Abstract 19037: Exercise Reduces 24-hr Blood Pressure and Albuminuria in Patients with Moderate Diabetic Kidney Disease
Introduction: Observational studies have shown an inverse association between physical function and CVD mortality in patients with chronic kidney disease (CKD) through unknown mechanisms. We have previously reported a significant exercise-induced reduction in resting blood pressure (BP) in 85 patients with stage 2-4 type 2 diabetes related CKD (DKD). The efficacy of exercise to reduce 24-hour ambulatory blood pressure (ABP) and albumin-creatinine ratio (ACR) is unclear. The purpose of this study was to test the hypothesis that 12wks of exercise would reduce 24-hr ABP and ACR in patients with stage 3-4 DKD and hypertension, compared to the control group.
Methods: We randomly assigned 28 participants (21 male, age 62.9 yrs, BMI 34.8 kg/m2) with stage 3-4 DKD and hypertension (141(17)/75 (10) mmHg) to either 12-wks of moderate-intensity exercise training, 4x/wk for 45 minutes (n=15) or a usual medical care control group (n=13). The primary endpoint was change in 24-hr ABP at 12-wks.
Results: There were no significant differences between groups in baseline demographic or medical variables. There were no changes in pharmacological variables at 12-week follow-up; group comparisons were analyzed by ANCOVA using baseline and exercise performed as covariates. Systolic BP levels and ACR were significantly reduced in the exercise-intervention group compared to the control group (Table 1). Reductions in diastolic BP levels were not significant between groups. Heart rate variables did not differ between groups. There was a strong inverse association between change in aerobic capacity and change in systolic and diastolic BP levels in the exercise group only (r=-.56, p=.039, and -.66, p=.011).
Conclusion: This study suggests that exercise training imparts a favorable modulation of BP levels and ACR in patients with stage 3-4 DKD, potentially providing insight into the cardioprotective effect of exercise in this population.
Author Disclosures: U.G. Bronas: Research Grant; Significant; NIH-NIDDK Grant Support. M. Weber: None. P. Drawz: None. J. Bantle: None. D. Duprez: None. M. Rosenberg: None.
- © 2014 by American Heart Association, Inc.