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Exercise in patients with hypertension and chronic kidney disease: a randomized controlled trial

Journal of Human Hypertension volume 32, pages 397–407 (2018)Cite this article

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Abstract

Hypertension and chronic kidney disease (CKD) are global public health problems, both associated with higher risk of cardiovascular (CV) and renal events. This trial randomized non-diabetic adult patients with hypertension and CKD stages 2–4 to 16 weeks of aerobic and resistance training or usual care. The primary outcome was the change in estimated glomerular filtration rate (eGFR). Secondary outcomes included changes in systolic and diastolic blood pressure (BP), body weight, fasting blood glucose, lipid profile, high-sensitivity C-reactive protein (hs-CRP), and functional capacity. The analysis was performed by intention-to-treat, using linear mixed-effects models for repeated measures over time. A hundred fifty patients were included in the intervention (76) or control (74) groups. No difference was found in eGFR, BP, body weight, or lipid profile changes between the groups. However, there were significant decreases in hs-CRP [−6.7(−11.7 to −1.8) mg/L] and fasting blood glucose [−11.3(−20.0 to −1.8) mg/dL], and an increase in functional capacity [2′ Step Test 33.9 (17.7–50.0); 30″ Stand Test 2.3 (0.9–3.7)] in exercise group compared with control group. The results of this RCT show that combined aerobic and resistance training could reduce inflammation and insulin resistance in hypertensive patients with earlier stages of CKD, without a significant effect on kidney disease progression. Clinical trials.gov NCT01155128.

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Author contributions

FCB, ISS, and PCH conceived the concept for the study and are accountable for its design. FCB, AR, FBDV, and GM conducted the data management process and statistical analyses with help and guidance from drafted the manuscript. MB, DU, GM, ISS, and PCH contributed to the interpretation of the data. All the authors revised the text for important intellectual content, approved the final manuscript, and are accountable for all aspects of the work.

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Authors and Affiliations

  1. Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil

    Franklin C. Barcellos, Gregore Mielke, Iná S. Santos & Pedro C. Hallal

  2. School of Medicine, Catholic University of Pelotas, Pelotas, Brazil

    Franklin C. Barcellos, Annelise Reges & Maristela Bohlke

  3. Superior School of Physical Education, Federal University of Pelotas, Pelotas, Brazil

    Fabricio Boscolo Del Vecchio & Pedro C. Hallal

  4. School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia

    Gregore Mielke

  5. Federal University of Rio Grande do Sul, Porto Alegre, Brazil

    Daniel Umpierre

  6. Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil

    Maristela Bohlke

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  1. Franklin C. Barcellos
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Correspondence to Franklin C. Barcellos.

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Barcellos, F.C., Del Vecchio, F.B., Reges, A. et al. Exercise in patients with hypertension and chronic kidney disease: a randomized controlled trial. J Hum Hypertens 32, 397–407 (2018). https://doi.org/10.1038/s41371-018-0055-0

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