In addition to elevated blood pressure, hypertension is characterized by neuroimmune and cell adhesion molecule activation, which are predictive of morbidity and mortality-outcomes. Pharmacological treatment for hypertension successfully reduces blood pressure, but has limited effectiveness for reducing accompanying pro-atherogenic inflammation. Exercise plus dietary interventions have been shown to reduce inflammation, but few if any studies have examined their effects on inflammation in hypertension. Our studies to date have extended the current literature on inflammation in human Hypertension showing that in addition to endothelial activation, hypertensive subjects display increased expression of cellular adhesion molecules on circulating leukocytes, and increased proinflammatory cytokine and leukocyte reactivity to stressors. These effects support an adverse circulating environment of increased leukocyte adhesion and migration. The primary aim of this revised competing renewal of HL57265 is to determine the effects of a 12-week exercise intervention and a 12-week exercise plus diet intervention on inflammation and cell adhesion in 150 patients with hypertension. Prior to and following the interventions, we will assess resting and stress-induced (speech stressor and acute treadmill testing) changes in circulating levels of CRP, IL-6, TNF-alpha, sICAM-1 and sE-selectin, leukocyte CDlla and CDlib expression, leukocyte activation, and peripheral blood mononuclear cell chemotaxis. Changes in cardiovascular fitness, weight, neuroendocrineactivation (catecholamine and cortisol levels), and insulin sensitivity will be examined as possible mechanisms for the anticipated reductions in inflammationand cell adhesion.
Showing the most recent 10 out of 77 publications
