Effect Of Antihypertensive Treatment On Aerobic Training Adaptations In Patients With Metabolic Syndrome

Hypertension is a modifiable risk factor that increases the risk of cardiovascular disease and all-cause mortality. Hypertension is present in almost 80% of patients with metabolic syndrome (MetS). Lifestyle modification and improvements in cardiorespiratory fitness (CRF) through high-intensity interval training (HIIT) have been shown to have great benefits in this population. However, treatment with antihypertensive medication (AHM) could attenuate the adaptations expected from an exercise program on the factors of MetS and CRF. PURPOSE: To determine the effect of chronic treatment with AHM on exercise adaptations in patients with MetS after completing a HIIT training program. METHODS: Using a non-randomized block design, a total of 91 middle-aged (53 ± 8 years), MetS-obese volunteers (BMI = 32.9 ± 4.2 kg/m2) completed 16 weeks of supervised HIIT (3 days/week, 45 min/session). Participants on pharmacological treatment took AHM (HYPER; n = 50), while the remainder were not treated for MetS factors (CONTROL; n = 41). Both groups were matched at baseline for sex, body composition, MetS factors, and CRF. All cardiometabolic variables were assessed before and after the 16 weeks of exercise training. RESULTS: MetS and cardiovascular risk factors improved similarly in both groups, with a notable improvement in blood pressure (p < 0.001, time effect; systolic blood pressure [SBP] and diastolic blood pressure [DBP]). Maximal power output (WMAX) also improved in the HYPER and CONTROL groups, with no differences between the groups (p < 0.001, time effect). However, although an increase in CRF (VO2MAX) was observed in both groups, the improvement was greater in the CONTROL group compared to the HYPER group (p = 0.033, time x group effect) with a 23% increase in the CONTROL group (5.0 ± 3.2 ml·kg·min-1; p < 0.001) and a 16% increase in the HYPER group (3.6 ± 2.8 ml·kg·min-1, p < 0.001). In addition, only the CONTROL group achieved changes in HRMAX. CONCLUSIONS: The chronic use of antihypertensive drugs does not interfere with the improvements in the components of the metabolic syndrome obtained with a supervised HIIT exercise training program. However, the group of patients treated with antihypertensives attenuated the improvements in CRF compared with the unmedicated control group.ClinicalTrials.gov identifier: NCT03019796. Supported by: Spanish Ministry of Science and Innovation (PID2020- 116159RB- IOO MCIN/AEI/10.13039/501 100 011 033)