Effects on Cardiovascular Risk Scores and Vascular Age After Aerobic Exercise and Nutritional Intervention in Sedentary and Overweight/Obese Adults with Primary Hypertension: The EXERDIET-HTA Randomized Trial Study
The EXERDIET-HTA study was a multi-arm parallel, a randomized, single-blind controlled experimental trial comparing the effects of 16 weeks of different aerobic exercise programs two days per week, and dietary intervention in a hypertensive, overweight/obese and non-physically active population.
To evaluate the influence of diet and aerobic exercise program intervention on cardiovascular risk (CVR) factors and predicted CVR and vascular age (VA) profiles in overweight/obese people with primary hypertension (HTN), and to analyze the potential sex differences in the ability to predict VA and CVR via different methods.
The CVR and VA determined (n = 167, 53.7 ± 7.8 years) using the Framingham Risk Score (FRS) and the new equation for the prediction of 10-year atherosclerotic cardiovascular disease (ASCVD) risk, before and after the 16-week intervention period (different aerobic exercise programs + hypocaloric diet). The sex-specific risk factors considered were age, high-density lipoprotein cholesterol (HDL-C), total cholesterol, systolic blood pressure (SBP), diabetes mellitus (DM) and smoking status.
From baseline to follow-up, participants reduced (p ≤ 0.001) FRS-CVR score and VA, and SBP. Total cholesterol decreased significantly, but specifically in men (p ≤ 0.001), and antihypertensive medication (%) in women (p = 0.047). No significant differences over time were observed for HDL-C, smoking, DM overall for either sex. For ASCVD-CVR there was no overall change or for either sex. After the intervention, women had a lower CVR score than men (p ≤ 0.001), irrespective of the calculation method.
The improvement in CVR factors after 16-week lifestyle changes reduced the risk of suffering a cardiovascular event in overweight/obese adults with HTN through the FRS estimation tool, but not with the ASCVD score. The risk score algorithms could underestimate CVR in women. In contrast, VA could be a useful and easier tool in the management of individuals with CVR factors.
KeywordsLifestyle intervention Gender Systolic blood pressure Vascular age Cardiovascular risk score Obesity Overweight
Our special thanks to G. Rodrigo Aispuru, the medical doctor who has taken part in this project with medical assessment. Also thanks to Exercycle S.L. (BH Fitness Company) for the machines donated to conduct the exercise intervention. Last but not least to all undergraduate students who collaborated in this project (2011–2017 academic years).
Compliance with Ethical Standards
This work was supported by the University of the Basque Country (EHU14/08, PPGA18/15) and the Government of the Basque Country supported IGA, AMAB, and PC with predoctoral grants.
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
All participants provided written informed consent prior to any data collection.
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