Abstract
The optimal exercise-training characteristics for reducing blood pressure (BP) are unclear. We investigated the effects of 6-weeks of high-intensity interval training (HIIT) or moderate-intensity continuous training (MICT) on BP and aortic stiffness in males with overweight or obesity. Twenty-eight participants (18–45 years; BMI: 25–35 kg/m2) performed stationary cycling three times per week for 6 weeks. Participants were randomly allocated (unblinded) to work-matched HIIT (N = 16; 10 × 1-min intervals at 90–100% peak workload) or MICT (N = 12; 30 min at 65–75% peak heart rate). Central (aortic) and peripheral (brachial) BP and aortic stiffness was assessed before and after training. There were no significant group × time interactions for any BP measure (all p > 0.21). HIIT induced moderate reductions in central (systolic/diastolic ∆: −4.6/−3.5 mmHg, effect size d = −0.51/−0.40) and peripheral BP (−5.2/−4 mmHg, d = −0.45/−0.47). MICT induced moderate reductions in diastolic BP only (peripheral: −3.4 mmHg, d = −0.57; central: −3 mmHg, d = −0.50). The magnitude of improvement in BP was strongly negatively correlated with baseline BP (r = −0.66 to −0.78), with stronger correlations observed for HIIT (r = −0.73 to −0.88) compared with MICT (r = −0.43 to −0.61). HIIT was effective for reducing BP (~3–5 mmHg) in the overweight to obese cohort. Exercise training induced positive changes in central (aortic) BP. The BP-lowering effects of exercise training are more prominent in those with higher baseline BP, with stronger correlation in HIIT than MICT.
Similar content being viewed by others
References
Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics-2019 update: a report from the American Heart Association. Circulation. 2019;139:e56–e528.
Olsen MH, Angell SY, Asma S, Boutouyrie P, Burger D, Chirinos JA, et al. A call to action and a lifecourse strategy to address the global burden of raised blood pressure on current and future generations: the Lancet Commission on hypertension. Lancet (Lond, Engl). 2016;388:2665–712.
Collaborators GRF. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet (Lond, Engl). 2018;392:1923–94.
Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, et al. Global disparities of hypertension prevalence and control: a systematic analysis of population-based studies from 90 countries. Circulation. 2016;134:441–50.
Naci H, Salcher-Konrad M, Dias S, Blum MR, Sahoo SA, Nunan D, et al. How does exercise treatment compare with antihypertensive medications? A network meta-analysis of 391 randomised controlled trials assessing exercise and medication effects on systolic blood pressure. Br J Sports Med. 2019;53:859–69.
Wewege M, van den Berg R, Ward RE, Keech A. The effects of high-intensity interval training vs. moderate-intensity continuous training on body composition in overweight and obese adults: a systematic review and meta-analysis. Obes Rev. 2017;18:635–46.
Liou K, Ho SY, Fildes J, Ooi SY. High intensity interval versus moderate intensity continuous training in patients with coronary artery disease: a meta-analysis of physiological and clinical parameters. Heart Lung Circulation. 2016;25:166–74.
Ramos JS, Dalleck LC, Tjonna AE, Beetham KS, Coombes JS. The impact of high-intensity interval training versus moderate-intensity continuous training on vascular function: a systematic review and meta-analysis. Sports Med. 2015;45:679–92.
Jelleyman C, Yates T, O’Donovan G, Gray LJ, King JA, Khunti K, et al. The effects of high-intensity interval training on glucose regulation and insulin resistance: a meta-analysis. Obes Rev. 2015;16:942–61.
Costa EC, Hay JL, Kehler DS, Boreskie KF, Arora RC, Umpierre D, et al. Effects of high-intensity interval training versus moderate-intensity continuous training on blood pressure in adults with pre- to established hypertension: a systematic review and meta-analysis of randomized trials. Sports Med (Auckl, NZ). 2018;48:2127–42.
McEniery CM, Cockcroft JR, Roman MJ, Franklin SS, Wilkinson IB. Central blood pressure: current evidence and clinical importance. Eur Heart J. 2014;35:1719–25.
Roman MJ, Devereux RB, Kizer JR, Lee ET, Galloway JM, Ali T, et al. Central pressure more strongly relates to vascular disease and outcome than does brachial pressure: the Strong Heart Study. Hypertension. 2007;50:197–203.
Williams B, Lacy PS. Central aortic pressure and clinical outcomes. J Hypertens. 2009;27:1123–5.
Wang KL, Cheng HM, Chuang SY, Spurgeon HA, Ting CT, Lakatta EG, et al. Central or peripheral systolic or pulse pressure: which best relates to target organs and future mortality? J Hypertens. 2009;27:461–7.
Kollias A, Lagou S, Zeniodi ME, Boubouchairopoulou N, Stergiou GS. Association of central versus brachial blood pressure with target-organ damage: systematic review and meta-analysis. Hypertension (Dallas, Tex: 1979). 2016;67:183–90.
Williams B, Lacy PS, Thom SM, Cruickshank K, Stanton A, Collier D, et al. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation. 2006;113:1213–25.
Asmar RG, London GM, O’Rourke ME, Safar ME. Improvement in blood pressure, arterial stiffness and wave reflections with a very-low-dose perindopril/indapamide combination in hypertensive patient: a comparison with atenolol. Hypertension. 2001;38:922–6.
Hakansson S, Jones MD, Ristov M, Marcos L, Clark T, Ram A, et al. Intensity-dependent effects of aerobic training on pressure pain threshold in overweight men: a randomized trial. Eur J Pain. 2018;22:1813–23.
Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006;27:2588–605.
Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14:377–81.
Cohen, JW. Statistical power analysis for the behavioral sciences. 2nd edn. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.
MacDonald HV, Pescatello LS. Exercise and blood pressure control in hypertension. In: Kokkinos P, Narayan P, editors. Cardiorespiratory fitness in cardiometabolic diseases: prevention and management in clinical practice. Cham: Springer International Publishing; 2019. 137–68.
Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc. 2013;2:e004473.
Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71:e13–e115.
Víctor Hugo A-S, Yuri F, Fredy Alonso P-V, Astrid Viviana V-R, Elkin Fernando A-V. Effects of high-intensity interval training compared to moderate-intensity continuous training on maximal oxygen consumption and blood pressure in healthy men: a randomized controlled trial. Biomedica. 2019;39:524–36.
Millar PJ, McGowan CL, Cornelissen VA, Araujo CG, Swaine IL. Evidence for the role of isometric exercise training in reducing blood pressure: potential mechanisms and future directions. Sports Med. 2014;44:345–56.
Wewege MA, Ahn D, Yu J, Liou K, Keech A. High-intensity interval training for patients with cardiovascular disease-is it safe? a systematic review. J Am Heart Assoc. 2018;7:e009305.
Carpio-Rivera E, Moncada-Jiménez J, Salazar-Rojas W, Solera-Herrera A. Acute effects of exercise on blood pressure: a meta-analytic investigation. Arquivos Brasileiros de Cardiologia. 2016;106:422–33.
Angadi SS, Bhammar DM, Gaesser GA. Postexercise hypotension after continuous, aerobic interval, and sprint interval exercise. J Strength Conditioning Res. 2015;29:2888–93.
Wegmann M, Hecksteden A, Poppendieck W, Steffen A, Kraushaar J, Morsch A, et al. Postexercise hypotension as a predictor for long-term training-induced blood pressure reduction: a large-scale randomized controlled trial. Clin J Sport Med. 2018;28:509–15.
Hecksteden A, Grutters T, Meyer T. Association between postexercise hypotension and long-term training-induced blood pressure reduction: a pilot study. Clin J Sport Med. 2013;23:58–63.
Liu S, Goodman J, Nolan R, Lacombe S, Thomas SG. Blood pressure responses to acute and chronic exercise are related in prehypertension. Med Sci Sports Exerc. 2012;44:1644–52.
Pescatello LS, Franklin BA, Fagard R, Farquhar WB, Kelley GA, Ray CA. American College of Sports Medicine position stand. Exercise and hypertension. Med Sci Sports Exerc. 2004;36:533–53.
Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34:2159–219.
Umemura S, Arima H, Arima S, Asayama K, Dohi Y, Hirooka Y, et al. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019). Hypertension Res. 2019;42:1235–481.
Sharman JE, Stowasser M. Australian association for exercise and sports science position statement on exercise and hypertension. J Sci Med Sport. 2009;12:252–7.
James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). J Am Med Assoc. 2014;311:507–20.
Pescatello LS. Exercise measures up to medication as antihypertensive therapy: its value has long been underestimated. Br J Sports Med. 2019;53:849–52.
Author information
Authors and Affiliations
Contributions
TC, RM, SH, MR, LM, AR, AF, CM and LC recruited participants and collected study data. TC, RM, MJ and AK analysed and interpreted the study data. TC, RM and AK wrote the manuscript. AK and RW designed the study.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Clark, T., Morey, R., Jones, M.D. et al. High-intensity interval training for reducing blood pressure: a randomized trial vs. moderate-intensity continuous training in males with overweight or obesity. Hypertens Res 43, 396–403 (2020). https://doi.org/10.1038/s41440-019-0392-6
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41440-019-0392-6
- Springer Nature Singapore Pte Ltd.
Keywords
This article is cited by
-
Annual reports on hypertension research 2020
Hypertension Research (2022)
-
Post-exercise hypotension time-course is influenced by exercise intensity: a randomised trial comparing moderate-intensity, high-intensity, and sprint exercise
Journal of Human Hypertension (2021)
-
The impact of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on arterial stiffness and blood pressure in young obese women: a randomized controlled trial
Hypertension Research (2020)