Effects of exercise and weight loss on cardiac risk factors associated with syndrome X.
BACKGROUND
Patients with high blood pressure (BP) often exhibit syndrome X, an aggregation of abnormalities in carbohydrate and lipoprotein metabolism associated with increased risk of coronary heart disease (CHD). The present study evaluated the effects of a 6-month intervention involving either aerobic exercise training alone (EX only) or exercise combined with a structured weight loss program (EX + WL) on CHD risk factors associated with syndrome X.


METHODS
A total of 53 men and women were selected from a larger behavioral intervention trial, who showed the hyperinsulinemia, dyslipidemia, and high BP characteristic of syndrome X. Participants were randomly assigned to EX only (n = 21), EX + WL (n = 21), or a waiting list control group (n = 11). Before and following treatment, participants underwent measurement of glucose tolerance, lipid levels, and clinical BP.


RESULTS
Hyperinsulinemic responses to glucose challenge were significantly reduced in both the EX + WL group (P<.001) and the EX-only group (P =.003). Participants who showed the largest amount of weight loss showed the most robust improvements in abnormal insulin responses (EX + WL group, 47% reduction; EX-only group, 27% reduction). Diastolic BP was significantly reduced in the EX + WL group (96 +/- 4 to 87 +/- 5 mm Hg [mean +/- SD]; P =.01), but not in the EX-only group (93 +/- 4 to 89 +/- 5 mm Hg [mean +/- SD]; P =.08). Lipid profile was not significantly improved by either intervention.


CONCLUSIONS
These results suggest that EX + WL is an effective treatment for hyperinsulinemia and lowering of diastolic BP in patients with the syndrome X.
Watkins
Lana L
LL
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA. watki017@mc.duke.edu
Sherwood
Andrew
A
Feinglos
Mark
M
Hinderliter
Alan
A
Babyak
Michael
M
Gullette
Elizabeth
E
Waugh
Robert
R
Blumenthal
James A
JA
D000328:Adult; D001794:Blood Pressure; D001823:Body Composition; D015992:Body Mass Index; D003324:Coronary Artery Disease / Q000150:complications; D002149:Energy Intake; D015444:Exercise; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006946:Hyperinsulinism / Q000628:therapy; D006949:Hyperlipidemias / Q000628:therapy; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000628:therapy*; D010101:Oxygen Consumption; D012044:Regression Analysis; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss