Exercise training in type 2 diabetes and hypertension

2型糖尿病和高血压的运动训练

• 批准号: 7163522
• 负责人: Kerry J. Stewart
• 金额: $ 51.09万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-02-02 至 2008-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7163522
• 关键词: Abdomen; Accounting; Address; Aerobic; Affect; American; Arterioloscleroses; Attenuated; Blood Pressure; Blood Vessels; Body Composition; C-reactive protein; Caliber; Cardiac; Cardiovascular Diseases; Cardiovascular system; Caring; Carotid Arteries; Condition; Control Groups; Diabetes Mellitus; Disease; Doppler Echocardiography; Doppler Ultrasound; Echocardiography; Enrollment; Evaluation; Exercise; Failure; Fatty acid glycerol esters; Functional disorder; Gender; Glucose; Guidelines; Health; Hypertension; Hypotension; Inflammation; Inflammatory; Insulin; Interleukin-6; Interleukins; Knowledge; Left; Left Ventricular Mass; Lipids; Lipoproteins; Magnetic Resonance Imaging; Measures; Mediating; Modality; Non-Insulin-Dependent Diabetes Mellitus; Numbers; Organ; Outcome; Oxygen; Peripheral; Persons; Physical Fitness; Physical activity; Physiologic pulse; Process; Proteins; Pulse Pressure; Pulse taking; Randomized; Resolution; Risk Factors; Sex Characteristics; Sports Medicine; Structure; Testing; Therapeutic; Thick; Training; Ultrasonography; Vasodilation; Vasodilator Agents; Ventricular; Visceral; Woman; brachial artery; college; cysteine rich protein; fitness; glycemic control; health organization; improved; insight; men; muscle strength; novel; reactive hyperemia; response; size; subcutaneous; tonometry; uptake

DESCRIPTION (provided by applicant): Type 2 diabetes is associated with damage, dysfunction, and failure of various organs. The coexistence of diabetes and hypertension is particularly damaging to cardiac and peripheral vascular structure and function. These diseases, either alone or combined, result in increased left ventricular mass and wall thickness, left ventricular diastolic dysfunction, impaired endothelial vasodilator function, and increased vascular stiffness. Although several health organizations endorse exercise training as a therapeutic modality for type 2 diabetes, most studies of exercise and diabetes have focused on glycemic control but not on cardiovascular health. Although exercise lowers blood pressure in persons without diabetes, there are profound gaps in knowledge about the effects of exercise training on blood pressure and cardiovascular health in persons with type 2 diabetes. The primary specific aim of this study is to determine if exercise training reduces blood pressure in persons who have both type 2 diabetes and high normal blood pressure or mild hypertension. Subjects will be randomized to 6-months of exercise training, consistent with established guidelines for diabetes and for hypertension, or to a usual care control group. The second specific aim is to identify the effects of exercise training on parameters of cardiac and peripheral vascular structure and function related to cardiovascular disease in diabetes and hypertension. We will assess left ventricular mass, left ventricular diastolic function, endothelial vasodilator function, and vascular stiffness using high-resolution ultrasound, Doppler echocardiography, and magnetic resonance imaging. We will also examine interleukin-6 and high resolution C-reactive protein as novel risk factors for cardiovascular disease and diabetes to determine the effects of exercise training on the inflammatory process. Because exercise training improves fitness and may improve body composition and regional fat distribution, the associations of change in these parameters with change in blood pressure and cardiac and peripheral vascular structure and function will be analyzed. An equal number of men and women will be enrolled, and a third specific aim of the study is to examine gender differences in response to exercise training. This study will expand the scientific knowledge that defines exercise guidelines and will provide new insight into the mechanisms by which exercise reduces blood pressure and improves cardiovascular health in persons with type 2 diabetes and hypertension.

描述（申请人提供）：2型糖尿病与各种器官的损伤、功能障碍和衰竭有关。糖尿病和高血压的共存对心脏和外周血管结构和功能特别有害。这些疾病，无论是单独或组合，导致左心室质量和壁厚度增加，左心室舒张功能障碍，内皮血管舒张功能受损，血管硬度增加。虽然一些健康组织认可运动训练作为2型糖尿病的治疗方式，但大多数运动和糖尿病的研究都集中在血糖控制上，而不是心血管健康。虽然运动可以降低非糖尿病患者的血压，但对于运动训练对2型糖尿病患者血压和心血管健康的影响，人们的认识还存在很大的差距。本研究的主要具体目的是确定运动训练是否可以降低2型糖尿病患者的血压，同时伴有正常高血压或轻度高血压。 受试者将被随机分配至6个月的运动训练组（与糖尿病和高血压的既定指南一致）或常规护理对照组。第二个具体目标是确定运动训练对糖尿病和高血压患者心脏和外周血管结构和功能参数的影响。我们将使用高分辨率超声、多普勒超声心动图和磁共振成像评估左心室质量、左心室舒张功能、内皮血管舒张功能和血管僵硬度。我们还将研究白细胞介素-6和高分辨率C反应蛋白作为心血管疾病和糖尿病的新风险因素，以确定运动训练对炎症过程的影响。由于运动训练可以改善健康状况，并可能改善身体成分和局部脂肪分布，因此将分析这些参数变化与血压、心脏和外周血管结构和功能变化的相关性。男女人数相同，研究的第三个具体目标是检查运动训练的性别差异。这项研究将扩展定义运动指南的科学知识，并将为运动降低血压和改善2型糖尿病和高血压患者心血管健康的机制提供新的见解。