title: Study of endothelial function response to exercise training in hypertensive individuals (SEFRET): study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Endothelial dysfunction is a hallmark of diabetes mellitus and systemic arterial hypertension (SAH) and an early maker for atherosclerosis. Aerobic exercise training is known to enhance endothelial function, but little is understood about the effects of resistance or combined exercise training on endothelial function. The aim of this study is to investigate the effect of a 12-week aerobic (AT), resistance (RT), or combined (aerobic and resistance, CT) training program on endothelial function and assess associated effects on blood pressure in individuals with SAH.
  
  
  METHODS
  Eighty-one subjects with SAH aged 18 to 70 years will be selected and randomly assigned to three types of exercise training: AT, RT or CT. The study will involve the following procedures and tests: anamnesis, anthropometric assessment, echocardiography, blood pressure measurements through ambulatory blood pressure monitoring, flow-mediated dilation, ergospirometry, one repetition maximum test (1-RM), and blood collection (number of circulating endothelial progenitor cells, number of circulating endothelial microparticles, lipid profile, glucose, glycated hemoglobin, and creatinine). The AT intervention will consist of a 40-min exercise session with progressive intensities ranging from 50 to 75% of heart rate reserve. The RT intervention will consist of a 40-minute session with four sets of six to 12 repetitions with a rest period of 60 to 90 seconds between each set and each type of exercise. Weight loads will be adjusted to 60 to 80% of 1-RM for six types of exercise. The CT intervention will consist of a 20-min aerobic exercise session, followed by an additional 20-min resistance exercise session; each resistance exercise will have two sets less to match the total training volume.
  
  
  CONCLUSIONS
  The study results are expected evidence of cardiovascular protective effects of different types of exercise training through the modulation of endothelial function in hypertensive individuals. Knowing the magnitude of improvement of endothelium-dependent vasodilation for the different types of exercise training can provide scientific evidence for the prescription of exercise programs for vascular protection targeting hypertensive individuals.
  
  
  BACKGROUND
  The Brazilian Clinical Trials Registry ( http://www.ensaiosclinicos.gov.br/) under RBR-9ygmdn and dated 1 March 2015.
authors.affiliation: Laboratório de Investigação Clínica, Instituto de Cardiologia / Fundação Universitária de Cardiologia - ICFUC, Av. Princesa Isabel, 395. Bairro Santana, 90620 001, Porto Alegre, RS, Brazil. marinei.lopespedralli@gmail.com.|Universidade Luterana do Brasil - ULBRA, Torres, Rio Grande do Sul, Brazil. marinei.lopespedralli@gmail.com.
authors.forename: Marinei Lopes
authors.initials: ML
authors.lastname: Pedralli
authors.affiliation: Laboratório de Investigação Clínica, Instituto de Cardiologia / Fundação Universitária de Cardiologia - ICFUC, Av. Princesa Isabel, 395. Bairro Santana, 90620 001, Porto Alegre, RS, Brazil. gwsaude@yahoo.com.br.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Waclawovsky
authors.affiliation: Laboratório de Investigação Clínica, Instituto de Cardiologia / Fundação Universitária de Cardiologia - ICFUC, Av. Princesa Isabel, 395. Bairro Santana, 90620 001, Porto Alegre, RS, Brazil. augusto.santos.cmacho@gmail.com.
authors.forename: Augusto
authors.initials: A
authors.lastname: Camacho
authors.affiliation: Laboratório de Investigação Clínica, Instituto de Cardiologia / Fundação Universitária de Cardiologia - ICFUC, Av. Princesa Isabel, 395. Bairro Santana, 90620 001, Porto Alegre, RS, Brazil. melmarkoski@gmail.com.
authors.forename: Melissa Medeiros
authors.initials: MM
authors.lastname: Markoski
authors.affiliation: Laboratório de Investigação Clínica, Instituto de Cardiologia / Fundação Universitária de Cardiologia - ICFUC, Av. Princesa Isabel, 395. Bairro Santana, 90620 001, Porto Alegre, RS, Brazil. irancstro@gmail.com.
authors.forename: Iran
authors.initials: I
authors.lastname: Castro
authors.affiliation: Laboratório de Investigação Clínica, Instituto de Cardiologia / Fundação Universitária de Cardiologia - ICFUC, Av. Princesa Isabel, 395. Bairro Santana, 90620 001, Porto Alegre, RS, Brazil. amlehnen@gmail.com.|Faculdade Sogipa de Educação Física, Porto Alegre, Rio Grande do Sul, Brazil. amlehnen@gmail.com.
authors.forename: Alexandre Machado
authors.initials: AM
authors.lastname: Lehnen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002985:Clinical Protocols; D004452:Echocardiography; D042783:Endothelial Cells / Q000502:physiology*; D015444:Exercise; D005081:Exercise Therapy; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D055070:Resistance Training; D014664:Vasodilation