Ilargi Gorostegi-Anduaga1, Sara Maldonado-Martín2, Aitor MartinezAguirre-Betolaza1, Pablo Corres1, Estíbaliz Romaratezabala1, Anna C Whittaker3, Silvia Francisco-Terreros4, Javier Pérez-Asenjo5. 1. Laboratory of Performance Analysis in Sport, Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Science Section, University of the Basque Country (UPV/EHU), Portal de Lasarte 71, 01007, Vitoria-Gasteiz, Araba/Álava, Basque Country, Spain. 2. Laboratory of Performance Analysis in Sport, Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Science Section, University of the Basque Country (UPV/EHU), Portal de Lasarte 71, 01007, Vitoria-Gasteiz, Araba/Álava, Basque Country, Spain. sara.maldonado@ehu.eus. 3. School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK. 4. Clinical Trials Unit, Health and Quality of Life Area, TECNALIA, Vitoria-Gasteiz, Araba/Álava, Basque Country, Spain. 5. Cardiology Unit, Igualatorio Médico Quirúrgico (IMQ-Amárica), Vitoria-Gasteiz, Araba/Álava, Basque Country, Spain.
Abstract
INTRODUCTION: The EXERDIET-HTA study was a multi-arm parallel, a randomized, single-blind controlled experimental trial comparing the effects of 16 weeks of different aerobic exercise programs two days per week, and dietary intervention in a hypertensive, overweight/obese and non-physically active population. AIM: To evaluate the influence of diet and aerobic exercise program intervention on cardiovascular risk (CVR) factors and predicted CVR and vascular age (VA) profiles in overweight/obese people with primary hypertension (HTN), and to analyze the potential sex differences in the ability to predict VA and CVR via different methods. METHODS: The CVR and VA determined (n = 167, 53.7 ± 7.8 years) using the Framingham Risk Score (FRS) and the new equation for the prediction of 10-year atherosclerotic cardiovascular disease (ASCVD) risk, before and after the 16-week intervention period (different aerobic exercise programs + hypocaloric diet). The sex-specific risk factors considered were age, high-density lipoprotein cholesterol (HDL-C), total cholesterol, systolic blood pressure (SBP), diabetes mellitus (DM) and smoking status. RESULTS: From baseline to follow-up, participants reduced (p ≤ 0.001) FRS-CVR score and VA, and SBP. Total cholesterol decreased significantly, but specifically in men (p ≤ 0.001), and antihypertensive medication (%) in women (p = 0.047). No significant differences over time were observed for HDL-C, smoking, DM overall for either sex. For ASCVD-CVR there was no overall change or for either sex. After the intervention, women had a lower CVR score than men (p ≤ 0.001), irrespective of the calculation method. CONCLUSIONS: The improvement in CVR factors after 16-week lifestyle changes reduced the risk of suffering a cardiovascular event in overweight/obese adults with HTN through the FRS estimation tool, but not with the ASCVD score. The risk score algorithms could underestimate CVR in women. In contrast, VA could be a useful and easier tool in the management of individuals with CVR factors.
RCT Entities:
INTRODUCTION: The EXERDIET-HTA study was a multi-arm parallel, a randomized, single-blind controlled experimental trial comparing the effects of 16 weeks of different aerobic exercise programs two days per week, and dietary intervention in a hypertensive, overweight/obese and non-physically active population. AIM: To evaluate the influence of diet and aerobic exercise program intervention on cardiovascular risk (CVR) factors and predicted CVR and vascular age (VA) profiles in overweight/obesepeople with primary hypertension (HTN), and to analyze the potential sex differences in the ability to predict VA and CVR via different methods. METHODS: The CVR and VA determined (n = 167, 53.7 ± 7.8 years) using the Framingham Risk Score (FRS) and the new equation for the prediction of 10-year atherosclerotic cardiovascular disease (ASCVD) risk, before and after the 16-week intervention period (different aerobic exercise programs + hypocaloric diet). The sex-specific risk factors considered were age, high-density lipoprotein cholesterol (HDL-C), total cholesterol, systolic blood pressure (SBP), diabetes mellitus (DM) and smoking status. RESULTS: From baseline to follow-up, participants reduced (p ≤ 0.001) FRS-CVR score and VA, and SBP. Total cholesterol decreased significantly, but specifically in men (p ≤ 0.001), and antihypertensive medication (%) in women (p = 0.047). No significant differences over time were observed for HDL-C, smoking, DM overall for either sex. For ASCVD-CVR there was no overall change or for either sex. After the intervention, women had a lower CVR score than men (p ≤ 0.001), irrespective of the calculation method. CONCLUSIONS: The improvement in CVR factors after 16-week lifestyle changes reduced the risk of suffering a cardiovascular event in overweight/obese adults with HTN through the FRS estimation tool, but not with the ASCVD score. The risk score algorithms could underestimate CVR in women. In contrast, VA could be a useful and easier tool in the management of individuals with CVR factors.
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