Effect of aerobic and resistance exercise training on inflammation, endothelial function and ambulatory blood pressure in middle-aged hypertensive patients.

OBJECTIVE: The current randomized controlled trial tested the hypothesis that both aerobic training and dynamic resistance training will improve inflammation, endothelial function and 24-h ambulatory blood pressure (ABP) in middle-aged adults with hypertension, but aerobic training would be more effective. METHODS: Forty-two hypertensive patients on at least one antihypertensive medication (19 men/23 women; 30-59 years of age) were randomly assigned to 12 weeks of supervised aerobic training (n = 15), resistance training (n = 15) or a nonexercise control (n = 12) group. Inflammation, endothelial function, 24-h ABP and related measures were evaluated at pre and postintervention. RESULTS: We found that aerobic training and resistance training were well tolerated. Both aerobic training and resistance training reduced daytime systolic ABP (-7.2 ±â€Š7.9 and -4.4 ±â€Š5.8 mmHg; P < 0.05) and 24-h systolic ABP (-5.6 ±â€Š6.2 and -3.2 ±â€Š6.4 mmHg; P < 0.05). aerobic training and resistance training both improved brachial artery flow-mediated dilation by 1.7 ±â€Š2.8 and 1.4 ±â€Š2.6%, respectively (7.59 ±â€Š3.36 vs. 9.26 ±â€Š2.93 and 7.24 ±â€Š3.18 vs. 8.58 ±â€Š2.37; pre vs. post P < 0.05). However, only aerobic training decreased markers of inflammation (C-reactive protein, monocyte chemoattractant protein-1, vascular cell adhesion molecule-1 and lectin-like oxidized LDL receptor-1) and endothelin-1 and increased nitrite and nitrate levels (P < 0.05). CONCLUSION: Healthcare providers should continue to emphasize aerobic training for hypertension management given the established role of nitric oxide, endothelin-1 and chronic low-level inflammation in the pathogenesis of cardiovascular disease. However, our study demonstrates that resistance training should also be encouraged for middle-aged hypertensive patients. Our results also suggest that even if patients are on antihypertensive medications, regular aerobic training and resistance training are beneficial for blood pressure control and cardiovascular disease risk reduction.

The effect of ABO blood group on von Willebrand response to exercise.

Individuals of O blood group have significantly lower plasma levels of either Factor VIII (FVIII) or the von Willebrand factor (vWF). Conversely, there is accumulating evidence that elevated FVIII-vWF levels may represent an important risk factor for ischemic heart and venous thromboembolic disease. In this study, individuals exercised for 20 minutes at 10% below the first ventilatory threshold (aerobic threshold), which corresponds to 48% of maximum oxygen uptake. People with non-O blood group show higher resting and postexercise vWF levels compared with those of O blood group, as evidenced by a lower maximal heart rate. The groups were compared using the ANOVA one-way test, and a P < 0.05 was considered statistically significant. These results could change the way in which exercise training is designed for both healthy and sick individuals because O group individuals could have a more thrombogenic response to exercise.

The effects of diet- and diet plus exercise-induced weight loss on basal metabolic rate and acylated ghrelin in grade 1 obese subjects.

BACKGROUND: Diet and exercise are often prescribed as primary intervention regarding obesity-related disorders. Additionally, recent studies have shown beneficial effects of weight loss through diet and exercise in ghrelin concentrations in obese subjects. The aim of this study was to evaluate the effects of a 5% weight loss on lipid profile, resting metabolic rate (RMR), and acylated ghrelin (AG) using two different methods of intervention (diet or diet plus exercise). MATERIALS AND METHODS: Eighteen subjects (twelve women and six men) aged 20-40 years with a body mass index of 30-34.9 kg/m(2) (grade 1 obesity) were randomized into two intervention groups: diet (n=9) or diet plus exercise (n=9). Both groups underwent treatment until 5% of the initial body weight was lost. At baseline and upon completion, RMR and AG were analyzed. RESULTS: Both groups showed a significant decrease in body fat percentage and fat mass. The diet-plus-exercise group showed a decrease in AG (pre: 54.4±25.3 pg/mL and post: 33.2±19.1 pg/mL) and an increase in RMR (pre: 1,363±379 kcal/day, post: 1,633±223 kcal/day). CONCLUSION: These data suggest that diet plus exercise induced weight loss and had beneficial effects on AG concentration and RMR, essential factors to ensure the benefits of a weight-loss program.

[Levels of beta-endorphin in response to exercise and overtraining]. / Níveis de beta-endorfina em resposta ao exercício e no sobretreinamento.

Overtraining (OT) is a complex and multifactorial sport phenomenon, and there is no independent marker that can diagnose OT. Interestingly, some symptoms of OT are related to beta-endorphin (beta-end(1-31)) effects. Some of its effects, such as analgesia, increasing lactate tolerance, and exercise-induced euphoria, are important for training. These effects can be reverted by detraining or OT, which may cause decrease in performance, reduced load tolerance, and depression. The main stimulus for beta-end(1-31) secretion is to exercise because its secretion is volume/intensity dependent for both aerobic and anaerobic exercise. Excess training, however, may reduce beta-end(1-31) concentrations, thus altering its beneficial effects. Therefore, beta-end(1-31) could be used as an additional OT marker, mainly because its effects are strongly related to OT symptoms.

Níveis de beta-endorfina em resposta ao exercício e no sobretreinamento: [revisão] / Levels of beta-endorphin in response to exercise and overtraining: [review]

O sobretreinamento (ST) é um fenômeno esportivo complexo e multifatorial; e atualmente não existe nenhum marcador independente que possa diagnosticá-lo. Interessantemente, alguns sintomas do ST apresentam relação com os efeitos da b-endorfina (b-end1-31). Alguns de seus efeitos são importantes para o treinamento, como analgesia, maior tolerância ao lactato e euforia do exercício. Esses efeitos podem ser revertidos por destreinamento ou por ST, ocasionando diminuição no desempenho, redução da tolerância à carga e depressão. O exercício físico é o principal estímulo da b-end1-31, pois sua secreção é volume/intensidade dependente, tanto para exercícios aeróbios quanto anaeróbios. No entanto, o treinamento excessivo pode diminuir suas concentrações, alterando assim seus efeitos benéficos para o treinamento. Portanto, a b-end1-31 poderia ser utilizada como um marcador adicional de ST, principalmente porque seus efeitos apresentam extensa relação com os sintomas do ST.

Overtraining (OT) is a complex and multifactorial sport phenomenon, and there is no independent marker that can diagnose OT. Interestingly, some symptoms of OT are related to b-endorphin (b-end1-31) effects. Some of its effects, such as analgesia, increasing lactate tolerance, and exercise-induced euphoria, are important for training. These effects can be reverted by detraining or OT, which may cause decrease in performance, reduced load tolerance, and depression. The main stimulus for b-end1-31 secretion is to exercise because its secretion is volume/intensity dependent for both aerobic and anaerobic exercise. Excess training, however, may reduce b-end1-31 concentrations, thus altering its beneficial effects. Therefore, b-end1-31 could be used as an additional OT marker, mainly because its effects are strongly related to OT symptoms.

Efeitos do exercício e do treinamento físico na hemostasia / Exercise and training effects on blood haemostasis

O estado hipercoagulante pós-exercício tem sido bem demonstrado, pois aumentos na atividade coagulante são freqüentemente registrados após diversos protocolos de exercício. Um dos efeitos agudos do exercício mais consistente é o aumento da atividade coagulante refletido pelo aumento da atividade do FVIII, dos marcadores TAT e F1+2. Esse aumento é intensidade dependente. Quanto aos efeitos crônicos, a atividade coagulante de repouso não se modifica com o treinamento. Os níveis de FVIII pós-exercício, entretanto, são maiores em sedentários do que em treinados e os níveis de repouso de pacientes pós-infarto diminuem com o treinamento. A hiperfibrinólise provocada pelo exercício também está comprovada e, assim como a atividade coagulante, parece depender da intensidade. Foram registrados aumentos dos níveis de t-PA, u-PA, plasminogênio e diminuição dos níveis de PAI-1 após o exercício. Os níveis de repouso de t-PA de pessoas inativas é maior que em ativos e atletas. Além disso, pacientes pós-infarto apresentaram diminuição significativa dos níveis de PAI-1 após período de reabilitação física. Os dados mais controversos estão relacionados aos efeitos crônicos dos níveis de t-PA. Enquanto estudos demonstram níveis maiores de t-PA em treinados comparados a sedentários, outros mostram o contrário. Resultados mais consistentes acerca dos efeitos do exercício no processo hemostático, incluindo atividades coagulante e fibrinolítica, ainda são necessários. Existe ainda carência quanto aos efeitos crônicos do exercício, tanto em relação aos benefícios na saúde quanto à influência na performance de atletas.

Post-exercise hypercoagulability state has been well demonstrated as increases in coagulation activity are often reported after many exercise protocols. One of the most consistent effects of acute exercise is an increase in coagulation activity reflected by the FVIII activity of thrombin generation markers (TAT and F1+2). This increase is intensity-dependent. In relation to chronic effects, resting coagulant activity does not change with training. However, post-exercise FVIII levels have been reported to be greater in sedentary individuals than in trained subjects and resting levels of post-infarction patients decrease with training. Hyperfibrinolysis related to exercise has also been reported and, similar to coagulation activity, may be intensity-dependent. Increases in t-PA, u-PA, and plasminogen levels and decreases in PAI-1 after exercise have been reported. Resting t-PA levels of non-trained individuals are higher than in active subjects or athletes. In addition, post-infarction patients have a significant decrease of PAI-1 levels after rehabilitation. More controversial results are related to the chronic effects of t-PA. While some studies have shown higher levels of t-PA in trained individuals compared with non-trained subjects, others have not shown this. More consistent results related to the effects of exercise on the hemostatic process, including coagulation and fibrinolytic activities, remain necessary. Chronic effects of exercise need to be studied further, both in relation to the health benefits and the influence on the performance of athletes.