Effect of Exercise on Blood Pressure in Type 2 Diabetes: A Randomized Controlled Trial
Abstract BACKGROUND: Increased blood pressure (BP) in type 2 diabetes (T2DM) markedly increases cardiovascular disease morbidity and mortality risk compared to having increased BP alone.
OBJECTIVE: To investigate whether exercise reduces suboptimal levels of untreated suboptimal BP or treated hypertension.
PATIENTS: 140 participants with T2DM not requiring insulin and untreated SBP of 120-159 or DBP of 85-99Â mmHg, or, if being treated for hypertension, any SBP <159Â mmHg or DBPâ<â99Â mmHg; 114 completed the study.
INTERVENTION: Supervised exercise, 3 times per week for 6Â months compared with general advice about physical activity.
MEASUREMENTS: Resting SBP and DBP (primary outcome); diabetes status, arterial stiffness assessed as carotid-femoral pulse-wave velocity (PWV), body composition and fitness (secondary outcomes).
RESULTS: Overall baseline BP was 126.8âÂ±â13.5 / 71.7âÂ±â9.0Â mmHg, with no group differences.
At 6Â months, BP was unchanged from baseline in either group, BP 125.8âÂ±â13.2 / 70.7âÂ±â8.8Â mmHg in controls; and 126.0âÂ±â14.2 / 70.3âÂ±â9.0Â mmHg in exercisers, despite attaining a training effects as evidenced by increased aerobic and strength fitness and lean mass and reduced fat mass (all pâ<â0.05), Overall baseline PWV was 959.9âÂ±â333.1Â cm/s, with no group difference.
At 6-months, PWV did not change and was not different between group; exercisers, 923.7âÂ±â319.8Â cm/s, 905.5âÂ±â344.7, controls.
CONCLUSIONS: Though exercisers improve fitness and body composition, there were no reductions in BP.
The lack of change in arterial stiffness suggests a resistance to exercise-induced BP reduction in persons with T2DM.