Effects of Caloric Intake and Aerobic Activity in Individuals with Prehypertension and Hypertension on Levels of Inflammatory, Adhesion and Prothrombotic Biomarkers-Secondary Analysis of a Randomized Controlled Trial

En-Young N Wagner; Suzi Hong; Kathleen L Wilson; Karen J Calfas; Cheryl L Rock; Laura S Redwine; Roland von Känel; Paul J Mills

doi:10.3390/jcm9030655

Effects of Caloric Intake and Aerobic Activity in Individuals with Prehypertension and Hypertension on Levels of Inflammatory, Adhesion and Prothrombotic Biomarkers-Secondary Analysis of a Randomized Controlled Trial

J Clin Med. 2020 Feb 28;9(3):655. doi: 10.3390/jcm9030655.

Authors

En-Young N Wagner^{1

2

3}, Suzi Hong^{1

4}, Kathleen L Wilson^{1

4}, Karen J Calfas⁴, Cheryl L Rock⁴, Laura S Redwine⁵, Roland von Känel², Paul J Mills^{1

4}

Affiliations

¹ Department of Psychiatry, University of California, San Diego, CA 92093, USA.
² Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, 8091 Zurich, Switzerland.
³ Department of BioMedical Research, Inselspital, Bern University Hospital, 3010 Bern, Switzerland.
⁴ Department of Family Medicine and Public Health, University of California, San Diego, CA 92093, USA.
⁵ College of Nursing, University of South Florida, Tampa, FL 33612, USA.

Abstract

Background: Cardiopulmonary fitness and low calorie diets have been shown to reduce inflammation but few studies have been conducted in individuals with elevated blood pressure (BP) in a randomized intervention setting. Thereby, adhesion biomarkers, e.g., soluble intercellular adhesion molecule (sICAM)-3, have not been examined so far.

Methods: Sixty-eight sedentary prehypertensive and mildly hypertensive individuals (mean age ± SEM: 45 ± 1 years; mean BP: 141/84 ± 1/1 mmHg) were randomized to one of three 12-week intervention groups: cardio training and caloric reduction, cardio training alone, or wait-list control group. Plasma levels of inflammatory, adhesion and prothrombotic biomarkers were assessed. In a second step, intervention groups were combined to one sample and multivariate regression analyses were applied in order to account for exercise and diet behavior changes.

Results: There were no significant differences among the intervention groups. In the combined sample, greater caloric reduction was associated with a larger increase of sICAM-3 (p = 0.026) and decrease of C-reactive protein (p = 0.018) as a result of the interventions. More cardio training was associated with increases of sICAM-3 (p = 0.046) as well as interleukin-6 (p = 0.004) and a decrease of tumor necrosis factor- (p = 0.017) levels. Higher BP predicted higher plasminogen activator inhibitor (PAI)-1 (p = 0.001), and greater fitness predicted lower PAI-1 levels (p = 0.006) after the intervention.

Conclusions: In prehypertensive and hypertensive patients, plasma levels of the adhesion molecule sICAM-3 and inflammatory biomarkers have different response patterns to cardio training with and without caloric reduction. Such anti-inflammatory and anti-thrombotic effects may have implications for the prevention of atherothrombotic cardiovascular disease among individuals at increased risk.

Keywords: adhesion molecule; diet; exercise; hypertension; inflammatory markers; intervention; prehypertension; sICAM; soluble intercellular adhesion molecule.