Ambulatory and successive home-based heart rate targeted aerobic training improves arterial parameters: a follow-up study in people with metabolic syndrome

Abstract

Background

Studies demonstrated that outpatient aerobic exercise programs (aEP) can significantly decrease aortic stiffness in people with metabolic syndrome (MetS). There is some limited data that remotely supervised home-based aEP can also improve arterial stiffness in this population. We aimed to evaluate the changes in the arterial wall parameters after the 2-month ambulatory supervised aEP followed by the 6-month home-based aEP with and without targeting of heart rate (HR) by electrocardiogram (ECG) in people with MetS.

Methods

In this prospective study (ClinicalTrials.gov identifier: NCT05592704) 132 MetS subjects (mean age 52.44 ± 6.26 years, 54.55% female) were evaluated. At first, all subjects participated in the 2-month ambulatory supervised aEP, which consisted of 40 individual aerobic training sessions on a cycle ergometer 5 times/week for 40 min and received the recommendations for home-based training. Then the study (n = 66) and the control (n = 66) groups participated in the 6-month home-based aEP, but only the study group subjects targeted their HR using ECG monitor connected to the smartphone during workouts. Arterial stiffness parameters and carotid artery intima-media thickness (cIMT) were evaluated in all participants at baseline and after 8 months.

Results

After 8 months, carotid-femoral pulse wave velocity (c-f PWV) significantly reduced in both groups (−12.22% in the study group vs. −7.85% in the control group, all p < .001) without a significant between-group difference (p = 0.144). A significant improvement of carotid-radial pulse wave velocity (c-r PWV) was observed only in the study group (-11.37%, p < .001, d = −0.671) with significant between-group difference (p < .001). The reduction of c-r PWV after 8 months of aEP occurred when c-r PWV at baseline was in the 2nd quartile (>7.90 m/s). A significant decrease of 3.32% in cIMT was present only in the study group (p = .032, d = −0.288).

Conclusions

The combination of 2-month ambulatory supervised aEP and successive 6-month home-based aEP targeted by HR monitoring using ECG improved arterial properties in MetS subjects more than the same combination without HR targeting, leading to the greater reduction of c-r PWV and cIMT.

Key Messages

• The combination of 2-month ambulatory supervised aEP and successive 6-month home-based aEP targeted by HR monitoring using ECG improved arterial properties in MetS subjects more than the same combination without HR targeting, leading to the greater reduction of c-r PWV and cIMT.

• This study foregrounds the importance of home-based training with HR targeting using ECG in people with MetS.

Keywords:

• Arterial stiffness
• carotid artery intima-media thickness
• metabolic syndrome
• physical activity
• outpatient aerobic training
• home-based training
• remote supervision
• wearable devices
• ECG heart rate monitoring

Acknowledgments

We would like to express our gratitude to the outpatient clinic InMedica, where the clinical examination and motivational counseling of our participants were performed. We would also like to show our gratitude to the public institution ‘Informeda’ for its technical support while the course of this study.

Author contributions

Conception and design: AL, JZ, IL, LR, PN, RK; data curation: JZ, IL, LR, PN, RK; investigation: JZ, IL; formal analysis: JZ, LR; writing – original draft: JZ, AL, LR, RK; critical review and editing: JZ, IL, LR, PN, AL, RK; Final approval of the version to be published: JZ, IL, LR, PN, AL, RK. All authors agree to be accountable for all aspects of the work.

Disclosure statement

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

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.