PMID 41163928

Research
All papers

Salusin-beta, Arterial Stiffness, and Heart Rate Variability Influence the Blood Pressure Response to High-Intensity Interval Training Among Older Adults With Hypertension: A Randomized Control Trial

Ghardashi-Afousi A, Pescatello LS, Asvadi Fard M, Sabouri A

Question

Does 12 weeks of supervised HIIT affect blood pressure in older adults with hypertension, and are changes in salusin-beta, carotid-femoral pulse wave velocity, heart-rate variability, and VO2peak associated with the blood pressure response?

Summary

In an 80-participant randomized controlled trial, older adults with mild or moderate hypertension were assigned to 12 weeks of supervised cycling HIIT or usual daily activity. The HIIT group trained three times weekly using 12 intervals of 1.5 minutes at 85%-90% heart-rate reserve separated by 2 minutes at 50%-55% heart-rate reserve, with 10-minute warm-up and cooldown periods. Compared with control, HIIT reduced systolic and diastolic blood pressure, improved VO2peak, reduced arterial stiffness, shifted heart-rate variability toward more favorable autonomic balance, increased salusin-alpha, and decreased salusin-beta.

Methodology

  • Eighty inactive older adults with mild or moderate hypertension, BMI 25-30 kg/m2, recruited from a hypertension department and community recreation center.
  • 80 participants.
  • Cycle ergometer.
  • Work intervals: 1.5 minutes at 85%-90% HRR.
  • Recovery: 2 minutes at 50%-55% HRR.
  • Intensity: HRR prescribed by Karvonen method; warm-up/cooldown at 40% HRR.
  • Approximately 62 minutes including 10-minute warm-up and cooldown.
  • 3 sessions/week.
  • 12 weeks.
  • Randomized controlled trial with baseline and 48-hour postintervention assessments; repeated-measures ANCOVA and multivariate linear regression were used.
  • Systolic and diastolic blood pressure, VO2peak, Carotid-femoral pulse wave velocity, and Heart-rate variability were tracked.

Outcomes

Blood pressure

HIIT reduced SBP by 17.69 +/- 4.37 mmHg more and DBP by 6.90 +/- 2.35 mmHg more than control.

SBP group x time p < 0.001, partial eta-squared = 0.800; DBP group x time p = 0.001, partial eta-squared = 0.672; between-group changes p = 0.001.

Improved

VO2peak

VO2peak increased by 4.00 +/- 1.20 mL/kg/min more after HIIT than control.

p = 0.001

Improved

Arterial stiffness

cfPWV decreased by 336.71 +/- 81.32 cm/s more after HIIT than control.

Group x time p < 0.001, partial eta-squared = 0.903; between-group p = 0.001.

Improved

Heart-rate variability

HF increased by 7.07 +/- 2.13 nu, SDNN by 6.85 +/- 1.38 ms, LF decreased by 14.22 +/- 3.15 nu, and LF/HF ratio decreased by 1.05 +/- 0.41 more after HIIT than control.

Between-group changes reported at p = 0.001; group x time interactions p < 0.0001 for HF and SDNN, p < 0.001 for LF and LF/HF.

Improved

Salusin and neurohumoral markers

Salusin-alpha increased 144.9 +/- 34.3 pg/mL more, salusin-beta decreased 308.6 +/- 98.71 pg/mL more, AVP decreased 0.66 +/- 0.19 pg/mL more, and NE decreased 59.42 +/- 13.96 pg/mL more after HIIT than control.

Salusin-alpha, salusin-beta, salusin beta/alpha ratio, AVP, and NE group x time interactions all p <= 0.0001 or p < 0.001; between-group changes p = 0.001 or p < 0.001.

Improved

Predictors of blood pressure response

After HIIT, salusin-beta, LF, HF, and VO2peak explained 82.4% of SBP response variance; salusin-beta, cfPWV, VO2peak, and HF explained 72.4% of DBP response variance.

SBP model p < 0.001, R2 = 0.824; DBP model p < 0.001, R2 = 0.724.

Mixed

Insights

  • A clinically supervised cycling HIIT protocol using 90-second work intervals and 2-minute active recoveries can produce large blood-pressure reductions in screened older adults with mild or moderate hypertension.
  • For clinical populations, translation should preserve screening, heart-rate monitoring, and conservative contraindication language.
  • Mechanistic content can discuss blood pressure improvements alongside arterial stiffness, autonomic markers, VO2peak, and salusin-beta, but should avoid implying proven single-pathway causality.

Limitations

  • Relatively small sample size
  • Limited racial/ethnic and age diversity
  • 70% adherence may have influenced outcomes
  • Microvascular atherosclerotic plaque was not evaluated
  • Supervised cycling protocol may not generalize to unsupervised or bodyweight HIIT

Safety

  • No adverse events or injuries were reported in the paper.
  • The trial used supervised exercise, heart-rate monitoring, clinical screening, and multiple cardiovascular exclusion criteria.