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Lifestyle change diminishes a hypertensive response to exercise in type 2 diabetes.
MedLine Citation:
PMID:  20881877     Owner:  NLM     Status:  In-Data-Review    
PURPOSE: : A hypertensive response to exercise (HRE) is common in patients with type 2 diabetes and is associated with increased left ventricular (LV) mass and mortality. This study aimed to determine whether lifestyle modification would improve exercise blood pressure (BP) and reduce LV mass in patients with type 2 diabetes.
METHODS: : One hundred and eighty-five patients with type 2 diabetes were randomized to 1 yr of lifestyle intervention (n = 97, mean ± SD age = 54.7 ± 11.3 yr, 51% men) or usual care (control; n = 88, age = 53.8 ± 8.1 yr, 61% men). Brachial BP was measured at rest and during a graded maximal exercise test at baseline and 1 yr. Patients also underwent two-dimensional echocardiography to determine LV dimensions. A subgroup of 61 patients had resting and exercise central BP estimated from radial tonometry. An HRE was defined as a maximal exercise systolic BP of ≥210 mm Hg for men and ≥190 mm Hg for women.
RESULTS: : At study entry, there were 101 patients (55%) with an HRE (n = 51 controls). Compared with controls, lifestyle intervention significantly reduced the propensity to develop an HRE in those participants who did not have HRE at baseline (29.8% vs 59.5%, P = 0.006). However, absolute values of exercise and resting (brachial and central) BP and LV mass were not significantly changed (all P values > 0.05). There were significant (all P values < 0.05) improvements in V˙O2max, body mass index, plasma glucose, insulin resistance, and HDL cholesterol after lifestyle intervention compared with control.
CONCLUSIONS: : Lifestyle intervention significantly attenuates the development of an HRE but does not reduce cardiac size after 1 yr in patients with type 2 diabetes.
Martin G Schultz; Matthew D Hordern; Rodel Leano; Jeffrey S Coombes; Thomas H Marwick; James E Sharman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Medicine and science in sports and exercise     Volume:  43     ISSN:  1530-0315     ISO Abbreviation:  Med Sci Sports Exerc     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8005433     Medline TA:  Med Sci Sports Exerc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  764-9     Citation Subset:  IM; S    
1Menzies Research Institute, Hobart, AUSTRALIA; 2Department of Medicine, The University of Queensland, Brisbane, AUSTRALIA; 3Centre for Clinical Research Excellence in Cardiovascular and Metabolic Disease, The University of Queensland, Brisbane, AUSTRALIA; and 4School of Human Movement Studies, The University of Queensland, Brisbane, AUSTRALIA.
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