Combined effects of angiotensin receptor blocker use and physical training in hypertensive men

ABSTRACT

Purpose

Pharmacological (angiotensin II receptor type 1 receptor blocker use) and non-pharmacological treatment (physical aerobic exercise) are important strategies to reduces blood pressure and control arterial hypertension; however, only few clinical studies have evaluated their combined effects on autonomic cardiovascular control. Therefore, we investigated the effect of a combination intervention that involved losartan administration and physical aerobic training on autonomic cardiovascular control.

Methods

Thirty-two men (aged 40 to 60 years) were assigned into two groups: normotensive group, without any pharmacological treatment (NG, N = 16), or hypertensive group, with losartan administration (HG, N = 16). They underwent a physical aerobic training for 16 weeks, thrice a week. Hemodynamic parameters, heart rate variability (HRV), blood pressure variability, and spontaneous baroreflex sensitivity (BRS) were measured before and after training.

Results

Before training, both the groups showed similar values of hemodynamic parameters. However, the HG showed decreased BRS and HRV, characterized by reduction in sympathetic (p = .02) and vagal (p < .001) modulation. After training, the NG exhibited decreased heart rate (HR) at rest (p < .001), whereas the HG showed decreased HR at rest (p < .001) and blood pressure (BP) (p = .001). The HG showed decreased sympathetic modulation (p = .02) and increased BRS (p < .001) and vagal modulation (p < .001), but HRV (p < .001) and BRS gain (p < .001) remained significantly lower when compared to the NG.

Conclusions

Physical aerobic training was essential to improve the BRS and HRV cardiac autonomic modulation in the HG. However, it was not sufficient to normalize the analyzed autonomic parameters.

KEYWORDS:

• Angiotensin
• autonomic nervous system
• cardiorespiratory fitness
• hypertension
• losartan

Acknowledgments

The author expresses sincere gratitude to all volunteers who participated in this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Author contributions

TPF, SVP, and HCDS contributed to conception and design of the work. TPF, BAA, and ACV contributed to acquisition and analysis of data. TPF and SVP contributed to interpretation of data. TPF, BAA, and ACV drafted the manuscript. TPF, SVP, and HCDS critically revised the manuscript for important intellectual content. All the authors gave final approval and agreed to be accountable for all aspects of work, ensuring integrity and accuracy.

Additional information

Funding

This study was supported by grant 2018/08569-6 S’ão Paulo Research Foundation (FAPESP).