Time-efficient inspiratory muscle strength training lowers blood pressure and improves endothelial function, no bioavailability, and oxidative stress in midlife/older adults with above-normal blood pressure

Daniel H. Craighead, Thomas C. Heinbockel, Kaitlin A. Freeberg, Matthew J. Rossman, Rachel A. Jackman, Lindsey R. Jankowski, Makinzie N. Hamilton, Brian P. Ziemba, Julie A. Reisz, Angelo D’Alessandro, L. Madden Brewster, Christopher A. Desouza, Zhiying You, Michel Chonchol, E. Fiona Bailey, Douglas R. Seals

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

BACKGROUND: High-resistance inspiratory muscle strength training (IMST) is a novel, time-efficient physical training modality. METHODS AND RESULTS: We performed a double-blind, randomized, sham-controlled trial to investigate whether 6 weeks of IMST (30 breaths/day, 6 days/week) improves blood pressure, endothelial function, and arterial stiffness in midlife/older adults (aged 50-79 years) with systolic blood pressure ≥120 mm Hg, while also investigating potential mechanisms and long-lasting effects. Thirty-six participants completed high-resistance IMST (75% maximal inspiratory pressure, n=18) or low-resistance sham training (15% maximal inspiratory pressure, n=18). IMST was safe, well tolerated, and had excellent adherence (≈95% of training sessions completed). Casual systolic blood pressure decreased from 135±2 mm Hg to 126±3 mm Hg (P<0.01) with IMST, which was ≈75% sustained 6 weeks after IMST (P<0.01), whereas IMST modestly decreased casual diastolic blood pressure (79±2 mm Hg to 77±2 mm Hg, P=0.03); blood pressure was unaffected by sham training (all P>0.05). Twenty-four hour systolic blood pressure was lower after IMST versus sham training (P=0.01). Brachial artery flow-mediated dilation improved ≈45% with IMST (P<0.01) but was unchanged with sham training (P=0.73). Human umbilical vein endothelial cells cultured with subject serum sampled after versus before IMST exhibited increased NO bioavailability, greater endothelial NO synthase activation, and lower reactive oxygen species bioactivity (P<0.05). IMST decreased C-reactive protein (P=0.05) and altered select circulating metabolites (targeted plasma metabolomics) associated with cardiovascular function. Neither IMST nor sham training influenced arterial stiffness (P>0.05). CONCLUSIONS: High-resistance IMST is a safe, highly adherable lifestyle intervention for improving blood pressure and endothelial function in midlife/older adults with above-normal initial systolic blood pressure.

Original languageEnglish (US)
Article numbere020980
JournalJournal of the American Heart Association
Volume10
Issue number13
DOIs
StatePublished - Jul 6 2021

Keywords

  • Exercise training
  • Flow-mediated dilation
  • Hypertension
  • NO
  • Oxidative stress
  • Reactive oxygen species

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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