minutes post-exercise.)
- Body Composition (Skinfold Thickness)(Baseline and 8 weeks)
Investigators
Alvaro Reischak-Oliveira
Professor at Universidade Federal do Rio Grande do Sul
Federal University of Rio Grande do Sul