Effects of different aerobic exercise programmes with nutritional intervention in sedentary adults with overweight/obesity and hypertension: EXERDIET-HTA study

Background: Both exercise training and diet are recommended to prevent and control hypertension (HTN) and overweight/obesity. Purpose: To determine the effectiveness of different 16-week aerobic exercise programs with hypocaloric diet on blood pressure (BP), body composition, cardiorespiratory fitness (CRF) and pharmacological treatment. Methods: Overweight/obese, sedentary participants (n=175, 54.08.2 yrs) with HTN, were randomized into attention control group (AC, physical activity recommendations) or one of three supervised exercise groups [two days/week: high-volume with 45 min of moderate-intensity continuous training (HV-MICT), HV and high-intensity interval training, alternating high and moderate intensities (HV-HIIT), and low volume-HIIT (LVHIIT, 20 min)]. All variables were assessed pre and post intervention. All participants received the same hypocaloric diet. Results: Following the intervention, there was a significant reduction in BP and body mass in all groups with no between-group differences for BP. However, body mass was significantly less reduced in the AC group compared with all exercise groups (AC=-6.6%, HV-MICT=-8.3%, HV-HIIT=-9.7%, LV-HIIT=-6.9%). HIIT groups had significantly higher CRF than HV-MICT, but there were no significant between-HIIT differences (AC=16.4%, HV-MICT=23.6%, HV-HIIT=36.7%, LV-HIIT=30.5%). Medication was removed in 7.6% and reduced in 37.7% of the participants. Conclusions: The combination of hypocaloric diet with supervised aerobic exercise 2 days/week offers an optimal non-pharmacological tool in the management of BP, CRF and body composition in overweight/obese and sedentary individuals with HTN. HVHIIT seems to be better for reducing body mass compared to LV-HIIT. The exerciseinduced improvement in CRF is intensity dependent with LV-HIIT as a time-efficient method in this population