Jamie M O'Driscoll1,2, Jamie J Edwards3, Jonathan D Wiles3, Katrina A Taylor3, Paul Leeson4, Rajan Sharma5. 1. School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK. jamie.odriscoll@canterbury.ac.uk. 2. Department of Cardiology, St George's University Hospitals NHS Foundation Trust, Blackshaw Road, Tooting, London, SW17 0QT, UK. jamie.odriscoll@canterbury.ac.uk. 3. School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK. 4. Oxford Clinical Cardiovascular Research Facility, Department of Cardiovascular Medicine, University of Oxford, Oxford, UK. 5. Department of Cardiology, St George's University Hospitals NHS Foundation Trust, Blackshaw Road, Tooting, London, SW17 0QT, UK.
Abstract
PURPOSE: Hypertension is a major risk factor for cardiovascular disease. Isometric exercise training (IET) reduces resting and ambulatory blood pressure; however, few studies have investigated the myocardial adaptations following IET. METHODS: We randomly assigned 24 unmedicated hypertensive patients in a cross-over study design to 4-weeks of IET and control period, separated by a 3-week washout period. Speckle tracking echocardiography was used to measure left ventricular (LV) mechanics, and global myocardial work indices were derived from non-invasive LV pressure-strain loops constructed from global longitudinal strain (GLS) indexed to brachial systolic blood pressure. RESULTS: IET significantly improved GLS (- 2.3 ± 2%, p < 0.001) and global work efficiency (2.8 ± 2%, p < 0.001), and significantly reduced global wasted work (- 42.5 ± 30 mmHg%, p < 0.001) with no significant change during the control period. CONCLUSIONS: This is the first evidence to demonstrate that IET significantly improved cardiac health in a relevant patient population. Our findings have important clinical implications for patients with high blood pressure and support the role of IET as a safe and viable therapeutic and preventative intervention in the treatment of hypertension.
PURPOSE: Hypertension is a major risk factor for cardiovascular disease. Isometric exercise training (IET) reduces resting and ambulatory blood pressure; however, few studies have investigated the myocardial adaptations following IET. METHODS: We randomly assigned 24 unmedicated hypertensive patients in a cross-over study design to 4-weeks of IET and control period, separated by a 3-week washout period. Speckle tracking echocardiography was used to measure left ventricular (LV) mechanics, and global myocardial work indices were derived from non-invasive LV pressure-strain loops constructed from global longitudinal strain (GLS) indexed to brachial systolic blood pressure. RESULTS: IET significantly improved GLS (- 2.3 ± 2%, p < 0.001) and global work efficiency (2.8 ± 2%, p < 0.001), and significantly reduced global wasted work (- 42.5 ± 30 mmHg%, p < 0.001) with no significant change during the control period. CONCLUSIONS: This is the first evidence to demonstrate that IET significantly improved cardiac health in a relevant patient population. Our findings have important clinical implications for patients with high blood pressure and support the role of IET as a safe and viable therapeutic and preventative intervention in the treatment of hypertension.
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Authors: Jamie M O'Driscoll; Steven M Wright; Katrina A Taylor; Damian A Coleman; Rajan Sharma; Jonathan D Wiles Journal: J Appl Physiol (1985) Date: 2018-06-28
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