Exercise Training for High Blood Pressure

Overseen By Marc Cook, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: North Carolina Agriculture & Technical State University

Must not be taking: Hypertension, Anti-inflammatories, Statins, Thyroid

Disqualifiers: Uncontrolled hypertension, Heart disease, Diabetes, Inflammatory diseases, Others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 12

Duration: 12 weeks

36 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

Yes, if you are taking medications for hypertension or those affecting inflammation or metabolic function, you must stop taking them at least one month before joining the trial.

What data supports the effectiveness of the treatment Exercise Training for High Blood Pressure?

Research shows that physical activity can help lower blood pressure in people with high blood pressure, and exercise is recommended as part of managing this condition. Studies have found that endurance training can reduce heart rate and blood pressure during exercise, which may improve overall heart health. ^{1 2 3 4 5}

Is exercise training safe for people with high blood pressure?

Exercise training, including aerobic and resistance exercises, is generally safe for people with high blood pressure. Studies show it can be performed without increasing blood pressure or causing adverse events, and it is often recommended as part of a lifestyle modification to manage hypertension. ^{4 6 7 8 9}

How does exercise training as a treatment for high blood pressure differ from other treatments?

Exercise training is a unique treatment for high blood pressure because it is a non-drug approach that can lower blood pressure by about 10 mmHg through regular physical activity. Unlike medications, it also improves overall fitness, insulin sensitivity, and heart health, and can be as effective at low to moderate intensity as at higher intensity levels. ^{4 10 11 12 13}

What is the purpose of this trial?

African Americans have the greatest burden of endothelial dysfunction and hypertension. Recently, gut microbial dysbiosis (a term that describes a poorly diverse gut microbial profile and lower short-chain fatty acid (SCFA) production) has been linked to hypertension and may be involved in the pathogenesis of hypertension in African Americans. African Americans have been reported to have lower gut SCFA and SCFA can reduce blood pressure. Exercise reduces blood pressure and improves gut dysbiosis (increases SCFA) and likely couples' improvements in gut microbial health and vascular function to reduce blood pressure. Thus, the goals of this research are to fill a critical void concerning the interaction of gut dysbiosis, hypertension, and utilizing exercise to identify gut microbial adaptations that accompany a reduction in blood pressure. The short-term implications of this work will advance the clinical communities understanding of the relationship between dysbiosis and the pathogenesis of hypertension in African Americans, while long term implications will promote identifying adaptable gut microbes associated with vascular health to aid in amending treatment strategies for hypertension.

Research Team

Marc Cook, PhD

Principal Investigator

North Carolina Agriculture & Technical State University

Eligibility Criteria

This trial is for African Americans aged 30-50 who are sedentary, have slightly elevated to stage 1 high blood pressure but no other major health issues like heart disease, kidney or lung diseases, and aren't on medications that affect blood pressure. Smokers and pregnant women can't participate.

Inclusion Criteria

You don't exercise regularly and have a job that involves sitting most of the time.

I am between 30 and 50 years old.

Your blood pressure is within the normal range (systolic BP: 90-120 mmHg/diastolic BP: 60-80 mmHg).

Exclusion Criteria

I have taken medication for blood pressure, inflammation, cholesterol, or thyroid in the last month.

Pregnant females

You have heart-related symptoms during exercise testing that would prevent you from doing vigorous physical activity.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants with hypertension perform 3 months of supervised aerobic exercise (5 days/week) and submit blood and fecal samples every 4 weeks

12 weeks

12 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Exercise Training

Trial Overview The study investigates how exercise training affects high blood pressure and gut microbial diversity in African Americans. It aims to understand if improving gut health through exercise can help lower blood pressure.

Participant Groups

Group I: Hypertension (Exercise Intervention) Experimental Treatment 1 Intervention

Participants with hypertension will submit blood and fecal samples for comparison to control participants with normal blood pressure. Control group will only donate fecal and blood samples and will not participate in the exercise intervention. Participants with hypertension will also perform 3 months of supervised aerobic exercise (5 days/week) and submit blood and fecal samples every 4 weeks until the completion of the study.

Who Is Running the Clinical Trial?

North Carolina Agriculture & Technical State University

Lead Sponsor

Trials

9

Recruited

180+

Findings from Research

Physical conditioning can be an effective alternative or complement to medication for managing borderline or mild hypertension, as studies show it can lead to modest reductions in blood pressure.

Exercise programs for hypertensive patients should be personalized based on individual assessments and may include activities like arm crank ergometry and moderate weight training, while avoiding pure isometric exercises.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise prescription for hypertensive patients. Franklin, BA., Gordon, S., Timmis, GC.[2019]

Dynamic resistance training can be safely included in cardiac rehabilitation for selected patients, as it does not pose a higher risk than aerobic training when properly supervised and tailored to individual needs.

Low-intensity resistance training (40-60% of maximum voluntary contraction) with controlled repetitions leads to only modest increases in blood pressure, similar to moderate endurance training, making it a viable option for improving muscle strength and cardiovascular health in patients with good cardiac function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Recommendations for resistance exercise in cardiac rehabilitation. Recommendations of the German Federation for Cardiovascular Prevention and Rehabilitation. Bjarnason-Wehrens, B., Mayer-Berger, W., Meister, ER., et al.[2019]

Isometric resistance training (IRT) has been shown to significantly lower blood pressure by an average of 7.4/3.3 mmHg, which is comparable to the effects of antihypertensive medications, and can reduce the risk of major cardiovascular events by 13% to 22%.

IRT is safe for a variety of patient populations and is particularly beneficial for individuals who cannot engage in aerobic exercise or have resistant hypertension, requiring only about 17 minutes of training per week.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An evidence-based guide to the efficacy and safety of isometric resistance training in hypertension and clinical implications. Baffour-Awuah, B., Pearson, MJ., Dieberg, G., et al.[2023]

Aerobic exercise is highly effective in reducing blood pressure, especially in hypertensive patients, with guidelines recommending 30-60 minutes of moderate to vigorous exercise 4-7 days a week as a primary strategy for managing hypertension.

While resistance training is considered safe and can be included as an adjunct to aerobic exercise, its role in directly managing hypertension is less established, and it is recommended to be performed 2-3 days a week with proper medical clearance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise as medicine: role in the management of primary hypertension. Millar, PJ., Goodman, JM.[2014]

Regular physical activity is crucial for controlling blood pressure in individuals with mild hypertension, potentially preventing related health issues and reducing mortality rates.

For effective blood pressure management through exercise, it is recommended to engage in aerobic activities at 55-85% of maximal heart rate, aiming for a weekly energy expenditure of 14-20 kcal/kg of body weight, while considering any interactions with antihypertensive medications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise and mild essential hypertension. Gordon, NF., Scott, CB.[2009]

References

1. United States pubmed.ncbi.nlm.nih.gov

Exercise and hypertension. [2019]

2. England pubmed.ncbi.nlm.nih.gov

Exercise prescription for hypertensive patients. [2019]

3. United States pubmed.ncbi.nlm.nih.gov

Failure of exercise to reduce blood pressure in patients with mild hypertension. Results of a randomized controlled trial. [2016]

4. United States pubmed.ncbi.nlm.nih.gov

Blood pressure response to exercise in normotensives and hypertensives. [2007]

5. England pubmed.ncbi.nlm.nih.gov

Recommendations for resistance exercise in cardiac rehabilitation. Recommendations of the German Federation for Cardiovascular Prevention and Rehabilitation. [2019]

6. England pubmed.ncbi.nlm.nih.gov

An evidence-based guide to the efficacy and safety of isometric resistance training in hypertension and clinical implications. [2023]

7. Canada pubmed.ncbi.nlm.nih.gov

Exercise as medicine: role in the management of primary hypertension. [2014]

8. Australia pubmed.ncbi.nlm.nih.gov

Australian association for exercise and sports science position statement on exercise and hypertension. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Exercise and mild essential hypertension. [2009]

10. Sweden pubmed.ncbi.nlm.nih.gov

Exercise training and hypertension. [2019]

11. New Zealand pubmed.ncbi.nlm.nih.gov

The role of exercise training in the treatment of hypertension: an update. [2022]

12. United States pubmed.ncbi.nlm.nih.gov

Is Concurrent Training Efficacious Antihypertensive Therapy? A Meta-analysis. [2022]

13. United States pubmed.ncbi.nlm.nih.gov

Exercise and hypertension. [2019]