Response of Proinflammatory Cytokine, Tumor Necrosis Factor-alpha to Moderate Physical Activity in Nondiabetic Hypertensives and Type 2 Diabetic Hypertensives

Abstract

Introduction: Hypertension is a multifactorial disease and is a major risk factor for cardiovascular disease, particularly in patients of diabetes mellitus. Management of hypertension is one of the critical components of comprehensive clinical management of diabetics. Aim: The aim of this study is to evaluate the effect of physical activity on systemic inflammation in patients with hypertension and type 2 diabetes mellitus in patients with hypertension. Methods: A total of 100 participants of either gender aged 40–69 years of Stage 2 essential hypertension were included in the study and assigned to 12 weeks of moderate physical activity (walking 10,000 steps/day). These study participants were further divided into two groups: type 2 diabetic (n =66) and nondiabetic (n = 34) hypertensives. Anthropometric parameters were noted and biochemical variables estimated at baseline and postintervention and evaluated statistically. Results: Twelve weeks of walking resulted in improved levels of inflammatory cytokine tumor necrosis factor-alpha (TNF-α). Systolic and diastolic blood pressure (BP) were reduced from 168.98 ± 3.76 to 154.29 ± 7.48 mmHg and from 103.38 ± 2.46 to 89.08 ± 3.62 mmHg, respectively. Body weight and body mass index were reduced from 69.8 ± 7.09 to 68.3 ± 6.53 kg and 23.21 ± 3.35 to 22.70 ± 3.16 kg/m2, respectively. A significant decrease in glycated hemoglobin (Group 1: 8.36% ± 1.83% vs. 7.74% ± 1.82%; Group 2: 5.56% ± 0.4% vs. 5.09% ± 0.19%) was found. A significant reduction in TNF-α levels in hypertensives with diabetes and a significant (P < 0.0001) decrease in nondiabetic hypertensive participants (Group 1: 1.38 ± 0.701 vs. 1.068 ± 0.657 pg/ml; Group 2: 1.341 ± 0.749 vs. 0.894 ± 0.601 pg/ml, respectively; pre vs. postP < 0.0001) were observed, respectively. Conclusion: Regular moderate physical activity induces anti-inflammatory state in hypertensives by reducing levels of proinflammatory marker TNF-α. It also resulted in good glycemic control and improvement in BP and has health beneficial effects.