The Role of Exercise in Patients with Obesity and Hypertension
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HYPERTENSION AND METABOLIC SYNDROME (J SPERATI, SECTION EDITOR)
The Role of Exercise in Patients with Obesity and Hypertension Shelley E. Keating 1,2
&
Jeff S. Coombes 1 & Michael Stowasser 3 & Tom G. Bailey 1,2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review This review sought to evaluate the role of exercise in patients with obesity and comorbid hypertension, with a focus on contemporary literature (since January 2015). Recent Findings No reviews have included patients classified with both obesity and hypertension and there is a paucity of randomised controlled trials examining the benefits of exercise in this population. Moreover, just one of 19 reviews examining the role of exercise on blood pressure included studies that met pre-defined inclusion criterion for hypertension, although seven conducted subgroup analyses stratified by mean baseline blood pressure. These demonstrated significantly larger reductions in blood pressure in hypertensive than pre-hypertensive and normotensive samples. Summary There is a significant research-practice gap for understanding and influencing the role of exercise for patients with obesity and hypertension. This review provides recommendations for future research and consensus-based recommendations that promote exercise as a principle therapy for patients with obesity and hypertension. Keywords Exercise training . Weight management . Blood pressure . Hypertension . Obesity . Physical activity
Abbreviations BMI Body mass index CVD Cardiovascular disease VAT Visceral adipose tissue FFA Free fatty acids HIIT High-intensity interval training MICT Moderate-intensity continuous training SBP Systolic blood pressure DBP Diastolic blood pressure MAP Mean arterial pressure RCT Randomized controlled trial This article is part of the Topical Collection on Hypertension and Metabolic Syndrome * Shelley E. Keating [email protected] 1
Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, Australia
2
Physiology and Ultrasound Lab in Science and Exercise (PULSE), School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, Australia
3
Endocrine Hypertension Research Center, University of Queensland Diamantina Institute, Princess Alexandra Hospital, Brisbane, QLD, Australia
Introduction Obesity is escalating globally, with more than 650 million adults (13%) classified as having obesity (body mass index, BMI, ≥ 30 kg/m2) in 2016 [1]. In developed nations, including the USA [2] and Australia [3], the prevalence of obesity is over 30%. This is concerning given the links between obesity, chronic disease and mortality. In particular, excess visceral adipose tissue (VAT) and ectopic fat stores (e.g. liver fat, renal sinus fat, myocardial fat and pancreatic fat) are hallmark pathophysiological features of obesity that drive the severity of cardiometabolic dysfunction [4, 5]. Hypertension is also a major contri
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