Clinical Science| Volume 61, ISSUE 12, P1739-1746, December 2012

Exercise training improves hemodynamic recovery to isometric exercise in obese men with type 2 diabetes but not in obese women



      Women with type 2 diabetes (T2D) show greater rates of mortality due to ischemic heart disease than men with T2D. We aimed to examine cardiovascular and autonomic function responses to isometric handgrip (IHG) exercise between men and women with T2D, before and after an exercise training program.


      Hemodynamic responses were measured in 22 men and women with T2D during and following a 3-min IHG test, and before and after 16 wks of aerobic exercise training.


      Women had a smaller decrease in mean arterial pressure (MAP) and systolic blood pressure (BP) during recovery from IHG (ΔMAPREC) than men pre- and post-training (P<0.05). Men showed a greater reduction in diastolic BP during recovery from IHG (P<0.05), and exercise training improved this response in men but not in women (men, pre-training: −13.9±1.8, post-training: −20.5±5.3 mmHg vs. women, pre-training: −10.7±1.7, post-training: −4.1±4.9 mmHg; P<0.05). Men had a greater reduction in sympathetic modulation of vasomotor tone (P<0.05), as estimated by blood pressure variability, following IHG. This response was accentuated after training, while this training effect was not seen in women. Post-training ΔMAPREC was correlated with recovery of low frequency component of the BP spectrum (ΔLFSBPrec, r=0.52, P<0.05).


      Differences in BP recovery immediately following IHG may be attributed to gender differences in cardiovascular autonomic modulation. An improvement in these responses occurs following aerobic exercise training in obese men, but not in obese women with T2D which reflects a better adaptive autonomic response to exercise training.


      T2D (type 2 diabetes), IHG (isometric handgrip), MAP (mean arterial pressure), SBP (systolic blood pressure), Δ (change), ΔMAPREC (recovery from IHG), ΔLFSBPrec (low frequency component of the BP spectrum), HR (heart rate), DBP (diastolic blood pressure), MSNA (muscle sympathetic nerve activity), HF (high frequency), HFRRI (index of cardiac parasympathetic modulation, component of HR spectrum), OGTT (oral glucose tolerance test), VO2 peak (aerobic capacity, peak oxygen consumption), MVC (maximal voluntary contraction), CO (cardiac output), HFRRI (HR variability spectrum), Nu (normalized units), LFRRI (low frequency), HbA1c (Hemoglobin A1C), QUICKI (quantitative insulin sensitivity check index), HOMA-IR (homeostatic model assessment for insulin resistance), ln (logarithmic transformation), TPR (Total peripheral resistance), HRIHG (HR response to IHG), HRREC (HR response following IHG)


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