Articles | Advances in Musculoskeletal and Neuromuscular Rehabilitation

Effects of moderate physical training program in post-myocardial infarction patients with arterial hypertension

Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Received: 2 May 2025
Published: 10 July 2025
766
Views
368
Downloads
7
HTML

Authors

The clinical effectiveness of physical training in a Cardiac Rehabilitation Program (CRP) was assessed in hypertensive (Arterial Hypertension, AH), post-Myocardial Infarction (MI) patients. 206 patients were randomized into a physically trained group (PhTG, n=102) and an untrained, control group (CG, n=104). All patients received standard drug therapy. PhTG patients performed mild callisthenic exercises and moderately intensive bicycle exercise three times/week for one year. Compared to control patients, PhTG patients had significant changes in exercise capacity (duration +38%, p<0.001; total work +63.6%, p<0.001); rate-pressure product (-8.2%, p<0.01); left ventricular ejection fraction (+7.6%, p<0.001); left ventricular stroke volume (+5.1%, p<0.01). Resting BP decreased in PhTG patients (systolic BP, -3.1%, p<0.05; diastolic BP, -3.5%, p<0.001), but increased in CG patients (systolic BP, +3.1%, p<0.05; diastolic BP +3.4%, p<0.05). PhTG patients had fewer myocardial ischemic episodes, including painless ischemia during exercise, fewer angina attacks, less nitroglycerin consumption, improved quality of life, fewer cardiovascular events (-50%, p<0.05), and days of absence from work (-43.2%, p<0.05). Thus, supplementing a CRP with moderate exercise improved BP, work capacity, cardiac function, and quality of life in hypertensive, post-MI patients.

Downloads

Download data is not yet available.

Mancia G, Kreutz R, Brunström M, et al. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J Hypertens 2023;41:1874-2071. DOI: https://doi.org/10.1097/HJH.0000000000003480

Agabiti-Rosei E, Rizzoni D. Microvascular structure as a prognostically relevant endpoint. J Hypertens 2017;35:914-21. DOI: https://doi.org/10.1097/HJH.0000000000001259

Zdravkovic M, Popadic V, Klasnja S, et al., Coronary microvascular dysfunction and hypertension: A bond more important than we think. Medicina (Kaunas). 2023;59:2149. DOI: https://doi.org/10.3390/medicina59122149

Briones AM, Hernanz R, García-Redondo AB, et al. Role of Inflammatory and Proresolving Mediators in Endothelial Dysfunction. Basic Clin Pharmacol Toxicol 2025;136:e70026. DOI: https://doi.org/10.1111/bcpt.70026

Ellulu MS, Patimah I, Khaza'ai H, et al. Atherosclerotic cardiovascular disease: a review of initiators and protective factors. Inflammopharmacology 2016;24:1-10. DOI: https://doi.org/10.1007/s10787-015-0255-y

Chlorogiannis DD, Pargaonkar S, Apostolos A, et al. The Predictive Value of Aortic Calcification on Computed Tomography for Major Cardiovascular Events. J Clin Med 2024;13:4019. DOI: https://doi.org/10.3390/jcm13144019

Sun Y, Yao J, Wang C, et al. Epigenetic modification of TWIST1 in macrophages promotes hypertension-induced atherosclerotic plaque instability. Int Immunopharmacol 2024;127:111313. DOI: https://doi.org/10.1016/j.intimp.2023.111313

Saba L, Saam T, Jäger HR, et al. Imaging biomarkers of vulnerable carotid plaques for stroke risk prediction and their potential clinical implications. Lancet Neurol 2019;18:559-72. DOI: https://doi.org/10.1016/S1474-4422(19)30035-3

Natali A, Vichi S, Landi P, Toschi E, Severi S, L'abbate A, Ferrannini E. Coronary artery disease and arterial hypertension: clinical, angiographic and follow-up data. Intern Med 2000;247:219-30. DOI: https://doi.org/10.1046/j.1365-2796.2000.00637.x

Bubnova MG, Aronov DM, Oganov RG, et al. Clinical characteristics of stable angina patients and their treatment strategies in real-world clinical practice. A Russian Federation PERSPECTIVE Study (Part I). Cardiovasc Ther Prev 2010;9:47-56.

Steg PhG, Greenlaw N, Tardif J-C, et al. Women and men with stable coronary artery disease have similar clinical outcomes: insights from the international prospective CLARIFY registry. Eur Heart J 2012;33:2831-40. DOI: https://doi.org/10.1093/eurheartj/ehs289

Dibben GO, Faulkner J, Oldridge N, et al. Exercise-based cardiac rehabilitation for coronary heart disease: a meta-analysis. Eur Heart J 2023;44:452-69. DOI: https://doi.org/10.1093/eurheartj/ehac747

Li C, Wu S, Lei B, et al. Effect of aerobic exercise on endothelial function in hypertensive and prehypertensive patients: a systematic review and meta-analysis of randomized controlled trials. J Hypertens 2025;43:727-38. DOI: https://doi.org/10.1097/HJH.0000000000003980

Tozo JVA, Tadiotto MC, Tozo TAA, et al Effects of different physical exercise programs on blood pressure in overweight children and adolescents: systematic review and meta-analysis. BMC Pediatr 2025;25:252. DOI: https://doi.org/10.1186/s12887-025-05575-y

Wang B, Gan L, Deng Y, et al. Cardiovascular disease and exercise: from molecular mechanisms to clinical applications. J Clin Med 2022;11:7511. DOI: https://doi.org/10.3390/jcm11247511

.Schroeder EC, Franke WD, Sharp RL, D-c L. Comparative effectiveness of aerobic, resistance, and combined training on cardiovascular disease risk factors: a randomized controlled trial. PLoS One 2019;14:e0210292. DOI: https://doi.org/10.1371/journal.pone.0210292

Hanssen H, Boardman H, Deiseroth A, et al. Personalized exercise prescription in the prevention and treatment of arterial hypertension: a Consensus Document from the European Association of Preventive Cardiology (EAPC) and the ESC Council on Hypertension. Eur J Prev Cardiol 2022;29:205-15. DOI: https://doi.org/10.1093/eurjpc/zwaa141

Leprêtre PM, Ghannem M, Bulvestre M, et al. Exercise-based cardiac rehabilitation in coronary disease: Training impulse or modalities? Int J Sports Med 2016;37:1144-9. DOI: https://doi.org/10.1055/s-0042-112591

Friedewald WT, Levy RI and Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972;18:499-502. DOI: https://doi.org/10.1093/clinchem/18.6.499

Krasnitskyi VB, Aronov DM, Dzhanchotov SO. Study of physical activity in patients with ischemic heart disease using a specialized questionnaire “QPHA-23+”. Cardiovasc Ther Prev 2011;10:90-7. [Russian]

Аronov DM, Zajtsev VP. Methods of assessing the quality of life of patients with cardiovascular disease. Kardiologiya 2002;42:92-5. [Russian]

Leon AS, Franklin BA, Costa F, et al. Cardiac rehabilitation and secondary prevention of coronary heart disease: an American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American association of Cardiovascular and Pulmonary Rehabilitation. Circulation 2005;111:369-76. DOI: https://doi.org/10.1161/01.CIR.0000151788.08740.5C

Bubnova MG, Aronov DM, Krasnitskyi VB, Iosiliani DG, Novikova NK, Rodzinskaya EM. A home exercise training program after acute coronary syndrome and/or endovascular coronary intervention: efficiency and a patient motivation problem. Теr Arkh 2014;86:23-32. [Russian]

Waclawovsky G, Pedralli ML, Eibel B, Schaun MI, Lehnen AM. Effects of Different types of exercise training on endothelial function in prehypertensive and hypertensive individuals: A systematic review. Arq Bras Cardiol 2021;116:938-47. DOI: https://doi.org/10.36660/abc.20190807

Jabbarzadeh Ganjeh B, Zeraattalab-Motlagh S, Jayedi A, et al. Effects of aerobic exercise on blood pressure in patients with hypertension: a systematic review and dose-response meta-analysis of randomized trials. Hypertens Res 2024;47:385-98. DOI: https://doi.org/10.1038/s41440-023-01467-9

Thomopoulos C, Parati G, Zanchetti A. Effects of blood pressure-lowering treatment on cardiovascular outcomes and mortality: 13 - benefits and adverse events in older and younger patients with hypertension: overview, meta-analyses and meta-regression analyses of randomized trials. J Hypertens 2018;36:1622-36. DOI: https://doi.org/10.1097/HJH.0000000000001787

Sabbahi A, Arena R, Elokda A, Phillips SA. Exercise and hypertension: Uncovering the mechanisms of vascular control. Prog Cardiovasc Dis 2016;59:226-34. DOI: https://doi.org/10.1016/j.pcad.2016.09.006

Pastore MC, Cavigli L, Olivoni G, et al. Physical exercise in hypertensive heart disease: From the differential diagnosis to the complementary role of exercise. Int J Cardiol 2024;410:132232. DOI: https://doi.org/10.1016/j.ijcard.2024.132232

Liang C, Song Z, Yao X, et al. Exercise interventions for the effect of endothelial function in hypertensive patients: A systematic review and meta-analysis. J Clin Hypertens (Greenwich) 2024;26:599-614. DOI: https://doi.org/10.1111/jch.14818

Boeno FP, Ramis TR, Munhoz SV, et al. Effect of aerobic and resistance exercise training on inflammation, endothelial function and ambulatory blood pressure in middle-aged hypertensive patients. J Hypertens 2020;38:2501-9. DOI: https://doi.org/10.1097/HJH.0000000000002581

Heaps CL, Parker JL. Effects of exercise training on coronary collateralization and control of collateral resistance. J Appl Physiol 2011;111:587-98. DOI: https://doi.org/10.1152/japplphysiol.00338.2011

Schuler G, Adams V, Goto Y. Role of exercise in the prevention of cardiovascular disease: results, mechanisms, and new perspectives. Eur Heart J 2013;34:1790-9. DOI: https://doi.org/10.1093/eurheartj/eht111

Möbius-Winkler S, Uhlemann M, Adams V, et al. Coronary collateral growth induced by physical exercise: Results of the impact of intensive exercise training on coronary collateral circulation in patients with stable coronary artery disease (EXCITE) trial. Circulation 2016;133:1438-48; discussion 1448. DOI: https://doi.org/10.1161/CIRCULATIONAHA.115.016442

Heutinck JM, de Koning IA, Vromen T, et al. Exercise-based cardiac rehabilitation in stable angina pectoris: a narrative review on current evidence and underlying physiological mechanisms. Neth Heart J 2024;32:23-30. DOI: https://doi.org/10.1007/s12471-023-01830-y

Hoier B, Hellsten Y. Exercise-induced capillary growth in human skeletal muscle and the dynamics of VEGF. Microcirculation 2014;21:301-14. DOI: https://doi.org/10.1111/micc.12117

Aronov DM, Bubnova MG, Perova NV, Orekhov AN, Bobryshev YuV. The effect of maximal versus submaximal exertion on postprandial lipid levels in individuals with and without coronary heart disease. Clin Lipidol 2017;11:369-76. [Russian] DOI: https://doi.org/10.1016/j.jacl.2017.01.007

Robert J, Osto E, von Eckardstein A. The endothelium is both a target and a barrier of HDL's protective functions. Cells 2021;10:1041. DOI: https://doi.org/10.3390/cells10051041

Mahmood A, Ray R, Bin Salam SST, et al. The effectiveness of cardiac rehabilitation programs in improving cardiovascular outcomes: systematic review and meta-analysis. Cureus 2024;16:e72450. DOI: https://doi.org/10.7759/cureus.72450

Nishitani-Yokoyama M, Miyauchi K, Shimada K, et al. Impact of Physical Activity on coronary plaque volume and components in acute coronary syndrome patients after early phase II cardiac rehabilitation. Circ J 2018;83:101-9. DOI: https://doi.org/10.1253/circj.CJ-18-0738

Wang C, Xing J, Zhao B, et al. The effects of high-intensity interval training on exercise capacity and prognosis in heart failure and coronary artery disease: A systematic review and meta-analysis. Cardiovasc Ther 2022;2022:4273809. DOI: https://doi.org/10.1155/2022/4273809

Martin BJ, Hauer T, Arena R, et al. Cardiac rehabilitation attendance and outcomes in coronary artery disease patients/clinical perspective. Circulation 2012;126:677-87. DOI: https://doi.org/10.1161/CIRCULATIONAHA.111.066738

Zwisler ADO, Soja AMB, Rasmussen S, et al. Hospital-based comprehensive cardiac rehabilitation versus usual care among patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease: 12-month results of a randomized clinical trial. Am Heart J 2008;155:1106-13. DOI: https://doi.org/10.1016/j.ahj.2007.12.033

Anderson L, Thompson DR, Oldridge N, et al. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database of Systematic Review and Meta-Analysis. Am Coll Cardiol 2016;7:1-12. DOI: https://doi.org/10.1002/14651858.CD001800.pub3

Supporting Agencies

This study was performed as parts of State Assignment of the National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russian Federation #01201352203 and State Assignment of the Institute of General Pathology and Pathophysiology #FGFU-2025-0007

How to Cite



1.
Aronov DM, Bubnova MG, Lyamina NP, Downey HF, Manukhina EB, Lyamina S. Effects of moderate physical training program in post-myocardial infarction patients with arterial hypertension. Eur J Transl Myol [Internet]. 2025 Jul. 10 [cited 2026 May 10];35(3). Available from: https://www.pagepressjournals.org/bam/article/view/13943