Abstract MP027: Systolic Blood Pressure Reduction with Diet and Exercise is Attenuated in Diabetes
Background: Type 2 diabetes (T2DM) and prediabetes (preDM) are insulin resistant conditions associated with being overweight or obese. Increased BP and excessive abdominal fat further increase the risk of cardiovascular disease in these conditions. Exercise reduces BP and abdominal fat independent of weight loss. We hypothesized that a weight loss diet plus supervised exercise training will produce greater reductions in BP and abdominal fat than diet alone in individuals with T2DM and preDM.
Methods: This prospective clinical trial randomized persons aged 35–65 yrs with T2DM or preDM to 6-months of either an American Diabetes Association weight loss diet (D); or D combined with supervised moderate-intensity aerobic and resistance exercise training 3 times per week (D+E). Diabetes was defined as having fasting glucose ≥ 126 mg/dl or currently on oral hypoglycemic medication. Prediabetes was defined as having fasting glucose between 100 and 125 mg/dL.
Results: Fifty five participants (55.9 ± 7.3 years; 27 T2DM, 28 preDM) completed the study (24 D; 31 D+E). At baseline, there were no group differences in the following, and the combined values (mean ± SD) are: body weight (96.8 ± 16.1 kg), BP (126.7 ± 14.3 / 73.0 ± 8.4 mmHg) and total abdominal fat (711.9 ± 143.5 g) as measured by magnetic resonance imaging. At 6 months, reductions from baseline were observed in both groups for body weight (D: −6.1 ± 3.7 %; D+E: −6.9 ± 4.1 %), BP (D:−7.7 ± 13.1 / −5.7 ± 7.1 mmHg; D+E: −8.8 ± 17.1 / −4.6 ± 9.2 mmHg) and abdominal fat (D: −102.0 ± 68.6 g; D+E: ± −98.7 ± 72.7 g) (all p-values < 0.01 for change from baseline ). No differences in the change from baseline for these outcomes were observed between groups. Across the entire cohort, participants with T2DM versus preDM had an attenuated reduction in SBP (−4.1 ± 11.4 mmHg vs. −12.3 ± 17.7 mmHg p<0.05), whereas achieved weight loss or abdominal fat loss did not differ by diabetes status. Change in SBP did not correlate with the change in body weight (r=0.04, p=0.79) or abdominal fat (r=0.06, p=0.73).
Conclusions: Contrary to our hypothesis, adding exercise to diet did not further reduce SBP or abdominal fat. A novel finding that emerged from these data is that despite similar weight loss with both programs, the mean reduction in SBP was approximately 7 mmHg less in T2DM compared to those with preDM. These data suggest that the factors responsible for improved BP with diet and exercise extend beyond total body weight lost or changes in central obesity, and that these factors may be modified with T2DM.
- © 2012 by American Heart Association, Inc.