A10295 Effects of exercise training on arterial stiffness and peripheral and central blood pressure

Objectives: To assess whether exercise training improves arterial stiffness and derived measures of central blood pressure in patients with resistant hypertension. Methods: In this parallel-group trial, 19 patients with resistant hypertension (age: 60.2 ± 6.7 years, weight: 77.3 ± 9.7 kg, body mass index: 28.8 ± 2.7 kg/m2, 10 men) were randomized to either the exercise (EG, n = 11) or control group (CG, n = 8). Exercise training consisted of 3 months of aerobic exercise at 50–70% of VO2peak, 3 sessions (40 min) weekly. Both groups received usual care. Baseline and final assessments included arterial stiffness through carotid-femoral pulse wave velocity (cfPWV) and derived measures of central pressure obtained from the Complior device. (ClinicalTrials.gov: NCT03090529). Results: The number of antihypertensive drugs was similar between groups (EG 4.9 ± 1.1 vs. 4.6 ± 0.7, p = 0.546). Office systolic (148.4 ± 12.9 to 135.5 ± 10.9 mmHg, p = 0.022) and diastolic (85.0 ± 7.6 to 76.6 ± 6.7mmHg, p = 0.004) blood pressure decreased in the EG, whereas no changes were observed in the CG (142.4 ± 29.3 to 147.9 ± 27.8mmHg, p = 0.022 and 84.7 ± 17.0 to 87.9 ± 19.2mmHg, p = 0.265). After 3 months, no significant changes were found in cf-PWV in both groups (EG: 9.4 ± 2.5 to 9.2 ± 1.7m/s, p = 0.749; CG: 9.2 ± 2.8 to 9.5 ± 2.7m/s, p = 0.691). However, only 5 patients (4 in EG and 1 in CG) presented at baseline a cfPWV > 10m/s; the EG patients showed a significant decreased in cfPWV (12.1 ± 1.4 to 10.8 ± 1.6m/s, p = 0.035). Central systolic pressure decreased only in the EG (137.4 ± 14.5 to 125.4 ± 11.9mmHg, p = 0.041); this change was significantly different between groups (EG, − 12.0 ± 16.9 vs. 7.2 ± 12.5mmHg, p = 0.015). Conclusion: Exercise training seems to reduce peripheral and central blood pressure and improve arterial stiffness in resistant hypertension patients with elevated cfPWV at baseline.