- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03780309
Postexercise Hypotension and Exercise Adherence
October 30, 2023 updated by: Linda Pescatello, University of Connecticut
Using the Immediate Blood Pressure Benefits of Exercise to Improve Exercise Adherence Among Adults With Hypertension
Sedentary (n=24) adults ≥18 yr with elevated BP to established hypertension were enrolled into this randomized clinical trial entitled, 'Blood Pressure UtiLizing Self-Monitoring after Exercise study or PULSE'.
Participants were randomly assigned to either an exercise only (EXERCISE; n=12) or exercise plus BP self-monitoring (EXERCISE+PEH) (n=12) group.
All participants participated in a 12 wk supervised moderate intensity aerobic exercise training program 40 min/d for 3 d/wk.
In addition, they were encouraged to exercise at home ≥30 min/d for 1-2 d/wk.
All participants self-monitored exercise with a traditional calendar recording method and heart rate (HR) monitor.
In addition to traditional exercise self-monitoring (EXERCISE), individuals in the EXERCISE+PEH group were given a home BP monitor to assess home BP twice daily (in the morning upon awakening and in the evening) and prior to and after voluntary home exercise sessions.
Resting BP, peak oxygen consumption (VO2peak), physical activity, dietary and salt intake, and antihypertensive medication adherence were measured before and after the 12 wk supervised exercise training program.
In addition, integrated social-cognitive predictors of exercise that included questionnaires on exercise self-efficacy, barriers self-efficacy, outcome expectations for exercise, exercise intention, and affective responses to exercise were measured before and after the 12 wk supervised exercise training program.
Four weeks following the completion of exercise training, self-reported exercise levels were assessed during a telephone interview in both groups.
Among EXERCISE+PEH only, self-monitoring of BP was also self-reported during this telephone interview.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
A sub-study following the completion of the PULSE clinical trial investigated the reliability and time course of change of PEH during the 12-week exercise training program.
Participants (n = 10) were PEH responders from the EXERCISE + PEH control arm who underwent 12 wk of supervised aerobic exercise training, 40 min/session at moderate-to-vigorous intensity for 3 d/wk.
BP was assessed via a home BP monitor.
PEH was calculated as post- minus pre-exercise BP for 36 sessions.
To quantify the reliability of PEH, RMANCOVA and GRMANCOVA adjusted for pre-exercise BP derived the between-participant and measurement error variability that were used to calculate the intraclass correlation coefficient (ICC).
The Akaike Information Criterion (AIC) compared the goodness-of-fit of the PEH models for each week of training.
Study Type
Interventional
Enrollment (Actual)
24
Phase
- Not Applicable
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
Yes
Description
Inclusion Criteria:
- ≥18 yr
- SBP ≥130 mmHg or DBP ≥80 mmHg or taking antihypertensive medication regardless of BP with a SBP <160 mmHg and DBP <100 mmHg
- Free of diagnosed cardiovascular, pulmonary, renal, metabolic, or other chronic diseases or depression
- Non-smokers for at least 6 mo prior to entry
- Consumed <2 alcoholic drinks daily
- Physically inactive defined as engaging in formal exercise ≤ 2d/wk.
Exclusion Criteria:
- Taking medications that influenced blood pressure such as inhaled or oral steroids, nonsteroidal anti-inflammatory agents, aspirin, and nutritional supplements with the exception of a 1-a-day vitamin, cold medications, and herbal supplements
- Osteoarthritis and orthopedic problems that compromised ability to exercise.
- Past medical history of cancer-related lymphedema
- Seeking to gain or lose weight
- Pregnant, lactating, or planning to become pregnant.
- Hormone-altering contraception administered in a bolus
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: EXERCISE
Participants participated in a the exercise training program and engaged in exercise self-monitoring.
|
Participants engaged in exercise self-monitoring utilizing a traditional calendar recording method and heart rate monitor.
|
Experimental: EXERCISE+PEH
Participants participated in the exercise training program and engaged in exercise self-monitoring and blood pressure self-monitoring (daily and before and after exercise).
|
Participants engaged in exercise self-monitoring utilizing a traditional calendar recording method and heart rate monitor.
Participants engaged in blood pressure self-monitoring by measuring blood pressure twice daily and before and after exercise.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Exercise Adherence
Time Frame: 12 weeks
|
Exercise adherence to the 12 wk supervised portion of the aerobic exercise training program was calculated as the percent of supervised exercise sessions completed divided by the total number of supervised sessions possible (# of supervised sessions performed ÷ total number of possible supervised sessions X 100%).
In this calculation, the total number of possible sessions was calculated as: 3 supervised exercise training days per wk for 12 wk = 36 sessions with a maximum possible adherence of 100% (e.g., 36÷36 X 100% =100%).
|
12 weeks
|
Blood Pressure Response to Exercise Training
Time Frame: 12 weeks
|
The BP response to aerobic exercise training was calculated in two ways and in units 'mmHg': (1) in the laboratory (post training resting BP - pre training resting BP) during the control visits (Visits 1 or 2 vs. Visit 4 or 5); and (2) under ambulatory conditions (post training ambulatory BP - pre training ambulatory BP) following the control visits (Visits 1 or 2 vs. Visit 4 or 5) over the awake, sleep, and 19 hr.
|
12 weeks
|
Blood Pressure Response to Each Exercise Training Session
Time Frame: 12 weeks
|
In the sub study analysis, the difference in post- minus pre-exercise resting BP from three weekly exercise sessions per participant for each week of training was calculated for both SBP and DBP (in units of 'mmHg')
|
12 weeks
|
Relative Change in Blood Pressure From Baseline for Each Exercise Session
Time Frame: 12 weeks
|
The relative percent change in BP for each exercise session was calculated as post- minus pre-exercise BP divided by pre-exercise BP x 100%, for each exercise training session for both SBP and DBP.
A negative percent change in SBP and/or DBP from baseline was deemed that postexercise hypotension occurred.
|
12 weeks
|
Reliability of Postexercise Hypotension
Time Frame: 12 weeks
|
To quantify the reliability of postexercise hypotension, RMANCOVA and GRMANCOVA adjusted for pre-exercise BP derived the between-participant and measurement error variability that were used to calculate the intraclass correlation coefficient (unit-less)
|
12 weeks
|
Time Course of Change in the Magnitude of Postexercise Hypotension
Time Frame: 12 wk
|
The Akaike Information Criterion (unit-less) was calculated to compare the goodness-of-fit of the postexercise hypotension models for each week of training and to determine the week of exercise training after which the the magnitude of reductions in SBP and DBP ceased to differ week-to-week.
|
12 wk
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Exercise Training Characteristics: Frequency
Time Frame: 12 weeks
|
Exercise training frequency (d/wk) was recorded for supervised, unsupervised, and supervised plus unsupervised exercise training over the course of 12wk.
|
12 weeks
|
Exercise Training Characteristics: Intensity
Time Frame: 12 weeks
|
Exercise training intensity (%heart rate reserve) was recorded for supervised, unsupervised, and supervised plus unsupervised exercise training over the course of 12wk.
|
12 weeks
|
Exercise Training Characteristics: Time
Time Frame: 12 weeks
|
Exercise training time (min) was recorded for supervised, unsupervised, and supervised plus unsupervised exercise training over the course of 12wk.
|
12 weeks
|
Exercise Training Characteristics: Type
Time Frame: 12 weeks
|
Exercise training type (treadmill, cycle ergometer, elliptical) was recorded for unsupervised, and supervised plus unsupervised exercise training over the course of 12wk.
|
12 weeks
|
Integrated social-cognitive predictor of exercise
Time Frame: 12 weeks
|
Participants were administered a validated questionnaire packet to assess whether EXERCISE and EXERCISE+PEH self-monitoring favorably modulated measures of integrated social-cognitive predictors of exercise (unitless).
|
12 weeks
|
Self Reported Physical activity
Time Frame: 12 weeks
|
Participants were asked to maintain their usual lifestyle habits throughout study participation and were administered a validated questionnaire to assess self reported.
physical activity (min).
|
12 weeks
|
Dietary Intake
Time Frame: 12 weeks
|
Participants were asked to maintain their usual lifestyle habits throughout study participation and were administered a validated questionnaire to assess dietary intake (kcal/d).
|
12 weeks
|
Salt Intake
Time Frame: 12 weeks
|
Participants were asked to maintain their usual lifestyle habits throughout study participation and were administered a validated questionnaire to assess salt intake (mg/d).
|
12 weeks
|
Antihypertensive Medication Adherence.
Time Frame: 12 weeks
|
Participants taking antihypertensive medication were administered a validated questionnaire to assess antihypertensive medication adherence (%).
|
12 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Linda S Pescatello, PhD, University of Connecticut
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
October 28, 2016
Primary Completion (Actual)
May 1, 2018
Study Completion (Actual)
May 29, 2018
Study Registration Dates
First Submitted
December 11, 2018
First Submitted That Met QC Criteria
December 17, 2018
First Posted (Actual)
December 19, 2018
Study Record Updates
Last Update Posted (Actual)
November 2, 2023
Last Update Submitted That Met QC Criteria
October 30, 2023
Last Verified
October 1, 2023
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- H15-277HHC
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
YES
IPD Plan Description
All IPD data will be made available upon request.
IPD Sharing Time Frame
All IPD data will be available upon request with no time limit.
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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