Improvements in blood pressure, glucose metabolism, and lipoprotein lipids after aerobic exercise plus weight loss in obese, hypertensive middle-aged men

Dengel, Donald R.; Hagberg, James M.; Pratley, Richard E.; Rogus, Ellen M.; Goldberg, Andrew P.

« Previous Next »Metabolism - Clinical and Experimental
Volume 47, Issue 9 , Pages 1075-1082, September 1998

Improvements in blood pressure, glucose metabolism, and lipoprotein lipids after aerobic exercise plus weight loss in obese, hypertensive middle-aged men☆

Donald R. Dengel
- Department of Medicine, Division of Gerontology, University of Maryland School of Medicine, Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
- Geriatric Service and Geriatric Research, Education and Clinical Center (GRECC), Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
- Center on Aging, University of Maryland, College Park, Maryland, USA
- Current address: D.RD., GRECC Ann Arbor Veterans Affairs Medical Center, Ann Arbor, MI
James M. Hagberg
- Department of Medicine, Division of Gerontology, University of Maryland School of Medicine, Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
- Geriatric Service and Geriatric Research, Education and Clinical Center (GRECC), Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
- Center on Aging, University of Maryland, College Park, Maryland, USA
Richard E. Pratley
- Department of Medicine, Division of Gerontology, University of Maryland School of Medicine, Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
- Geriatric Service and Geriatric Research, Education and Clinical Center (GRECC), Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
- Center on Aging, University of Maryland, College Park, Maryland, USA
- Current address: R.E.P., National Institutes of Health, Phoenix, AZ.
Ellen M. Rogus
- Department of Medicine, Division of Gerontology, University of Maryland School of Medicine, Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
- Geriatric Service and Geriatric Research, Education and Clinical Center (GRECC), Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
- Center on Aging, University of Maryland, College Park, Maryland, USA
Andrew P. Goldberg
- Address reprint requests to Andrew P. Goldberg, MD, Baltimore VA Medical Center, GRECC (BT/18/GR), 10 N Greene St, Baltimore, MD 21201-1524.
- Department of Medicine, Division of Gerontology, University of Maryland School of Medicine, Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
- Geriatric Service and Geriatric Research, Education and Clinical Center (GRECC), Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
- Center on Aging, University of Maryland, College Park, Maryland, USA

Received 27 September 1997; accepted 27 March 1998.

Abstract

The clustering of metabolic abnormalities often associated with hypertension, including insulin resistance, glucose intolerance, and dyslipidemia, in middle-aged men may be the result of a decrease in cardiovascular fitness (Vo₂max) and the accumulation of body fat with aging. This study examines the effects of a 6-month program of aerobic exercise training plus weight loss (AEX + WL) on Vo₂max, body composition, blood pressure (BP), glucose and insulin responses during an oral glucose tolerance test (OGTT), glucose infusion rates (GIR) during 3-dose hyperinsulinemic-euglycemic clamps at insulin infusion rates of 120, 600, and 3,000 pmol · m⁻² · min⁻¹, and plasma lipoprotein levels. Compared with eight non-obese, normotensive, sedentary men (age, 62 ± 2 years; 19% ± 2% fat; BP, 117 ± ± 2 mm Hg), the nine obese, hypersensitive, sedentary men studied (age, 56 ± 1 year; 32% ± 1% body fat; BP, 147 ± ± 2 mm Hg) initially had a larger waist girth and waist-to-hip ratio (WHR) and were more hyperinsulinemic and insulin resistant with lower GIR at the two lower insulin infusion rates of the clamp and had a 2.9-fold higher EC₅₀, the insulin concentration producing a half-maximal increase in GIR. They had higher triglyceride (TG) and lower high-density lipoprotein cholesterol (HDL-C) levels. The AEX ± WL intervention reduced body weight by 9%, percent body fat by 21%, waist girth by 9%, and WHR by 3%, and increased V̇O₂max by 16% (P < .01 for all). This was associated with decreases 14 ± 3 mm Hg in systolic and 10 ± 2 mm Hg in diastolic BP, significant changes in GIR at the low (+42%) and intermediate (+39%) insulin infusion rates and EC₅₀ (−39%) and in glucose (−21%) and insulin (−51%) responses during OGTT (P < .02 for all). AEX + WL also lowered total cholesterol by 14% and TG by 34%, and raised HDL₂—C levels twofold (P < .01 for all). Thus, a 6-month AEX + WL intervention substantially lowers BP and improves glucose and lipid metabolism in obese, sedentary, hypertensive men. This suggests that hypertension and the metabolic risk factors for cardiovascular disease associated with it can be ameliorated by AEX + WL in obese, sedentary, middle-aged men.

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☆ Supported by a National Institutes of Health National Research Service Award (F32 AG-05555) to D.R.D.; National Institute on Aging Clinical Investigator Award (K08-AG-00494) to R.E.P.; a Veterans Administation Regional Advisory Group award, a grant from the Maryland Affiliate of the American Heart Association to J.M.H.; the Johns Hopkins Academic Nursing Home Award (PO1 AG-04402), R01AG07660, and 1KO7AG00608 to A.P.G.; and the John Hopkins Bayview Medical Center, General Clinical Research Center grant (MO1 RR-02719).

PII: S0026-0495(98)90281-5

« Previous Next »Metabolism - Clinical and Experimental
Volume 47, Issue 9 , Pages 1075-1082, September 1998

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