# Exercise as it relates to Disease/Effect of aerobic and nutritional intervention in overweight, obese and hypertensive adults

This wiki book critiques an article from the European Journal of Preventive Cardiology; Gorostegi-Anduaga, Corres, MartinezAguirre-Betolaza et al. Studying the effects of different aerobic exercises together with nutritional intervention among sedentary adults who are overweight/obese and suffering from hypertension.
This critique is an assignment at the University of Canberra in the unit; Health Disease and Exercise, during semester 2 2019.

## Background to research

Hypertension is a worldwide health problem and it remains steadily rising. The World Health Organisation reported in 2015 it affected 1 in 4 men and 1 in 5 women In 2017-2018 the prevalence of hypertension in Australians was 1 in 10 (2.6 million or 10.6% people) There wasn’t any significant difference between males (10.5%) and females (10.7%). Ultimately this medical condition is a leading cause of premature deaths worldwide.
Hypertension is a medical disease characterised by high blood pressure over a prolonged time. Blood pressure (BP) is the force of the blood being pumped by the heart and ejected into the arteries and circulating the body, High BP is characterised by the presence of high systolic (SBP) this is the first number. Occurs when the heart is contracting and symbolises the pressure of the blood in the blood vessels. A high reading is over 140mmHg and the norm is 120mmHg. Therefore a healthy range for BP is higher than 90/60mmHg and lower than 140/90 mmHg. The second number is the diastolic (DBP) represents the pressure between your heartbeats. Hypertension along with other factors is diagnosed when your BP presents high when tested on two or three consecutive days,

## Where is the research from?

The study was conducted in Vitoria- Gasteiz, Spain. It went on for three years, starting in September 2013 and concluded in June 2016 by Araba University Hospital. This study published in the European Journal of Preventive Cardiology. Even though this study was done in Europe, the research findings are still applicable to Australia.
Some parts in this study were recognised in several different health meetings, one being the 2015 25th European meeting on Hypertension and Cardiovascular protection. This justified the findings.

## What Kind of Research was this?

This was a multi-arm parallel experimental study meaning researchers compared the treatment of aerobic exercise intensities, researchers also used the method of randomisation to assign the participants into these exercise groups. These methods used were appropriate as it eliminates any bias allocation.

## What did the research involve?

A multidisciplinary team of Cardiologist, Nutritionists and a fitness company (for exercise machines) to make up the team that helped do the research.
Participants:
175 non- Hispanic Caucasians; 120 Males and 55 Females. All participants had to meet the requirements of being overweight/obese, sedentary and have hypertension.
Measurements taken: Pre and Post intervention
* Body Mass Index (BMI)
* Blood Pressure (BP)
* Cardio-respiratory fitness
* Dietary Assessment
* Prescribed Medication
Intervention:
16-week aerobic exercise program; training 2 days a week. 4 intervention groups; and 3 out of the 4 were supervised exercise groups, performing different intensity programmers.
* Group 1: Attention Control group (AC)
* Group 2:High-volume moderate-intensity continuous training (MICT)
* Group 3: High-volume of High-intensity Interval Training (HIIT)
* Group 4: Low Volume of HIIT
Each programme was tailored to each participant and A low-calorie diet, tailored to each individual.

## Results

At the beginning of the research, there was no significant difference amongst the groups for anthropometric measures, cardio-respiratory and pharmacological treatments. At the end of the 16-week intervention a difference was seen in both SBP and DBP, mean BP and heart rate decreased. All groups also had an increase in their cardiorespiratory fitness. Changes to BMI, body mass, waist and hip circumference, waist to hip ratio was visible in all groups. Significant changes were seen in the high volume HIIT, and Low Volume HIIT. These results are streamlined with other studies proving that any form of exercise will positively affect risk factors of hypertension.

## Conclusions

Overall the implantation of a regular exercise routine provided to be effective in improving the lifestyle of a person who is overweight, obese and presenting with hypertension. From the research, High volume HIIT exercise sessions showed to have a greater impact out of the three exercise groups. Individuals should also make some lifestyle changes and also combined with exercise the individuals diet should also change. The DASH diet has proven to be effective.
In Conclusion, we gather that it takes a combination of a low-calorie diet and exercise can be used to reduce the risk factors associated with hypertension to improve one's quality of life

## Practical advice

In total roughly 45% of the participants that took part in this study were males, therefore the results are basis favouring for the male population. Further research with a larger and more diverse sample pool is needed to produce more accurate and reliable results.
Furthermore, researchers can tailor their studies focusing on if females and males will get the same benefit from such intervention and exercises. Another area of study should also look into how different ethnic groups will adhere to an intervention like this one.

## Further readings/insights

When left untreated or not controlled, hypertension can result in different health complications and diseases, such as diabetes, kidney failure, heart attack, and stroke.
* Symptoms of Hypertension:,
* Chest pain
* Dizziness
* Severe headaches
* Vision Changes
* Nausea
* Vomiting
Below are some suggested lifestyle changes that can be implemented to reduce risk factors associated with obesity and hypertension.
* Lifestyle Changes
* Quit smoking
* low calorie diet
* Reduced Sodium intake
* Increase physical activity
* Limit Alcohol consumption
Further Readings
* Keep Your Blood Pressure Down
* Heart foundation: Blood Pressure
* Criticted Article
* Diet to help prevent and control hypertension
Please consult and seek medical advice from your GP or medical professional if you think you have or are at risk of developing hypertension.

## References

* ↑ Gorostegi-Anduaga,L et al.(2018) 'Effects Of different aerobic exercise programmes with nutritional Intervention in sedentary adults with overweight/obesity and hypertension.' European Journal of Preventive Cardiology vol 25(4) pp 343-353
* 1 2 3 4 5 6 WHO. (2019) 'Hypertension.' World Health Organization. https://www.who.int/news-room/fact-sheets/detail/hypertension
* ↑ ABS. (2018) 'Hypertension and Measured High Blood Pressure' Australian bureau of Statistics, https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.001~2017-18~Main%20Features~Hypertension%20and%20measured%20high%20blood%20pressure~60
* 1 2 3 Heart Foundation (n.d)'Blood Pressure' https://www.heartfoundation.org.au/your-heart/know-your-risks/blood-pressure
* 1 2 Health Direct (2018) 'What is a healthy Blood pressure' https://www.healthdirect.gov.au/what-is-a-healthy-blood-pressure
* 1 2 Gorostegi-Anduaga,et al.(2018) "Effects of different aerobic programmes with nutritional intervention in sedentary adults with overweight/obesity and hypertension" European Journal of preventive Cardiology
* ↑ Whelton S, Chin A, Xin X, He J, (2002) "Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials" Database of Abstracts of Reviews of Effects (DARE) Available from: https://www.ncbi.nlm.nih.gov/books/NBK69571/
* 1 2 Huang N, Duggan K, (2008) "Lifestyle management of hypertension" Australian Prescriber vol 31 (6) https://www.nps.org.au/australian-prescriber/articles/lifestyle-management-of-hypertension#body-weight
* 1 2 Health Direct (2018) "High blood pressure (hypertension), https://www.healthdirect.gov.au/high-blood-pressure-hypertension