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Purpose: A hypertensive response to exercise (HRE) is common in patients with type 2 diabetes and is associated with increased left ventricular (LV) mass and mortality. This study aimed to determine whether lifestyle modification would improve exercise blood pressure (BP) and reduce LV mass in patients with type 2 diabetes. Methods: One hundred and eighty-five patients with type 2 diabetes were randomized to 1 yr of lifestyle intervention (n = 97, mean T SD age = 54.7 T 11.3 yr, 51% men) or usual care (control; n = 88, age = 53.8 T 8.1 yr, 61% men). Brachial BP was measured at rest and during a graded maximal exercise test at baseline and 1 yr. Patients also underwent two-dimensional echocardiography to determine LV dimensions. A subgroup of 61 patients had resting and exercise central BP estimated from radial tonometry. An HRE was defined as a maximal exercise systolic BP of Q210 mm Hg for men and Q190 mm Hg for women. Results: At study entry, there were 101 patients (55%) with an HRE (n = 51 controls). Compared with controls, lifestyle intervention significantly reduced the propensity to develop an HRE in those participants who did not have HRE at baseline (29.8% vs 59.5%, P = 0.006). However, absolute values of exercise and resting (brachial and central) BP and LV mass were not significantly changed (all P values 9 0.05). There were significant (all P values G 0.05) improvements inVÿ O2max, body mass index, plasma glucose, insulin resistance, and HDL cholesterol after lifestyle intervention compared with control. Conclusions: Lifestyle intervention significantly attenuates the development of an HRE but does not reduce cardiac size after 1 yr in patients with type 2 diabetes.

Item Type:	Refereed Article
Keywords:	Lifestyle modification; exercise; blood pressure; hypertension
Research Division:	Medical and Health Sciences
Research Group:	Cardiorespiratory Medicine and Haematology
Research Field:	Cardiology (incl. Cardiovascular Diseases)
Objective Division:	Health
Objective Group:	Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:	Cardiovascular System and Diseases
Author:	Schultz, MG (Dr Martin Schultz)
Author:	Marwick, TH (Professor Tom Marwick)
Author:	Sharman, JE (Professor James Sharman)
ID Code:	69754
Year Published:	2011
Web of Science® Times Cited:	11
Deposited By:	Menzies Institute for Medical Research
Deposited On:	2011-05-17
Last Modified:	2014-05-05
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