Presidential Closing Remarks 12:05 PM – 12:15 PM: Immediately Following President's Lectures ROOM: Ballroom 2/3 and Ballroom 1: E-17 Free Communication/Slide – Clinical Exercise Testing: FRIDAY, JUNE 2, 2006 8:00 AM – 9:45 AM ROOM: 303
PURPOSE: There is a lack of data concerning the compatibility of AT 1 receptor blockers with exercise therapy. In this prospective, randomised, double-blind study the effects of the AT 1 receptor blocker Irbesartan (IRB 150 mg/die) vs. the beta-receptor blocker Metoprolol (MET 95 mg/die) in combination with an eight-week endurance-based individualized exercise program on physical performance, energy metabolism, cardiovascular and neurohormonal parameters in overweight patients with arterial Hypertension (H, WHO I) were investigated.
Patients & METHODS: 39 patients (9 f, 30 m), age: 54,7 ±9,5years, height: 175,8 ±8,6 cm weight: 86,9±13,7 kg, BMI: 28,3 ± 3,8 kg/m2, blood pressure (BP): 152,2±12,6/94,3±8,1 mm Hg, heart rate: 66,5±7,9/min.
METHODS: bicycle spiroergometry until exhaustion (WHO-scheme), submaximal bicycle exercise test (at 2,0 mmol/l lactate level), heart rate variability (HRV). Before, during and after exercise test blood samples were obtained. An identical protocol was repeated after the eight-week intervention.
RESULTS: With IRB and MET BP at rest and during exercise decreased significantly (p <0.001), while exercise performance (maximal and submaximal) significantly increased (p <0.001); favouring IRB at submaximal exercise.
Body weight fell with IRB and increased with MET (p < 0.01), HDL total cholesterol increased, serum leptin concentration significantly decreased in both groups. HRV significantly shifted towards parasympathetic activity. BNP plasma levels before and after maximal test were increased with MET. Endothelial function and plasma endothelin-1 concentrations stayed unaltered.
Conclusions: IRB and MET adequately controlled BP at rest and during exercise. Physical performance improved in both groups. Body weight was only reduced with IRB and exercise. HRV improved with IRB and MET. The AT 1 receptor blocker IRB proved to be suitable in the treatment of overweight patients with H in combination with an individualized exercise therapy.