Hypertension is the major risk factor for cardiovascular diseases and is one of the primary causes of morbidity and mortality worldwide. Apelin levels and NO bioavailability are impaired in older hypertensive patients. Exercise is an effective intervention for treating hypertension. Our purpose was to evaluate the effect of high-intensity interval training on blood pressure, apelin, and NOx plasma levels in older treated hypertensive individuals. Thirty treated hypertensive subjects (61.70 ± 5.78 years, 17 males, 13 females) were randomly divided into 6 weeks of high-intensity interval training (n = 15) and control (n = 15). The exercise training was conducted for three 35-min sessions a week (1.5-min interval at 85-90% of heart rate reserve [HRR] and 2 min active phase at 50-55% of HRR). Assessment of plasma apelin, nitrite/nitrate (NOx), and endothelin-1 (ET-1) was performed before and after the intervention. At the end of the study, apelin, and NOx plasma levels increased significantly in the high-intensity interval training (HIIT) group (P = 0.021, P = 0.003, respectively). Conversely, ET-1 plasma levels significantly decreased in the training group after the intervention (P = 0.015). Moreover, there was a positive correlation between the change of plasma apelin and change of plasma NOx (r = 0. 771, P = 0.0008). In addition, there was a negative correlation between the change of plasma ET-1, change of plasma apelin (r = - 0.595, P = 0.019), and variation of NOx (r = - 0.572, P = 0.025). This study indicates that, by increasing of apelin and NOx plasma levels, HIIT may be effective in reducing blood pressure.

Atherosclerosis in patients with type 2 diabetes is characterized by endothelial dysfunction associated with impaired flow-mediated dilatation (FMD) and increases retrograde and oscillatory shear. The present study investigated endothelium-dependent vasodilatation and shear rate in patients with type 2 diabetes at baseline and follow-up after 12 weeks of low-volume high-intensity interval training (LV-HIIT) or continuous moderate-intensity training (CMIT). Seventy-five sedentary patients with type 2 diabetes and untreated pre- or stage I hypertension were randomly divided into LV-HIIT, CMIT and control groups. The LV-HIIT group intervention was 12 intervals of 1.5 min at 85-90% maximal heart rate (HR ) and 2 min at 55-60% HR . The CMIT group intervention was 42 min of exercise at 70% HR for three sessions per week during 12 weeks. High-resolution Doppler ultrasound was used to measure FMD, arterial diameter, anterograde and retrograde blood flow, and shear rate patterns. Brachial artery FMD increased significantly in the LV-HIIT group (3.83 ± 1.13 baseline, 7.39 ± 3.6% follow-up), whereas there was no significant increase in the CMIT group (3.45 ± 0.97 baseline, 4.81 ± 2.36% follow-up) compared to the control group (3.16 ± 0.78 baseline, 4.04 ± 1.28% follow-up) (P < 0.05). Retrograde shear in the LV-HIIT group decreased significantly (P < 0.05), and no significant decrease in retrograde shear was seen in the CMIT group. Anterograde shear after LV-HIIT increased significantly (P < 0.05) but was unchanged in the CMIT group. However, oscillatory shear index in both exercise groups decreased significantly (P = 0.029). Nitrite/nitrate (NOx) level increased in both exercise groups, but the increase was greater in the LV-HIIT group (P < 0.001). The results indicate that by increasing NOx, HIIT decreases the oscillatory shear-induced improvement in FMD and outward artery remodelling in patients with type 2 diabetes.

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