Background: Hypertension is common in patients with metabolic syndrome (MS), and it is an important risk factor for cardiovascular-related morbidity and mortality. Compared to moderate-intensity continuous training (MICT), high-intensity interval training (HIIT) is considered a time-efficient exercise strategy for cardiometabolic health. We compared the effects of HIIT and MICT on epicardial fat thickness (EFT) and endothelial function in patients with hypertensive MS. Methods: In total, 34 participants with hypertensive MS (mean age: 50.9 ± 7.9 years) were randomized to either the HIIT ( n = 17) or MICT ( n = 17) group. In the HIIT group, participants performed for 3 min at 40% heart-rate reserve (HRR), which was alternated with 3 min at 80% HRR, whereas participants in the MICT group performed at 60% of HRR thrice a week for 8 weeks. EFT was measured with echocardiography, and endothelial function was determined by quantifying endothelial progenitor cells (EPCs), nitric oxide (NO), and flow-mediated dilation (FMD). Results: After exercise training, patients in both the groups showed significantly decreased EFT ( P < 0.001 and P < 0.01) and improved FMD ( P < 0.001 and P < 0.01). NO ( P < 0.05) and EPCs (CD34/KDR, P < 0.01; CD34/CD117, P < 0.05; CD34/CD133, P < 0.05) were significantly improved in the HIIT group, but not in the MICT group. In addition, HIIT had a greater effect than MICT on FMD (group difference, P < 0.05) and EFT (group difference, P < 0.05). Conclusions: Compared to MICT, HIIT seems to better improve FMD and EFT. This finding suggests that HIIT could be more effective than MICT in improving endothelial function in patients with hypertensive MS.

Kang JH, et al. J Cardiovasc Ultrasound. 2012 Sep;20(3):126-133. http://dx.doi.org/10.4250/jcu.2012.20.3.126

Chronic intermittent hypoxia, platelet activation and inflammation all play roles in the pathogenesis of obstructive sleep apnea syndrome (OSAS), which may increase the risk of cardiovascular disease (CVD). The aim of this study was to evaluate the relationship of the platelet-to-lymphocyte ratio (PLR) as a new biomarker showing systemic inflammation and platelet distribution width (PDW) as an indicator of platelet activation to the severity of OSAS. A total of 290 patients suspected with OSAS who underwent a full night of polysomnography were included. The patients were placed into 4 separate groups according to their apnea-hypopnea index (AHI) scores; the control group (AHI 30). CVD risk was defined by the presence of hypertension, diabetes mellitus, current smoking, and dyslipidemia. Higher AHI groups were significantly correlated with increasing age, body mass index, systolic blood pressure and male sex. PLR and PDW were also significantly associated with AHI (r = 0.417 for PLR and r = 0.227 for PDW, all p-values < 0.001) and the Epworth sleepiness scale (r = 0.160 for PLR and r = 0.189 for PDW, all p-values <0.05). Multivariate regression analysis revealed that AHI ≥9.2 (adjusted odds ratios [OR] 5.03, 95 % confidential interval (CI) = 1.67-15.2, p = 0.004) and PLR ≥159 (adjusted OR 2.81, 95 % CI = 1.34-5.91, p = 0.006) were independently associated with the presence of hypertension. PLR and PDW are associated with OSAS severity. PLR may also be useful as a systemic biomarker for the concurrent hypertension in OSAS patients.

Objective: Recently, exergames have been used an exercise modality as aerobic fitness activities. However, evidence of its effectiveness on cardiovascular (CV)‐related risk factors remain unclear.Hypothesis: We evaluate the effects of exergaming on CV‐related risk factors compared with traditional aerobic exercise in high CV risk patients.Methods: Sixty‐five postmenopausal women with high CV risk were randomized among exergame (n = 22), treadmill (n = 22), and control (n = 21) groups. The exergame group was engaged in the running‐based exergame using Exer Heart and the treadmill group walked or jogged on a treadmill. Cardiorespiratory fitness, flow‐mediated dilation, endothelial progenitor cells (EPCs), epicardial fat thickness, metabolic parameters, and anthropometric parameters were measured in patients before and 12 weeks after the training.Results: Exergaming significantly improved VO₂ peak (P < .001; different from control, P < .05), flow‐mediated dilation (P < .001; different from control, P < .05), EPCs (CD34/CD117⁺, P < .01). Treadmill exercise was effective at improving VO₂ peak (P < .01; different from control, P < .05), flow‐mediated dilation (P < .05), EPCs (CD34/CD117⁺, P < .01; different from control P < .05). Epicardial fat thickness decreased after both exercise programs (exergame, P < .01; treadmill, P < .01; no different from control).Conclusion: Exergaming showed similar effects to traditional aerobic exercise in improving cardiorespiratory fitness and endothelial function in postmenopausal women with high CV risk. These findings suggest that the exergames may serve as an alternative to conventional aerobic exercises for prevention and treatment in high CV risk patients.

Lee JH, et al. Korean Circ J. 2011 Oct;41(10):596-602. http://dx.doi.org/10.4070/kcj.2011.41.10.596

Wall shear stress (WSS) is critically important in both vascular remodeling and atherosclerosis. Carotid intima-media thickness (IMT) and deformation parameters have been used as relevant indicators of carotid atherosclerosis. This study aimed to investigate the relationships between hemodynamic parameters in the common carotid artery (CCA) and the severity of carotid atherosclerosis in untreated hypertensive patients.