Journal of General Internal Medicine

, Volume 27, Issue 11, pp 1453–1459 | Cite as

Effect of Exercise on Blood Pressure in Type 2 Diabetes: A Randomized Controlled Trial

  • Devon A. Dobrosielski
  • Bethany Barone Gibbs
  • Pamela Ouyang
  • Susanne Bonekamp
  • Jeanne M. Clark
  • Nae-Yuh Wang
  • Harry A. Silber
  • Edward P. Shapiro
  • Kerry J. Stewart
Original Research

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.

KEY WORDS

exercise training diabetes high blood pressure randomized trial 

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Copyright information

© Society of General Internal Medicine 2012

Authors and Affiliations

  • Devon A. Dobrosielski
    • 1
  • Bethany Barone Gibbs
    • 2
  • Pamela Ouyang
    • 1
  • Susanne Bonekamp
    • 3
  • Jeanne M. Clark
    • 4
    • 5
  • Nae-Yuh Wang
    • 4
    • 6
  • Harry A. Silber
    • 1
  • Edward P. Shapiro
    • 1
  • Kerry J. Stewart
    • 1
  1. 1.Department of Medicine, Division of CardiologyThe Johns Hopkins School of MedicineBaltimoreUSA
  2. 2.Department of Health and Physical ActivityUniversity of PittsburghPittsburghUSA
  3. 3.Department of RadiologyThe Johns Hopkins School of MedicineBaltimoreUSA
  4. 4.Department of Medicine, Division of General Internal MedicineThe Johns Hopkins School of MedicineBaltimoreUSA
  5. 5.Department of EpidemiologyThe Johns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  6. 6.Department of BiostatisticsThe Johns Hopkins Bloomberg School of Public HealthBaltimoreUSA

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