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Effect of exercise on blood pressure in type 2 diabetes: a randomized controlled trial.
J Gen Intern Med. 2012 Nov; 27(11):1453-9.JG

Abstract

BACKGROUND

Increased blood pressure (BP) in type 2 diabetes (T2DM) markedly increases cardiovascular disease morbidity and mortality risk compared to having increased BP alone.

OBJECTIVE

To investigate whether exercise reduces suboptimal levels of untreated suboptimal BP or treated hypertension.

DESIGN

Prospective, randomized controlled trial for 6 months.

SETTING

Single center in Baltimore, MD, USA.

PATIENTS

140 participants with T2DM not requiring insulin and untreated SBP of 120-159 or DBP of 85-99 mmHg, or, if being treated for hypertension, any SBP <159 mmHg or DBP<99 mmHg; 114 completed the study.

INTERVENTION

Supervised exercise, 3 times per week for 6 months compared with general advice about physical activity.

MEASUREMENTS

Resting SBP and DBP (primary outcome); diabetes status, arterial stiffness assessed as carotid-femoral pulse-wave velocity (PWV), body composition and fitness (secondary outcomes).

RESULTS

Overall baseline BP was 126.8 ± 13.5 / 71.7 ± 9.0 mmHg, with no group differences. At 6 months, BP was unchanged from baseline in either group, BP 125.8 ± 13.2 / 70.7 ± 8.8 mmHg in controls; and 126.0 ± 14.2 / 70.3 ± 9.0 mmHg in exercisers, despite attaining a training effects as evidenced by increased aerobic and strength fitness and lean mass and reduced fat mass (all p<0.05), Overall baseline PWV was 959.9 ± 333.1 cm/s, with no group difference. At 6-months, PWV did not change and was not different between group; exercisers, 923.7 ± 319.8 cm/s, 905.5 ± 344.7, controls.

LIMITATIONS

A completion rate of 81 %.

CONCLUSIONS

Though exercisers improve fitness and body composition, there were no reductions in BP. The lack of change in arterial stiffness suggests a resistance to exercise-induced BP reduction in persons with T2DM.

Authors+Show Affiliations

Department of Medicine, Division of Cardiology, The Johns Hopkins School of Medicine, 4940 Eastern Avenue, Baltimore, MD, 21204, USA. ddobros1@jhmi.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

22610907

Citation

Dobrosielski, Devon A., et al. "Effect of Exercise On Blood Pressure in Type 2 Diabetes: a Randomized Controlled Trial." Journal of General Internal Medicine, vol. 27, no. 11, 2012, pp. 1453-9.
Dobrosielski DA, Gibbs BB, Ouyang P, et al. Effect of exercise on blood pressure in type 2 diabetes: a randomized controlled trial. J Gen Intern Med. 2012;27(11):1453-9.
Dobrosielski, D. A., Gibbs, B. B., Ouyang, P., Bonekamp, S., Clark, J. M., Wang, N. Y., Silber, H. A., Shapiro, E. P., & Stewart, K. J. (2012). Effect of exercise on blood pressure in type 2 diabetes: a randomized controlled trial. Journal of General Internal Medicine, 27(11), 1453-9. https://doi.org/10.1007/s11606-012-2103-8
Dobrosielski DA, et al. Effect of Exercise On Blood Pressure in Type 2 Diabetes: a Randomized Controlled Trial. J Gen Intern Med. 2012;27(11):1453-9. PubMed PMID: 22610907.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of exercise on blood pressure in type 2 diabetes: a randomized controlled trial. AU - Dobrosielski,Devon A, AU - Gibbs,Bethany Barone, AU - Ouyang,Pamela, AU - Bonekamp,Susanne, AU - Clark,Jeanne M, AU - Wang,Nae-Yuh, AU - Silber,Harry A, AU - Shapiro,Edward P, AU - Stewart,Kerry J, Y1 - 2012/05/19/ PY - 2011/12/30/received PY - 2012/04/19/accepted PY - 2012/03/06/revised PY - 2012/5/22/entrez PY - 2012/5/23/pubmed PY - 2013/4/23/medline SP - 1453 EP - 9 JF - Journal of general internal medicine JO - J Gen Intern Med VL - 27 IS - 11 N2 - BACKGROUND: Increased blood pressure (BP) in type 2 diabetes (T2DM) markedly increases cardiovascular disease morbidity and mortality risk compared to having increased BP alone. OBJECTIVE: To investigate whether exercise reduces suboptimal levels of untreated suboptimal BP or treated hypertension. DESIGN: Prospective, randomized controlled trial for 6 months. SETTING: Single center in Baltimore, MD, USA. PATIENTS: 140 participants with T2DM not requiring insulin and untreated SBP of 120-159 or DBP of 85-99 mmHg, or, if being treated for hypertension, any SBP <159 mmHg or DBP<99 mmHg; 114 completed the study. INTERVENTION: Supervised exercise, 3 times per week for 6 months compared with general advice about physical activity. MEASUREMENTS: Resting SBP and DBP (primary outcome); diabetes status, arterial stiffness assessed as carotid-femoral pulse-wave velocity (PWV), body composition and fitness (secondary outcomes). RESULTS: Overall baseline BP was 126.8 ± 13.5 / 71.7 ± 9.0 mmHg, with no group differences. At 6 months, BP was unchanged from baseline in either group, BP 125.8 ± 13.2 / 70.7 ± 8.8 mmHg in controls; and 126.0 ± 14.2 / 70.3 ± 9.0 mmHg in exercisers, despite attaining a training effects as evidenced by increased aerobic and strength fitness and lean mass and reduced fat mass (all p<0.05), Overall baseline PWV was 959.9 ± 333.1 cm/s, with no group difference. At 6-months, PWV did not change and was not different between group; exercisers, 923.7 ± 319.8 cm/s, 905.5 ± 344.7, controls. LIMITATIONS: A completion rate of 81 %. CONCLUSIONS: Though exercisers improve fitness and body composition, there were no reductions in BP. The lack of change in arterial stiffness suggests a resistance to exercise-induced BP reduction in persons with T2DM. SN - 1525-1497 UR - https://www.unboundmedicine.com/medline/citation/22610907/Effect_of_exercise_on_blood_pressure_in_type_2_diabetes:_a_randomized_controlled_trial_ L2 - https://dx.doi.org/10.1007/s11606-012-2103-8 DB - PRIME DP - Unbound Medicine ER -