Clinical trial NCT02937922: Effect of Exercise on Endothelial Injury in Hypertensive Patients
Official title: Effect of Aerobic Exercise, Resistance or Combined in Endothelial Injury in Hypertensive Patients
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Hypertension
Healthy
Keywords: Exercise
Endothelium
Hypertension
Endothelial progenitor cell
Endothelial microparticle
Lead sponsor: Instituto de Cardiologia do Rio Grande do Sul
Sponsor class: OTHER
First posted: 2016-10-19
Enrollment: 33
Sex: ALL
Minimum age (years): 30
Maximum age (years): 59
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: FACTORIAL
Primary purpose: SUPPORTIVE_CARE

Brief summary: Introduction: Endothelial dysfunction precedes atherosclerosis being evidenced in patients with hypertension. Increasing physical activity levels and/or physical exercise are part of the recommendations of antihypertensive therapy. However, the effects of oscillations and/or increase the systemic blood pressure induced by exercise session on endothelial function has not been studied.

Objective: To evaluate the effect of aerobic exercise, resistance exercise and combined exercise on endothelial injury levels in patients with hypertension.

Methodology: Hypertensive (n = 51) and healthy subjects (n = 30) (30-59 years old) will perform at random 40 minutes of aerobic exercise (50-60% of heart rate reserve) or 40 minutes of resistance exercise (4 x 12 repetitions of exercises for lower limbs, 60-70% of one repetition maximum and 60-90 second interval) or 40 minutes of combined exercise (20 minutes of resistance exercise and 20 minutes of aerobic exercise, in that order). Blood will be collected 10 minutes before, 10 and 60 minutes after intervention for the quantification of endothelial microparticles (MPE) circulating (induced endothelial lesion) and endothelial progenitor cells (EPC) circulating (endothelial recovery capacity) by flow cytometry. Ambulatory blood pressure monitoring (ABPM) will be held before and after the intervention. Ultrasonography is used to measure the flow-mediated dilation of the brachial artery 10 minutes before, 10, 30 and 60 minutes after the intervention.

Statistics: generalized estimating equation (GEE) for repeated measurements and Person correlation, being significant p \< 0.05.

It is expected to show results to ensure cardiovascular protection in patients with hypertension caused by different types of exercise and consequent endothelial injury and release induced regenerative factors. Knowledge of the magnitude of injury and endothelial recovery provided by different types of exercise can contribute scientifically to health professionals aimed at prescribing exercise with a vascular protective vision in patients with hypertension.


Eligibility criteria: Inclusion Criteria:

* Adults with hypertension;
* 30 to 59 years old.

Exclusion Criteria:

* Diabetes;
* Heart disease;
* Participating in any regular exercise program over the last six months;
* Orthopedic impairments or any physical or mental limitation that prevents - achievement of physical exercise;
* Body Mass Index in class II obesity or more (BMI ≥ 35 kg / m2);
* Smoking.

Primary outcomes:
measure: Effects of exercise on the percentage of circulating endothelial progenitor cells analyzed by flow cytometry in patients with hypertension
timeFrame: two years
Secondary outcomes:
measure: Effects of exercise on the number of circulating endothelial microparticles analyzed by flow cytometry in patients with hypertension
timeFrame: two years
Other outcomes:
Locations:
Study officials:
References:
citation: Waclawovsky G, Umpierre D, Figueira FR, De Lima ES, Alegretti AP, Schneider L, Matte US, Rodrigues TC, Schaan BD. Exercise on Progenitor Cells in Healthy Subjects and Patients with Type 1 Diabetes. Med Sci Sports Exerc. 2016 Feb;48(2):190-9. doi: 10.1249/MSS.0000000000000764.
citation: Amabile N, Cheng S, Renard JM, Larson MG, Ghorbani A, McCabe E, Griffin G, Guerin C, Ho JE, Shaw SY, Cohen KS, Vasan RS, Tedgui A, Boulanger CM, Wang TJ. Association of circulating endothelial microparticles with cardiometabolic risk factors in the Framingham Heart Study. Eur Heart J. 2014 Nov 7;35(42):2972-9. doi: 10.1093/eurheartj/ehu153. Epub 2014 Apr 16.