Abstract 12827: Exercise Training Fails to Reduce Blood Pressure in Type 2 Diabetes: A Randomized Controlled Trial
Background: Though exercise is an integral part of diabetes care, the existing studies on exercise for BP reduction have inconsistent results. As noted in a 2010 position statement from the American Diabetes Association and American College of Sports Medicine, exercise may slightly reduce SBP and DBP reductions are less common. The evidence was rated category C, which indicates a consensus viewpoint or expert opinion rather than high-quality randomized controlled trials (RCT) or meta-analyses.
Methods: This was a 6-month prospective RCT of a supervised moderate-intensity combined aerobic and resistance training 3 times per week; controls followed usual care physical activity and diet advice. Patients (N=140, M=81, F=59; aged 40-65 years, mean (SD) 56.4±6.1 years) had uncomplicated diabetes not requiring insulin and untreated SBP of 120 to 159 mm Hg or DBP of 85 to 99 mm Hg, or, if being treated with one or more anti-hypertensive medications, any SBP below 159 mm Hg or DBP below 99 mm Hg. Arterial stiffness was indexed by the aortofemoral pulse-wave velocity (PWV).
Results: Fifty-three exercisers and 65 controls completed the study. Exercisers significantly improved aerobic and strength fitness, increased lean body mass and reduced general and abdominal obesity. Baseline BP was 126.3±12.3/71.7±7.9 mm Hg in exercisers and 126.0±13.5/70.3±8.7 mm Hg in controls, with no group differences p=ns. At 6-months, BP was 125.2±14.6/69.9±9.3 mm Hg in exercisers and 125.7±13.1/70.3±8.5 mm Hg in controls, with no group differences (p=ns) or change from baseline in either group (p=ns). Baseline PWV was 902.2±322.8 cm/s in exercisers and 918.4±351.0 in controls, p=ns. At 6-months, PWV was 902.7±307.0 cm/s in exercisers and 905.4±344.7 in controls, with no group differences (p=ns) or change from baseline in either group (p=ns).
Conclusions: Exercisers achieved a training effect as evidenced by increases in fitness and lean mass and reductions in body fat yet BP remained virtually unchanged. The lack of reduction in arterial stiffness suggests that patients with type 2 diabetes may be resistant to exercise-induced reductions in SBP. Though exercise produced several health benefits, this RCT did not find a reduction in SBP or DBP in patients with type 2 diabetes.
- © 2011 by American Heart Association, Inc.