Effect of High-Intensity Interval Training on Body Composition, Cardiorespiratory Fitness, Blood Pressure, and Substrate Utilization During Exercise Among Prehypertensive and Hypertensive Patients With Excessive Adiposity

Pedro Delgado-Floody, Mikel Izquierdo, Robinson Ramírez-Vélez, Felipe Caamaño-Navarrete, Roberto Moris, Daniel Jerez-Mayorga, David C Andrade, Cristian Álvarez, Pedro Delgado-Floody, Mikel Izquierdo, Robinson Ramírez-Vélez, Felipe Caamaño-Navarrete, Roberto Moris, Daniel Jerez-Mayorga, David C Andrade, Cristian Álvarez

Abstract

Regular exercise training is a recognized lifestyle strategy to lower resting blood pressure (BP), but little is known about substrate metabolism in population with high BP. Thus, the purpose of this study was to investigate the effects of 16-weeks of HIIT on body composition, BP, cardiorespiratory fitness by V . O2 max , and substrate utilization during exercise among prehypertensive and hypertensive patients with excessive adiposity. We also aimed to test the potential association between changes in cardiorespiratory fitness, substrate utilization during exercise and BP. Forty-two physically inactive overweight/obese participants participated in 16-weeks of HIIT intervention. The HIIT frequency was three times a week (work ratio 1:2:10, for interval cycling: rest period: repeated times; 80-100% of the maximum heart rate). Groups were distributed based on their baseline BP: HIIT-hypertensive (H-HTN: age 47.7 ± 12.0 years; body mass index [BMI] 30.3 ± 5.5 kg/m2; systolic [SBP]/diastolic BP [DBP] 151.6 ± 10/81.9 ± 4.2 mmHg), HIIT-pre-hypertensive (H-PreHTN: age 37.6 ± 12.0 years; BMI 31.9 ± 5.3 kg/m2; SBP/DBP 134.4 ± 3.2/74.9 ± 7.0 mmHg), and a normotensive control group (H-CG: age 40.7 ± 11.0 years; BMI 29.5 ± 4.2 kg/m2; SBP/DBP 117.0 ± 6.2/72.4 ± 4.1 mmHg). Anthropometry/body composition, BP, and metabolic substrate utilization during exercise (fat [FATox], carbohydrate [CHOox] oxidation, respiratory exchange ratio [RER], and V . O2 max), were measured before and after the 16-week HIIT intervention. Adjusted mixed linear models revealed a significant improved in V . O2 max were + 3.34 in the H-CG, + 3.63 in the H-PreHTN, and + 5.92 mL⋅kg-1⋅min-1, in the H-HTN group, however, the Time × Group interaction were not significant (p = 0.083). All the exercise types induced similar decreases on SBP (-8.70) in the H-HTN, (-7.14) in the H-CG, and (-5.11) mmHg in the H-PreHTN, as well as DBP levels (-5.43) mmHg in H-CG group (p = 0.032 vs. H-HTN group). At 16-week, no significant correlations were noted for the changes of blood pressure, cardiorespiratory fitness or exercise metabolism substrates outcomes. In conclusion, our results suggest that a 16-week HIIT-intervention improved V . O2 max and blood pressure BP, but these changes are independent of substrate utilization during exercise in normotensive and hypertensive participants with excessive adiposity.

Keywords: blood pressure; cardiorespiratory fitness; hypertension; metabolic flexibility; obesity.

Copyright © 2020 Delgado-Floody, Izquierdo, Ramírez-Vélez, Caamaño-Navarrete, Moris, Jerez-Mayorga, Andrade and Álvarez.

Figures

FIGURE 1
FIGURE 1
Flow-chart diagram.
FIGURE 2
FIGURE 2
Study protocol.
FIGURE 3
FIGURE 3
Maximum oxygen consumption (V.O2max), respiratory exchange ratio (RER), FATox and CHOox utilization during exercise measured by indirect calorimetry measured in healthy normotensive, prehypertensive, and hypertensive subjects. Panel (A) show absolute values of V.O2max, and Panel (B) show V.O2max in delta values pre-post 16-weeks HIIT intervention. Panel (C) show RER peak during exercise in delta values pre-post 16-weeks HIIT intervention. Panel (D) shows fat utilization during exercise in delta values pre-post 16-week high-intensity interval training (HIIT) intervention. Panel (E) shows CHO utilization during exercise in delta values pre-post 16-week HIIT intervention Groups are described as (H-CG) HIIT-normotensive control group, (H-PreHTN) HIIT-prehypertensive group, and (H-HTN) HIIT-hypertensive group. Within the mixed model, we calculated 95% Cis and P values for 3 prespecified intergroup contrasts and for change for all continuous variables within each group over time with adjustment for the baseline values, age, gender and BMI as covariates. A Sidack’s post hoc test was used for multiple comparisons. All results are presented as least-squares means with 95% confidence intervals (CIs).
FIGURE 4
FIGURE 4
Systolic (SBP) and diastolic blood pressure (DBP) in healthy normotensive, prehypertensive, and hypertensive subjects. Panel (A,C) show SBP and DBP delta changes in mean values from pre to post interventions groups. Panels (B,D) show show SBP and DBP according with each pre-post individual change, and by the old traditional cut-off point from Chobanian et al. (2003) (continuous, very intermittent, and less intermittent black lines) of blood pressure diagnosed ranged in green, cream, and red boxes, right side (B,D), as well as showing the new cut-off from Whelton et al. (2018) from the AHA 2017, (B,D), left side. Groups are described as (H-CG) HIIT-normotensive control group, (H-PreHTN) HIIT-prehypertensive group, and (H-HTN) HIIT-hypertensive group.
FIGURE 5
FIGURE 5
Correlations among the delta of fat (ΔFATox), delta of carbohydrate (ΔCHOox) oxidation, and delta of respiratory exchange ratio (ΔRER) with the delta of systolic (ΔSystolic BP), and diastolic (ΔDiastolic BP). Panel (A) show correlation ΔFATox with ΔSystolic BP. Panel (B) show correlation ΔCHOox with ΔDiastolic BP. Panel (C) show correlation ΔCHOox with ΔSystolic BP. Panel (D) show correlation ΔFATox with ΔDiastolic BP. Panel (E) show correlation ΔRER with ΔSystolic BP. Panel (F) show correlation ΔRER with ΔDiastolic BP. Groups are described as (H-CG) HIIT-normotensive control group, (H-PreHTN) HIIT-prehypertensive group, and (H-HTN) HIIT-hypertensive group. β = Standardized coefficients beta with adjustment for the age, gender and BMI as covariates. Both ΔFATox and ΔCHOox are expressed in %, respiratory exchange ratio (RER).

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