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Lifestyle Change Diminishes a Hypertensive Response to Exercise in Type 2 Diabetes
journal contribution
posted on 2023-05-17, 06:10 authored by Martin SchultzMartin Schultz, Hordern, MD, Leano, R, Coombes, JS, Thomas MarwickThomas Marwick, James SharmanJames SharmanPurpose: 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.
History
Publication title
Medicine and Science in Sports and ExerciseVolume
43Issue
5Pagination
764-769ISSN
0195-9131Department/School
Menzies Institute for Medical ResearchPublisher
Lippincott Williams & WilkinsPlace of publication
530 Walnut St, Philadelphia, USA, Pa, 19106-3621Rights statement
Copyright © 2011 Lippincott Williams & WilkinsRepository Status
- Restricted