Issue 173 Item 7 Exercise Plus Weight Loss Reduces Blood Pressure in Syndrome X

A program of exercise and weight loss is an effective treatment for hyperinsulinemia and significantly reduces diastolic blood pressure in patients with syndrome X

"Patients with high blood pressure often exhibit syndrome X, an aggregation of abnormalities in carbohydrate and lipoprotein metabolism associated with increased risk of coronary heart disease (CHD)," Dr. Lana L. Watkins, of the Duke University Medical Center, Durham, North Carolina, and colleagues note.

The researchers examined the effects of a 6-month intervention with either aerobic exercise training alone or a combination of exercise and a structured weight loss program on CHD risk factors associated with syndrome X. Fifty-three patients with hyperinsulinemia, dyslipidemia, and high blood pressure, characteristics of syndrome X, were included in the study.

Twenty-one patients were randomly assigned to exercise only, 21 to exercise plus weight loss, and 11 to a control group. The team measured glucose tolerance, lipid levels, and blood pressure at baseline and after treatment.

Significant reductions in hyperinsulinemic responses to glucose challenge were observed in both the exercise-only (p = 0.003) and exercise plus weight loss groups (p < 0.001).

"Compared with pretreatment levels, the 2-hour insulin response to oral glucose was reduced by 27% in the exercise -only group and by 47% in the exercise plus weight loss group," Dr. Watkins and colleagues report.

Significant reductions in diastolic blood pressure were observed in the exercise plus weight loss group, but not in the exercise-only group.
Neither intervention produced significant improvements in lipid profiles.

"The present data are consistent with the Adult Treatment Panel III recommendations that exercise plus weight loss is a valuable form of therapy for syndrome X," the authors conclude. Arch Intern Med 2003;163:1889-1895.

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