Effects of chronic angiotensin inhibition on exercise cardiovascular adaptations

BackgroundAngiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs) are commonly prescribed alongside exercise to manage hypertension in individuals with metabolic syndrome (MetS). However, their potential to interfere with exercise-induced physiological adaptations remains unclear. MethodsIn this prospective, parallel-group study, 62 sedentary obese adults with MetS completed a 16-week supervised high-intensity interval training (HIIT) program. Participants were either chronically medicated with ACEi or ARBs (antihypertensive medication group, AHM, n=27) or a non-medicated control group (CONTROL, n=35). Primary outcomes included changes in resting and graded exercise blood pressure, MetS components, and cardiorespiratory fitness (CRF). ResultsBoth groups exhibited significant comparable improvements (all p time x group > 0.05) in cardiometabolic health (MetS Z-score; AHM -0.22{+/-}0.42; CONTROL - 0.30{+/-}0.33; p time < 0.001) and CRF (VO2MAX: AHM 3.9{+/-}2.1; CONTROL 5.0{+/-}3.1 mL{middle dot}kg-{superscript 1}{middle dot}min-{superscript 1}; p time = 0.003). Resting blood pressure decreased similarly in both groups (Mean Arterial Pressure: AHM -4.2{+/-}8.7; CONTROL -6.5{+/-}6.3 mmHg; both p time = 0.005; p time x group > 0.05). Additionally, antihypertensive medication did not interfere with the maximal (MAP; p time = 0.008) and submaximal (DBP; p time = 0.047) blood pressure exercise responses following training with no significant time x group interaction (both p > 0.05) ConclusionsChronic treatment with angiotensin antagonist medication to treat hypertension does not restrain the effects of supervised HIIT program on improving cardiovascular function, cardiorespiratory fitness, or reducing the components of MetS. Our findings support aerobic exercise training as an effective nonpharmacological co-therapy for hypertensive patients treated with angiotensin antagonists.