Abstract
Purpose
To examine the effects of intermittent hypoxic breathing at rest (IHR) or during exercise (IHT) on blood pressure and nitric oxide metabolites (NOx) and hypoxia-inducible factor-1 alpha levels (HIF-1α) over a 6-week period.
Methods
47 hypertensive patients were randomly allocated to three groups: hypertensive control (CON: n = 17; IHR: n = 15 and IHT: n = 15. The CON received no intervention; whereas, IH groups received eight events of hypoxia (FIO2 0.14), and normoxia (FIO2 0.21), 24-min hypoxia and 24-min normoxia, for 6 weeks. The baseline data were collected 2 days before the intervention; while, the post-test data were collected at days 2 and 28 after the 6-week intervention.
Results
We observed a significant decrease of the SBP in both IH groups: IHR (− 12.0 ± 8.0 mmHg, p = 0.004 and − 9.9 ± 8.8 mmHg, p = 0.028, mean ± 95% CI) and IHT (− 13.0 ± 7.8 mmHg, p = 0.002 and − 10.0 ± 8.4 mmHg, p = 0.016) at days 2 and 28 post-intervention, respectively. Compared to CON, IHR and IHT had increased of NOx (IHR; 8.5 ± 7.6 μmol/L, p = 0.031 and IHT; 20.0 ± 9.1 μmol/L, p < 0.001) and HIF-1α (IHR; 170.0 ± 100.0 pg/mL, p = 0.002 and IHT; 340.5 ± 160.0 pg/mL, p < 0.001). At 2 days post-intervention, NOx and HIF-1α were negatively correlated with SBP in IHT.
Conclusion
IH programs may act as an alternative therapeutic strategy for hypertension patients probably through elevation of NOx and HIF-1α production.
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Abbreviations
- ATS:
-
American Thoracic Society
- CI:
-
Confidence interval
- EDTA:
-
Ethylenediaminetetraacetic acid
- FIO2 :
-
Fraction inspired of oxygen
- GEE:
-
Generalized estimating equation model
- HIF-1α:
-
Hypoxia-inducible factor-1 alpha levels
- IHR:
-
Intermittent hypoxic breathing at rest
- IHT:
-
Intermittent hypoxic training
- JNC 8:
-
The Eighth Joint National Committee
- MDA:
-
Malondialdehyde
- MWT:
-
Minute walk test
- MWCO:
-
Molecular weight cut-off
- MWD:
-
Minute walk distance
- NOx:
-
Nitric oxide metabolites
- RPD:
-
Rating of perceived of dyspnea
- RPE:
-
Rating of perceived of exertion
- TMB:
-
Tetramethylbenzidine
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Acknowledgements
The authors would like to thank all patients for their valuable time. We would like to thank the Exercise and Sport Sciences Developing and Research Group to support the biochemistry laboratory.
Funding
The study was financially supported by grants from the Khon Kaen University in collaboration with the National Research Council of Thailand (NRCT) and an Invitation Research Grant (Grant number IN61142), Faculty of Medicine, Khon Kaen University. Miss Nattha Muangritdech was partly supported by a Postgraduate Study Support Grant of Faculty of Medicine, Khon Kaen University, Thailand.
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NM (first author) and AM conceived and designed the trial. NM (first author), PP, WS, KS, NM conducted experiments. PP performed the molecular laboratory tests, PW provided support throughout the experiment. NM and AM analyzed data. NM, AM and HM wrote the manuscript. All authors read and edited manuscript. AM and HM approved the final version of manuscript for publication.
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Communicated by I. Mark Olfert.
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Muangritdech, N., Hamlin, M.J., Sawanyawisuth, K. et al. Hypoxic training improves blood pressure, nitric oxide and hypoxia-inducible factor-1 alpha in hypertensive patients. Eur J Appl Physiol 120, 1815–1826 (2020). https://doi.org/10.1007/s00421-020-04410-9
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DOI: https://doi.org/10.1007/s00421-020-04410-9