Combined aerobic and resistance training: are there additional benefits for older hypertensive adults?

OBJECTIVES:: The objective of this study was to compare the effects of a combination of aerobic and resistance training to those of isolated aerobic training on blood pressure, body composition, and insulin sensitivity in hypertensive older adults. METHOD:: Forty-four patients were randomly assigned to the aerobic group, resistance and aerobic group, and control group. Before and after 10 weeks, the following data were obtained: 24-hour ambulatory blood pressure data, abdominal circumference, waist circumference, body mass index, lean mass, fat mass, and insulin sensitivity. The study was conducted with 3 training sessions per week. RESULTS:: Comparison revealed significant reductions in the body mass index, abdominal and waist circumferences, and ambulatory blood pressure (24-hour, wakefulness and sleep systolic/diastolic blood pressures) in both the aerobic group and the resistance and aerobic (combined) group. The fat mass only changed in the combined group. There was no difference in the insulin sensitivity in any group. CONCLUSIONS:: The combined treatment and aerobic treatment alone were equally effective in reducing the blood pressure, body mass index, and abdominal and waist circumferences, although the addition of the resistance component also helped reduce the fat mass.

Effect of aerobic training and aerobic and resistance training on the inflammatory status of hypertensive older adults.

There is a relationship between high levels of inflammatory markers and low adhesion to the practice of physical activity in the older population. The objective of the present study was to compare the effect of two types of exercise programs, i.e., aerobic training and aerobic plus resistance training on the plasma levels of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) of elderly hypertensive subjects. Hypertensive older volunteers in use of antihypertensive drugs were randomized to three groups: aerobic group (AG), resistance and aerobic group (RAG) and control group (CG). Training lasted 10 weeks, with sessions held three times a week. Blood samples were collected before training and 24 h after completion of the 30 sessions for the determination of serum IL-6 and TNF-α levels. Body mass index was obtained before and after 10 weeks. After intervention, BMI values were lower in AG and RAG compared to CG (p < 0.001), IL-6 was reduced in AG compared to CG (p = 0.04), and TNF-α levels were lower only in RAG compared to CG (p = 0.01). Concluding, both types of training were effective in reducing BMI values in hypertensive older subjects. Aerobic exercise produced the reduction of plasma IL-6 levels. However, the combination of aerobic and resistance exercise, which would be more indicated for the prevention of loss of functionality with aging, showed lower TNF-α mediator after training than control group and a greater fall of TNF-α levels associated to higher BMI reduction.

The effect of different volumes of acute resistance exercise on elderly individuals with treated hypertension.

Acute resistance exercise can reduce the blood pressure (BP) of hypertensive subjects. The aim of this study was to evaluate the effect of different volumes of acute low-intensity resistance exercise over the magnitude and the extent of BP changes in treated hypertensive elderly individuals. Sixteen participants (7 men, 9 women), with mean age of 68 ± 5 years, performed 3 independent randomized sessions: Control (C: 40 minutes of rest), Exercise 1 (E1: 20 minutes, 1 lap in the circuit), and Exercise 2 (E2: 40 minutes, 2 laps in the circuit) with the intensity of 40% of 1 repetition maximum. Blood pressure was measured before (during 20 minutes) and after each session (every 5 minutes during 60 minutes) using both a mercury sphygmomanometer and a semiautomatic device (Omrom-HEM-431). After that, 24-hour ambulatory blood pressure monitoring was performed (Dyna-MAPA). Blood pressure decreased during the first 60 minutes (systolic: p < 0.01, diastolic: p < 0.05) after all exercise sessions. Only the highest volume session promoted a reduction of mean systolic 24-hour BP and awake BP (p < 0.05) after exercise, with higher diastolic BP during sleep (p < 0.05). Diastolic 24-hour BP and both systolic and diastolic BP during sleep were higher after E1 (p < 0.05). Concluding, acute resistive exercise sessions in a circuit with different volumes reduced BP during the first 60 minutes after exercise in elderly individuals with treated hypertension. However, only the highest volume promoted a reduction of mean 24-hour and awake systolic BP.

O papel do exercício físico na pressão arterial em idosos / The role of the physical exercise on blood pressure in older individuals

Está bem estabelecido que a pressão arterial (PA) aumenta como envelhecimento. Os exercícios físicos (EF), sejam agudos ou crônicos, podem promover alterações cardiovasculares, como redução da PA no repouso e em cargas submáximas de esforço. O efeito na PA tem sido observado com medidas casuais e por meio da monitorização ambulatorial da PA (MAPA). Além disso, o EF tem sido proposto como estratégia para prevenção, tratamento e controle da hipertensão arterial, com redução de outros fatores de risco para doenças cardiovasculares. Entretanto, existem poucas evidências em relação ao efeito do exercício nesta população, bem como escassa informação sobre a interação entre exercício e drogas terapêuticas utilizadas para hipertensão. Várias classes de medicamentos podem ser recomendadas para iniciar a terapia anti-hipertensiva, como diuréticos, antagonistas dos canais de cálcio, inibidores da enzima conversora da angiotensina e antagonistas dos receptores da angiotensina II. Entretanto, os betabloqueadores não são recomendados para a primeira linha de tratamento em pacientes hipertensos idosos, particularmente naqueles que se exercitam, por causa da redução do desempenho durante atividade física programada. Neste estudo serão abordados os efeitos agudo (única sessão) e crônico (período de treinamento) do EF na PA de indivíduos idosos.

It is well established that the blood pressure (BP) increases with aging. The physical exercise, acute or chronic, can promote cardiovascular changes as BP reductionin the rest and during sub maximal loads effort. The effecton BP have been observed by casual measurements and using the ambulatory BP monitoring. In addition, the physical exercise has been proposed as a strategy for hypertension prevention, treatment and control, reducing other risk factors for cardiovascular diseases. However, there are few evidences regarding the exercise effecton BP in this population, as well rare information about the interaction between exercise and therapeutic drugs to hypertension. Several classes of medications can be recommended to start anti-hypertensive treatment: diuretics, calcium antagonists, inhibitors of angiotensin converting enzyme, and angiotensin II receptor blockers. However, the beta-blockers are not recommended to the first line treatment of elderly patients, particularly to individuals who execute exercises, since they reduce the performance during planned physical activity. In this manuscript it will be described the acute, (single session) and chronic (training period) effect of physical exercise on BP of elderly individuals.