Effects on cardiovascular risk scores and vascular age after aerobic exercise and nutritional intervention in sedentary and overweight/obese adults with primary hypertension: the EXERDIET-HTA randomized trial study

Research output: Contribution to journalArticle

Authors

  • Ilargi Gorostegi-anduaga
  • Sara Maldonado-martín
  • Aitor Martinezaguirre-betolaza
  • Pablo Corres
  • Estíbaliz Romaratezabala
  • Silvia Francisco-terreros
  • Javier Pérez-asenjo

Colleges, School and Institutes

Abstract

Introduction: The EXERDIET-HTA study was a multi-arm parallel, a randomized, single-blind controlled experimental trial comparing the effects of 16 weeks of different aerobic exercise programs two days per week, and dietary intervention in a hypertensive, overweight/obese and non-physically active population.

Aim: To evaluate the influence of diet and aerobic exercise program intervention on cardiovascular risk (CVR) factors and predicted CVR and vascular age (VA) profiles in overweight/obese people with primary hypertension (HTN), and to analyze the potential sex differences in the ability to predict VA and CVR via different methods.

Methods: The CVR and VA determined (n = 167, 53.7 ± 7.8 years) using the Framingham Risk Score (FRS) and the new equation for the prediction of 10-year atherosclerotic cardiovascular disease (ASCVD) risk, before and after the 16-week intervention period (different aerobic exercise programs + hypocaloric diet). The sex-specific risk factors considered were age, high-density lipoprotein cholesterol (HDL-C), total cholesterol, systolic blood pressure (SBP), diabetes mellitus (DM) and smoking status.

Results: From baseline to follow-up, participants reduced (p ≤ 0.001) FRS-CVR score and VA, and SBP. Total cholesterol decreased significantly, but specifically in men (p ≤ 0.001), and antihypertensive medication (%) in women (p = 0.047). No significant differences over time were observed for HDL-C, smoking, DM overall for either sex. For ASCVD-CVR there was no overall change or for either sex. After the intervention, women had a lower CVR score than men (p ≤ 0.001), irrespective of the calculation method.

Conclusions: The improvement in CVR factors after 16-week lifestyle changes reduced the risk of suffering a cardiovascular event in overweight/obese adults with HTN through the FRS estimation tool, but not with the ASCVD score. The risk score algorithms could underestimate CVR in women. In contrast, VA could be a useful and easier tool in the management of individuals with CVR factors.

Details

Original languageEnglish
Pages (from-to)361-368
Number of pages8
JournalHigh Blood Pressure and Cardiovascular Prevention
Volume25
Issue number4
Early online date24 Sep 2018
Publication statusPublished - Dec 2018

Keywords

  • Lifestyle intervention, Gender, Systolic blood pressure, Vascular age, Cardiovascular risk score, Obesity, Overweight