Gorostegi-Anduaga Ilargi, Maldonado-Martín Sara, MartinezAguirre-Betolaza Aitor, Corres Pablo, Romaratezabala Estíbaliz, Whittaker Anna C, Francisco-Terreros Silvia, Pérez-Asenjo Javier
Laboratory of Performance Analysis in Sport, Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Science Section, University of the Basque Country (UPV/EHU), Portal de Lasarte 71, 01007, Vitoria-Gasteiz, Araba/Álava, Basque Country, Spain.
School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
High Blood Press Cardiovasc Prev. 2018 Dec;25(4):361-368. doi: 10.1007/s40292-018-0281-0. Epub 2018 Sep 24.
The EXERDIET-HTA study was a multi-arm parallel, a randomized, single-blind controlled experimental trial comparing the effects of 16 weeks of different aerobic exercise programs two days per week, and dietary intervention in a hypertensive, overweight/obese and non-physically active population.
To evaluate the influence of diet and aerobic exercise program intervention on cardiovascular risk (CVR) factors and predicted CVR and vascular age (VA) profiles in overweight/obese people with primary hypertension (HTN), and to analyze the potential sex differences in the ability to predict VA and CVR via different methods.
The CVR and VA determined (n = 167, 53.7 ± 7.8 years) using the Framingham Risk Score (FRS) and the new equation for the prediction of 10-year atherosclerotic cardiovascular disease (ASCVD) risk, before and after the 16-week intervention period (different aerobic exercise programs + hypocaloric diet). The sex-specific risk factors considered were age, high-density lipoprotein cholesterol (HDL-C), total cholesterol, systolic blood pressure (SBP), diabetes mellitus (DM) and smoking status.
From baseline to follow-up, participants reduced (p ≤ 0.001) FRS-CVR score and VA, and SBP. Total cholesterol decreased significantly, but specifically in men (p ≤ 0.001), and antihypertensive medication (%) in women (p = 0.047). No significant differences over time were observed for HDL-C, smoking, DM overall for either sex. For ASCVD-CVR there was no overall change or for either sex. After the intervention, women had a lower CVR score than men (p ≤ 0.001), irrespective of the calculation method.
The improvement in CVR factors after 16-week lifestyle changes reduced the risk of suffering a cardiovascular event in overweight/obese adults with HTN through the FRS estimation tool, but not with the ASCVD score. The risk score algorithms could underestimate CVR in women. In contrast, VA could be a useful and easier tool in the management of individuals with CVR factors.
EXERDIET-HTA研究是一项多组平行、随机、单盲对照实验性试验，比较了每周两天、为期16周的不同有氧运动计划以及饮食干预对高血压、超重/肥胖且缺乏体育锻炼人群的影响。
评估饮食和有氧运动计划干预对原发性高血压（HTN）超重/肥胖人群心血管风险（CVR）因素、预测的CVR和血管年龄（VA）状况的影响，并分析通过不同方法预测VA和CVR能力方面的潜在性别差异。
在为期16周的干预期（不同有氧运动计划+低热量饮食）前后，使用弗雷明汉风险评分（FRS）和预测10年动脉粥样硬化性心血管疾病（ASCVD）风险的新方程确定CVR和VA（n = 167，年龄53.7±7.8岁）。所考虑的性别特异性风险因素包括年龄、高密度脂蛋白胆固醇（HDL-C）、总胆固醇、收缩压（SBP）、糖尿病（DM）和吸烟状况。
从基线到随访，参与者的FRS-CVR评分、VA和SBP均降低（p≤0.001）。总胆固醇显著下降，但仅在男性中如此（p≤0.001），女性的抗高血压药物使用比例下降（p = 0.047）。对于HDL-C、吸烟、总体DM，无论男女，随时间均未观察到显著差异。对于ASCVD-CVR，总体或任何性别均无变化。干预后，无论计算方法如何，女性的CVR评分均低于男性（p≤0.001）。
通过FRS评估工具，16周生活方式改变后CVR因素的改善降低了超重/肥胖高血压成年人心血管事件的风险，但ASCVD评分未显示此效果。风险评分算法可能低估女性的CVR。相比之下，VA可能是管理有CVR因素个体的有用且更简便的工具。
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