Effects of Supervised Aerobic Exercise Training on Weight Loss, Functional Capacity, Quality of Life and Depression Level in Patients With Essential Hypertension: A Non-Randomized Controlled Trial
Öz
Background: Hypertension is a major risk factor for cardiovascular disease, and aerobic exercise is recommended as complementary therapy for its management. This study aimed to evaluate the effects of a supervised aerobic exercise program on weight loss, functional capacity, quality of life (QoL), and depression in patients with essential hypertension.
Methods: A nonrandomized controlled trial with patient preference allocation was conducted. The participants were assigned to either a supervised aerobic exercise group (n = 91) or a control group (n = 47). The exercise group underwent a six-week supervised aerobic training program (five sessions per week), while the control group maintained their usual lifestyle. Outcome measures, including resting blood pressure, weight, body mass index (BMI), lipid profile, functional capacity (6-minute walk test, 6 MWT), QoL (SF-36), and depression level (Beck Depression Inventory, BDI), were assessed at baseline and after six weeks.
Results: The supervised aerobic exercise group showed significant improvements in the 6 MWT distance, SF-36 subscales (physical function, role physical, vitality, role emotional, and mental health), and reductions in resting systolic blood pressure, weight, BMI, and BDI scores compared to the control group (p < 0.05). Within-group comparisons further confirmed significant improvements in physical and mental health measures post-intervention (P < 0.01).
Conclusions: A 6-week supervised aerobic exercise program significantly enhanced functional capacity, QoL, and mental health in patients with hypertension. These findings support supervised aerobic exercise as an effective complementary therapy for hypertension, promoting both physical and mental well-being with no reported adverse effects.
Anahtar Kelimeler
supervised aerobic exercise functional capacity quality of life depression level essential hypertension
Etik Beyan
This study was approved by Selcuk University Faculty of Medicine local ethics committee (No.2016/196). The research protocol adhered to the principles of the Helsinki Declaration. The study protocol was registered on ClinicalTrials.gov (NCT05987436). As this study did not involve animal subjects, no statement on ethical approval for animal research is required.
Destekleyen Kurum
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Teşekkür
None.
Kaynakça
- Brito LC, Pecanha T, Fecchio RY, Rezende RA, Sousa P, N DAS-J, et al. Morning versus Evening Aerobic Training Effects on Blood Pressure in Treated Hypertension. Med Sci Sports Exerc. 2019;51(4):653-62.
- Hunter PG, Chapman FA, Dhaun N. Hypertension: Current trends and future perspectives. Br J Clin Pharmacol. 2021;87(10):3721-36.
- Park DY, Kim YS, Ryu SH, Jin YS. The association between sedentary behavior, physical activity and hyperuricemia. Vasc Health Risk Manag. 2019:291-9.
- Dikmen AU, Altunsoy M, Koç AK, Koç E, Özkan S. Physical activity level of medical students: Is there a family effect? Arch Curr Med Res. 2022;3(2):63-73.
- Yeltekin SY, Görpelioğlu S. Investigation of the knowledge, attitudes and behaviors on active aging of people between 30-40 years: A multi-central cross-sectional study. Arch Curr Med Res.4(3):137-45.
- Ratnaparkhe V, Bhangale A. Left Ventricular Diastolic Dysfunction in Primary Hypertension and its Relation with Leisure Time Physical Activity. J Assoc Physicians India. 2015;63(7):20-4.
- Zeno SA, Kim-Dorner SJ, Deuster PA, Davis JL, Remaley AT, Poth M. Cardiovascular fitness and risk factors of healthy African Americans and Caucasians. J Natl Med Assoc. 2010;102(1):28-35.
- Garrahy E, Davison K, Hardcastle S, O'Brien J, Pedersen S, Williams A, et al. Exercise as cardiovascular medicine. Aust J Gen Pract. 2020;49(8):483-7.
- Saco‐Ledo G, Valenzuela PL, Ruiz‐Hurtado G, Ruilope LM, Lucia A. Exercise reduces ambulatory blood pressure in patients with hypertension: a systematic review and meta‐analysis of randomized controlled trials. J Am Heart Assoc. 2020;9(24):e018487.
- Baghaiee B, Karimi P, Ebrahimi K. Effects of a 12-week aerobic exercise on markers of hypertension in men. J Cardiovasc Thorac Res. 2018;10(3):162.
- Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc. 2013;2(1):e004473.
- Bakris G, Ali W, Parati G. ACC/AHA versus ESC/ESH on hypertension guidelines: JACC guideline comparison. J Am Coll Cardiol. 2019;73(23):3018-26.
- Zaleski AL, Taylor BA, Park CL, Santos LP, Panza G, Kramarz M, et al. Using the immediate blood pressure benefits of exercise to improve exercise adherence among adults with hypertension: a randomized clinical trial. J Hypertens. 2019;37(9):1877-88.
- Mahdi HM, Masoumeh S, Ali KM, Roohafza H, Mohammad RF. Relationship between Changes in Functional Capacity and Anthropometric, Clinical and Psychological Indicators in Cardiac Patients Participating in Cardiac Rehabilitation Program. Health 13.11 (2021): 1303-1313.
- Jaureguizar KV, Vicente-Campos D, Bautista LR, de la Pena CH, Gomez MJ, Rueda MJ, et al. Effect of High-Intensity Interval Versus Continuous Exercise Training on Functional Capacity and Quality of Life in Patients With Coronary Artery Disease: A randomized clinical trial. J Cardiopulm Rehabil Prev. 2016;36(2):96-105.
- Ades PA, Savage PD, Toth MJ, Harvey-Berino J, Schneider DJ, Bunn JY, et al. High-calorie-expenditure exercise: a new approach to cardiac rehabilitation for overweight coronary patients. Circulation. 2009;119(20):2671-8.
- Manzoni GM, Villa V, Compare A, Castelnuovo G, Nibbio F, Titon AM, et al. Short-term effects of a multi-disciplinary cardiac rehabilitation programme on psychological well-being, exercise capacity and weight in a sample of obese in-patients with coronary heart disease: a practice-level study. Psychol Health Med. 2011;16(2):178-89.
- Sarsan A, Alkan H, Başer S, Yıldız N, Özgen M, Ardıç F. The effect of aerobic exercise program on pulmonary function and cardiorespiratory capacity in obese women. Turk J Phys Med Rehabil. 2013.
- Arija V, Villalobos F, Pedret R, Vinuesa A, Jovani D, Pascual G, et al. Physical activity, cardiovascular health, quality of life and blood pressure control in hypertensive subjects: randomized clinical trial. Health Qual Life Outcomes. 2018;16(1):184.
- Ye R, Liu K, Zhang Z, Gong S, Chen X. Health-related quality of life of hypertension in China: a systematic review and meta-analysis. J Cardiovasc Med. 2018;19(8):430-8.
- Rozanski A, Blumenthal JA, Kaplan J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation. 1999;99(16):2192-217.
- Imboden C, Gerber M, Beck J, Eckert A, Pühse U, Holsboer-Trachsler E, et al. Effects of aerobic exercise as add-on treatment for inpatients with moderate to severe depression on depression severity, sleep, cognition, psychological well-being, and biomarkers: study protocol, description of study population, and manipulation check. Front Psychiatry. 2019;10:262.
- Molmen-Hansen HE, Stolen T, Tjonna AE, Aamot IL, Ekeberg IS, Tyldum GA, et al. Aerobic interval training reduces blood pressure and improves myocardial function in hypertensive patients. Eur J Prev Cardiol. 2012;19(2):151-60.
- Tsai JC, Yang HY, Wang WH, Hsieh MH, Chen PT, Kao CC, et al. The beneficial effect of regular endurance exercise training on blood pressure and quality of life in patients with hypertension. Clin Exp Hypertens. 2004;26(3):255-65.
- Sun J, Buys N. Community-Based Mind-Body Meditative Tai Chi Program and Its Effects on Improvement of Blood Pressure, Weight, Renal Function, Serum Lipoprotein, and Quality of Life in Chinese Adults With Hypertension. Am J Cardiol. 2015;116(7):1076-81.
- Stergiou GS, Alpert B, Mieke S, Asmar R, Atkins N, Eckert S, et al. A universal standard for the validation of blood pressure measuring devices: Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Collaboration Statement. Hypertension. 2018;71(3):368-74.
- Karvonen MJ, Kentala E, Mustala O. The effects of training on heart rate: A longitudinal study. Ann med exp biol fenn. 1957;35:307-15.
- Ash GI, Taylor BA, Thompson PD, MacDonald HV, Lamberti L, Chen M-H, et al. The antihypertensive effects of aerobic versus isometric handgrip resistance exercise. J Hypertens. 2017;35(2):291.
- Albayrak İ, Yilmaz H, Akkurt HE, Salli A, Karaca G. Is pain the only symptom in patients with benign joint hypermobility syndrome? Clin Rheumatol. 2015;34(9):1613-9.
- Beck AT, Guth D, Steer RA, Ball R. Screening for major depression disorders in medical inpatients with the Beck Depression Inventory for Primary Care. Behav Res Ther. 1997;35(8):785-91.
- Pagonas N, Vlatsas S, Bauer F, Seibert FS, Zidek W, Babel N, et al. Aerobic versus isometric handgrip exercise in hypertension: a randomized controlled trial. J Hypertens. 2017;35(11):2199-206.
- Cornelissen VA, Fagard RH, Coeckelberghs E, Vanhees L. Impact of resistance training on blood pressure and other cardiovascular risk factors: a meta-analysis of randomized, controlled trials. Hypertension. 2011;58(5):950-8.
- Tabara Y, Yuasa T, Oshiumi A, Kobayashi T, Miyawaki Y, Miki T, et al. Effect of acute and long-term aerobic exercise on arterial stiffness in the elderly. Hypertens Res. 2007;30(10):895-902.
- Baş VN, Aycan Z. Approach to obesity in childhood. Arch Curr Med Res. 2020;1(1):6-11.
- Blumenthal JA, Sherwood A, Gullette EC, Babyak M, Waugh R, Georgiades A, et al. Exercise and weight loss reduce blood pressure in men and women with mild hypertension: effects on cardiovascular, metabolic, and hemodynamic functioning. Arch Intern Med. 2000;160(13):1947-58.
- Ciolac EG, Bocchi EA, Bortolotto LA, Carvalho VO, Greve JM, Guimarães GV. Effects of high-intensity aerobic interval training vs. moderate exercise on hemodynamic, metabolic and neuro-humoral abnormalities of young normotensive women at high familial risk for hypertension. Hypertens Res. 2010;33(8):836-43.
- Muscella A, Stefàno E, Marsigliante S. The effects of exercise training on lipid metabolism and coronary heart disease. Am J Physiol Heart Circ Physiol. 2020;319(1):H76-H88.
- Mann S, Beedie C, Jimenez A. Differential effects of aerobic exercise, resistance training and combined exercise modalities on cholesterol and the lipid profile: review, synthesis and recommendations. Sports Med. 2014;44(2):211-21.
- Fett CA, Fett WC, Marchini JS. Circuit weight training vs jogging in metabolic risk factors of overweight/obese women. Arq Bras Cardiol. 2009;93(5):519-25.
Esansiyel Hipertansiyonlu Hastalarda Gözetimli Aerobik Egzersiz Eğitiminin Kilo Kaybı, Fonksiyonel Kapasite, Yaşam Kalitesi ve Depresyon Düzeyi Üzerine Etkileri: Non-Randomize Kontrollü Çalışma
Öz
Arka Plan: Hipertansiyon, kardiyovasküler hastalık için önemli bir risk faktörüdür ve aerobik egzersiz, tedavisinde tamamlayıcı bir yöntem olarak önerilmektedir. Bu çalışmanın amacı, esansiyel hipertansiyonu olan hastalarda denetimli aerobik egzersiz programının kilo kaybı, fonksiyonel kapasite, yaşam kalitesi (YK) ve depresyon üzerindeki etkilerini değerlendirmektir.
Yöntemler: Hasta tercihi esasına dayalı, randomize olmayan kontrollü bir çalışma yürütülmüştür. Katılımcılar, hasta tercihine göre denetimli aerobik egzersiz grubuna (n = 91) veya kontrol grubuna (n = 47) dahil edilmiştir. Egzersiz grubuna altı hafta boyunca haftada beş seans denetimli aerobik egzersiz programı uygulanırken, kontrol grubuna mevcut yaşam tarzlarını sürdürmeleri önerilmiştir. İstirahat kan basıncı, kilo, vücut kitle indeksi (VKİ), lipid profili, fonksiyonel kapasite (6 dakika yürüme testi - 6 DYT), yaşam kalitesi (Kısa Form 36- KF36) ve depresyon düzeyi (Beck Depresyon Envanteri - BDE) değerlendirmeleri başlangıçta ve altı hafta sonra yapılmıştır.
Bulgular: Denetimli aerobik egzersiz grubu, kontrol grubuna kıyasla 6 DYT mesafesinde ve KF-36 alt ölçeklerinde (fiziksel fonksiyon, fiziksel rol, canlılık, emosyonel rol ve ruhsal sağlık) anlamlı iyileşmeler gösterirken, istirahat sistolik kan basıncı, kilo, VKİ ve BDE skorlarında ise belirgin azalmalar kaydedilmiştir (p < 0.05). Grup içi karşılaştırmalar da müdahale sonrası fiziksel ve ruhsal sağlık ölçümlerinde önemli iyileşmeler olduğunu doğrulamıştır (p < 0.01).
Sonuç: Altı haftalık denetimli aerobik egzersiz programı, hipertansiyonlu hastalarda fonksiyonel kapasiteyi, yaşam kalitesini ve ruh sağlığını önemli ölçüde artırmıştır. Bu bulgular, denetimli aerobik egzersizin hipertansiyon tedavisinde etkili bir tamamlayıcı yaklaşım olduğunu ve herhangi bir yan etkiye neden olmaksızın hem fiziksel hem de zihinsel iyilik halini artırdığını göstermektedir.
Anahtar Kelimeler
Fonksiyonel kapasite Yaşam kalitesi Depresyon düzeyi Esansiyel hipertansiyon Gözetimli aerobik egzersiz
Kaynakça
- Brito LC, Pecanha T, Fecchio RY, Rezende RA, Sousa P, N DAS-J, et al. Morning versus Evening Aerobic Training Effects on Blood Pressure in Treated Hypertension. Med Sci Sports Exerc. 2019;51(4):653-62.
- Hunter PG, Chapman FA, Dhaun N. Hypertension: Current trends and future perspectives. Br J Clin Pharmacol. 2021;87(10):3721-36.
- Park DY, Kim YS, Ryu SH, Jin YS. The association between sedentary behavior, physical activity and hyperuricemia. Vasc Health Risk Manag. 2019:291-9.
- Dikmen AU, Altunsoy M, Koç AK, Koç E, Özkan S. Physical activity level of medical students: Is there a family effect? Arch Curr Med Res. 2022;3(2):63-73.
- Yeltekin SY, Görpelioğlu S. Investigation of the knowledge, attitudes and behaviors on active aging of people between 30-40 years: A multi-central cross-sectional study. Arch Curr Med Res.4(3):137-45.
- Ratnaparkhe V, Bhangale A. Left Ventricular Diastolic Dysfunction in Primary Hypertension and its Relation with Leisure Time Physical Activity. J Assoc Physicians India. 2015;63(7):20-4.
- Zeno SA, Kim-Dorner SJ, Deuster PA, Davis JL, Remaley AT, Poth M. Cardiovascular fitness and risk factors of healthy African Americans and Caucasians. J Natl Med Assoc. 2010;102(1):28-35.
- Garrahy E, Davison K, Hardcastle S, O'Brien J, Pedersen S, Williams A, et al. Exercise as cardiovascular medicine. Aust J Gen Pract. 2020;49(8):483-7.
- Saco‐Ledo G, Valenzuela PL, Ruiz‐Hurtado G, Ruilope LM, Lucia A. Exercise reduces ambulatory blood pressure in patients with hypertension: a systematic review and meta‐analysis of randomized controlled trials. J Am Heart Assoc. 2020;9(24):e018487.
- Baghaiee B, Karimi P, Ebrahimi K. Effects of a 12-week aerobic exercise on markers of hypertension in men. J Cardiovasc Thorac Res. 2018;10(3):162.
- Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc. 2013;2(1):e004473.
- Bakris G, Ali W, Parati G. ACC/AHA versus ESC/ESH on hypertension guidelines: JACC guideline comparison. J Am Coll Cardiol. 2019;73(23):3018-26.
- Zaleski AL, Taylor BA, Park CL, Santos LP, Panza G, Kramarz M, et al. Using the immediate blood pressure benefits of exercise to improve exercise adherence among adults with hypertension: a randomized clinical trial. J Hypertens. 2019;37(9):1877-88.
- Mahdi HM, Masoumeh S, Ali KM, Roohafza H, Mohammad RF. Relationship between Changes in Functional Capacity and Anthropometric, Clinical and Psychological Indicators in Cardiac Patients Participating in Cardiac Rehabilitation Program. Health 13.11 (2021): 1303-1313.
- Jaureguizar KV, Vicente-Campos D, Bautista LR, de la Pena CH, Gomez MJ, Rueda MJ, et al. Effect of High-Intensity Interval Versus Continuous Exercise Training on Functional Capacity and Quality of Life in Patients With Coronary Artery Disease: A randomized clinical trial. J Cardiopulm Rehabil Prev. 2016;36(2):96-105.
- Ades PA, Savage PD, Toth MJ, Harvey-Berino J, Schneider DJ, Bunn JY, et al. High-calorie-expenditure exercise: a new approach to cardiac rehabilitation for overweight coronary patients. Circulation. 2009;119(20):2671-8.
- Manzoni GM, Villa V, Compare A, Castelnuovo G, Nibbio F, Titon AM, et al. Short-term effects of a multi-disciplinary cardiac rehabilitation programme on psychological well-being, exercise capacity and weight in a sample of obese in-patients with coronary heart disease: a practice-level study. Psychol Health Med. 2011;16(2):178-89.
- Sarsan A, Alkan H, Başer S, Yıldız N, Özgen M, Ardıç F. The effect of aerobic exercise program on pulmonary function and cardiorespiratory capacity in obese women. Turk J Phys Med Rehabil. 2013.
- Arija V, Villalobos F, Pedret R, Vinuesa A, Jovani D, Pascual G, et al. Physical activity, cardiovascular health, quality of life and blood pressure control in hypertensive subjects: randomized clinical trial. Health Qual Life Outcomes. 2018;16(1):184.
- Ye R, Liu K, Zhang Z, Gong S, Chen X. Health-related quality of life of hypertension in China: a systematic review and meta-analysis. J Cardiovasc Med. 2018;19(8):430-8.
- Rozanski A, Blumenthal JA, Kaplan J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation. 1999;99(16):2192-217.
- Imboden C, Gerber M, Beck J, Eckert A, Pühse U, Holsboer-Trachsler E, et al. Effects of aerobic exercise as add-on treatment for inpatients with moderate to severe depression on depression severity, sleep, cognition, psychological well-being, and biomarkers: study protocol, description of study population, and manipulation check. Front Psychiatry. 2019;10:262.
- Molmen-Hansen HE, Stolen T, Tjonna AE, Aamot IL, Ekeberg IS, Tyldum GA, et al. Aerobic interval training reduces blood pressure and improves myocardial function in hypertensive patients. Eur J Prev Cardiol. 2012;19(2):151-60.
- Tsai JC, Yang HY, Wang WH, Hsieh MH, Chen PT, Kao CC, et al. The beneficial effect of regular endurance exercise training on blood pressure and quality of life in patients with hypertension. Clin Exp Hypertens. 2004;26(3):255-65.
- Sun J, Buys N. Community-Based Mind-Body Meditative Tai Chi Program and Its Effects on Improvement of Blood Pressure, Weight, Renal Function, Serum Lipoprotein, and Quality of Life in Chinese Adults With Hypertension. Am J Cardiol. 2015;116(7):1076-81.
- Stergiou GS, Alpert B, Mieke S, Asmar R, Atkins N, Eckert S, et al. A universal standard for the validation of blood pressure measuring devices: Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Collaboration Statement. Hypertension. 2018;71(3):368-74.
- Karvonen MJ, Kentala E, Mustala O. The effects of training on heart rate: A longitudinal study. Ann med exp biol fenn. 1957;35:307-15.
- Ash GI, Taylor BA, Thompson PD, MacDonald HV, Lamberti L, Chen M-H, et al. The antihypertensive effects of aerobic versus isometric handgrip resistance exercise. J Hypertens. 2017;35(2):291.
- Albayrak İ, Yilmaz H, Akkurt HE, Salli A, Karaca G. Is pain the only symptom in patients with benign joint hypermobility syndrome? Clin Rheumatol. 2015;34(9):1613-9.
- Beck AT, Guth D, Steer RA, Ball R. Screening for major depression disorders in medical inpatients with the Beck Depression Inventory for Primary Care. Behav Res Ther. 1997;35(8):785-91.
- Pagonas N, Vlatsas S, Bauer F, Seibert FS, Zidek W, Babel N, et al. Aerobic versus isometric handgrip exercise in hypertension: a randomized controlled trial. J Hypertens. 2017;35(11):2199-206.
- Cornelissen VA, Fagard RH, Coeckelberghs E, Vanhees L. Impact of resistance training on blood pressure and other cardiovascular risk factors: a meta-analysis of randomized, controlled trials. Hypertension. 2011;58(5):950-8.
- Tabara Y, Yuasa T, Oshiumi A, Kobayashi T, Miyawaki Y, Miki T, et al. Effect of acute and long-term aerobic exercise on arterial stiffness in the elderly. Hypertens Res. 2007;30(10):895-902.
- Baş VN, Aycan Z. Approach to obesity in childhood. Arch Curr Med Res. 2020;1(1):6-11.
- Blumenthal JA, Sherwood A, Gullette EC, Babyak M, Waugh R, Georgiades A, et al. Exercise and weight loss reduce blood pressure in men and women with mild hypertension: effects on cardiovascular, metabolic, and hemodynamic functioning. Arch Intern Med. 2000;160(13):1947-58.
- Ciolac EG, Bocchi EA, Bortolotto LA, Carvalho VO, Greve JM, Guimarães GV. Effects of high-intensity aerobic interval training vs. moderate exercise on hemodynamic, metabolic and neuro-humoral abnormalities of young normotensive women at high familial risk for hypertension. Hypertens Res. 2010;33(8):836-43.
- Muscella A, Stefàno E, Marsigliante S. The effects of exercise training on lipid metabolism and coronary heart disease. Am J Physiol Heart Circ Physiol. 2020;319(1):H76-H88.
- Mann S, Beedie C, Jimenez A. Differential effects of aerobic exercise, resistance training and combined exercise modalities on cholesterol and the lipid profile: review, synthesis and recommendations. Sports Med. 2014;44(2):211-21.
- Fett CA, Fett WC, Marchini JS. Circuit weight training vs jogging in metabolic risk factors of overweight/obese women. Arq Bras Cardiol. 2009;93(5):519-25.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | İç Hastalıkları, Spor Hekimliği |
| Bölüm | ORIGINAL ARTICLE |
| Yazarlar | |
| Yayımlanma Tarihi | 20 Mayıs 2025 |
| Gönderilme Tarihi | 29 Ocak 2025 |
| Kabul Tarihi | 24 Mart 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 6 Sayı: 2 |
Kaynak Göster
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