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High versus low-moderate intensity exercise training program as an adjunct to antihypertensive medication: a pilot clinical study
Avila-Gandia V, Sanchez-Macarro M, Luque-Rubia A, Garcia-Sanchez E, Canovas F, Lopez-Santiago A, Lopez-Roman FJ
Journal of Personalized Medicine 2021 Apr;11(4):291
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: In this pilot clinical study we investigated the effect on blood pressure (BP) of two community-based exercise training programs of high (HIT) versus low-moderate intensity (LMIT) in hypertensive individuals receiving at least one antihypertensive drug. METHOD(S): The study included two phases of physical exercises based on 1-h session, 3 days/week for 12 and 16 weeks, respectively, separately by a 7-week resting period. Each phase was preceded by a four-week conditioning training period. According to the average maximal heart rate at baseline, participants were randomized to HIT (80 to 90%), LMIT (50 to 70%) or no-exercise (control). Heart rate was monitored during workout and BP profiles were registered by ambulatory BP monitoring at the beginning and end of each phase. RESULT(S): Of 60 individuals randomized, 44 completed the study (HIT, n = 10; LMIT, n = 16; controls, n = 18). BP levels were significantly reduced after the second phase for both LMIT (SBP -3.1 mmHg, DBP -2.4 mmHg) and HIT (SBP -10.8 mmHg, DBP -8.3 mmHg). Similar levels of improvement were also found in daytime and night-time BP. Mean attendance of the prescribed training sessions was 87.4 +/- 6.2% for HIT and 87.4 +/- 5.3% for LMIT during the first phase and 84.1 +/- 5.0% and 85.2 +/- 5.9% during the second phase, respectively (p = 0.047). CONCLUSION(S): Both HIT and LMIT exercise training programs reduced BP but the HIT modality showed a lower rate of compliance with proposed training schedule. Intensity of training should be individually prescribed to improve tolerance to more high intensity exercises.

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