Intermittent hypoxic exposure with or without exercise improved cardiopulmonary functions in people with cardiovascular risk factors
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Abstract
This research aimed to explore the effects of intermittent hypoxic exposure (IH) with or without exercise on lung function, lipid profile, and a 6-min walk in people with three cardiovascular risk factors (hypertension stage I, hyperlipidemia, and obesity). Thirty participants were randomly allocated into 3 groups: a control group (CON, n=11) received no training, an intermittent hypoxic exposure during rest group (IHR, n=9), and an intermittent hypoxic training group (IHT, n=10) who combined IH with walking. Both IHR and IHT performed 8 sessions of 3-min of hypoxic breathing (14% O2) alternated with 3-min of normoxic breathing (21% O2) for 48-min per day, twice a week, for 6 consecutive weeks. All participants were measured before and after 6 weeks of theexperimental period. After training, IHR group significantly increased vital capacity (p=0.038) and forced vital capacity (p=0.025) compared to baseline. Similarly, compared to baseline, participants in the IHT group revealed significantly increased vital capacity (p=0.030), forced vital capacity (p=0.031), and forced expiratory volume in 1 second (p=0.042). Compared to CON, only IHT showed a significant increase in forced vital capacity of 8.6 ±4.5% (p=0.034) and forced expiratory volume in 1 second of 7.0 ± 3.9%, (p=0.033) after 6 weeks. Both the IHR and IHT participants demonstrated a significantly increased 6-min walk distance (p=0.048 and p=0.004, respectively) compared to CON. The study demonstrated that IH programs can improve lung function and cardio-pulmonary fitness which indicates that IH with or without exercise improves some cardiopulmonary functions in at risk patients.
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References
Kaptoge S, Pennells L, De Bacquer D, Cooney MT, Kavousi M, Stevens G, et al. World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions. Lancet Glob Health. 2019;7(10):e1332-e1345.
Malakar AK, Choudhury D, Halder B, Paul P, Uddin A, Chakraborty S. A review on coronary artery disease, its risk factors, and therapeutics. J Cell Physiol. 2019;234(10):16812-16823.
Mahmood SS, Levy D, Vasan RS, Wang TJ. The Framingham heart study and the epidemiology of cardiovascular disease: a historical perspective. Lancet. 2014;383(9921):999-1008.
Matthews CE, Sampson JN, Brenner DR, Moore SC, Courneya KS, Ziegler RG, et al. Effects of exercise and cardiorespiratory fitness on estrogen metabolism in postmenopausal womenexercise and estrogen metabolism. Cancer Epidemiol Biomarkers Prev. 2018;27(12):1480-1482.
Park HY, Jung WS, Kim J, Lim KJG, International G. Twelve weeks of exercise modality in hypoxia enhances health‐related function in obese older Korean men: a randomized controlled trial. Geriatr Gerontol Int. 2019;19(4):311-316.
Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M, et al. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. J Am Med Assoc. 2009;301(19):2024-2035.
Rowe GC, Safdar A, Arany Z. Running forward: new frontiers in endurance exercise biology. Circulation. 2014;129(7):798-810.
Urdampilleta A, González-Muniesa P, Portillo MP, Martínez JA. Usefulness of combining intermittent hypoxia and physical exercise in the treatment of obesity. J Physiol Biochem. 2012;68(2):289-304.
Millet GP, Debevec T, Brocherie F, Malatesta D, Girard O. Therapeutic use of exercising in hypoxia: promises and limitations. Front Physiol. 2016;7:1-4.
Lundby C, Calbet JA, Robach P. The response of human skeletal muscle tissue to hypoxia. Cell Mol Life Sci. 2009;66(22):3615-3623.
Bailey DM, Davies B, Young IS. Intermittent hypoxic training: implications for lipid peroxidation induced by acute normoxic exercise in active men. Clin Sci (Lond). 2001;101(5):465-475.
Wang JS, Wu MH, Mao TY, Fu TC, Hsu CC. Effects of normoxic and hypoxic exercise regimens on cardiac, muscular, and cerebral hemodynamics suppressed by severe hypoxia in humans. J Appl Physiol. 2010;109(1):219-229.
Ameln H, Gustafsson T, Sundberg CJ, Okamoto K, Jansson E, Poellinger L, et al. Physiological activation of hypoxia inducible factor‐1 in human skeletal muscle. FASEB J. 2005;19(8):1009-1011.
Muangritdech N, Hamlin MJ, Sawanyawisuth K, Prajumwongs P, Saengjan W, Wonnabussapawich P, et al. Hypoxic training improves blood pressure, nitric oxide and hypoxia-inducible factor-1 alpha in hypertensive patients. Eur J Appl Physiol. 2020;120(8):1815-1826.
Levashov MI. Beneficial effects of intermittent normobaric hypoxic training on respiratory function in patients with chronic pulmonary diseases. In: Xi L, Serebrovskaya TV, editors. Intermittent hypoxia and human diseases. 1st ed. London: Springer; 2012. p. 115-126.
Burtscher M, Haider T, Domej W, Linser T, Gatterer H, Faulhaber M, et al. Intermittent hypoxia increases exercise tolerance in patients at risk for or with mild COPD. Gerontology. 2009;165(1):97-103.
Lu YL, Jing W, Feng LS, Zhang L, Xu JF, You TJ, et al. Effects of hypoxic exercise training on microRNA expression and lipid metabolism in obese rat livers. J Zhejiang Univ Sci B. 2014;15(9):820-829.
Kong Z, Shi Q, Nie J, Tong TK, Song L, Yi L, et al. High-intensity interval training in normobaric hypoxia improves cardiorespiratory fitness in overweight chinese young women. Front Physiol. 2017;8:175.
Verges S, Chacaroun S, Godin-Ribuot D, Baillieul S. Hypoxic conditioning as a new therapeutic modality. Front Pediatr. 2015;3:58.
Boning D. Altitude and hypoxia training-effects on performance capacity and physiological functions at sea level. Int J Sports Med. 2002;6(2):E7-E18.
Muangritdech N, Saengjan W, Namboonlue C, Tunkamnerdthai O, Sumethanurakkhakun W, Manimmanakorn N, et al. The effect of intermittent hypoxic exposure on blood pressure and nitric oxide in hypertensive patients with excess weight. J Exerc Physiol Online. 2020;23(3):63-76.
Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J.
;26(2):319-338.
Whittaker HR, Bloom C, Morgan A, Jarvis D, Kiddle SJ, Quint JKJERJ. Accelerated FEV1 decline and risk of cardiovascular disease and mortality in a primary care population of COPD patients. Eur Respir J. 2021;57(3):1-12.
Faulhaber M, Gatterer H, Haider T, Linser T, Netzer N, Burtscher M. Heart rate and blood pressure responses during hypoxic cycles of a 3-week intermittent hypoxia breathing program in patients at risk for or with mild COPD. Int J Chron Obtruct Pulmon Dis.
;10:339.
Lyamina NP, Lyamina SV, Senchiknin VN, Mallet RT, Downey HF, Manukhina EB. Normobaric hypoxia conditioning reduces blood pressure and normalizes nitric oxide synthesis in patients with arterial hypertension. J Hypertents. 2011;29(11):2265-2272.
Silva LMT, Schalock M, Ayres R, Bunse C, Budden S. Qigong massage treatment for sensory and self-regulation problems in young children with autism: a randomized controlled trial. Am J Occup Ther. 2009;63(4):423-432.
Cannon CP. Cardiovascular disease and modifiable cardiometabolic risk factors. Clin Conrnerstone. 2007;8(3):11-28.
Wee J, Climstein M. Hypoxic training: Clinical benefits on cardiometabolic risk factors. J Sci Med Sport. 2015;18(1):56-61.
Hobbins L, Hunter S, Gaoua N, Girard O. Normobaric hypoxic conditioning to maximize weight loss and ameliorate cardio-metabolic health in obese populations: a systematic review. Am J Physiol Regul Integr Comp Physiol. 2017;313(3):R251-R264.
Quintero P, Milagro F, Campion J, Martínez J. Impact of oxygen availability on body weight management. Med Hypotheses. 2010;74(5):901-907.
Kong Z, Zang Y, Hu Y. Normobaric hypoxia training causes more weight loss than normoxia training after a 4-week residential camp for obese young adults. Sleep Breath. 2014;18(3):591-597.
Brinkmann C, Bloch W, Brixius K. Exercise during short‐term exposure to hypoxia or hyperoxia‐novel treatment strategies for type 2 diabetic patients?!. Scand J Med Sci Sports. 2018;28(2):549-564.
Wiesner S, Haufe S, Engeli S, Mutschler H, Haas U, Luft FC, et al. Influences of normobaric hypoxia training on physical fitness and metabolic risk markers in overweight to obese subjects. Obesity (Silver Spring). 2010;18(1):116-120.
Park HY, Jung WS, Kim J, Hwang H, Lim K. Twelve weeks of aerobic exercise at the lactate threshold improves autonomic nervous system function, body composition, and aerobic performance in women with obesity. J Obes Metab Syndr. 2020;29(1):67.
Geiser J, Vogt M, Billeter R, Zuleger C, Belforti F, Hoppeler H. Training high-living low: changes of aerobic performance and muscle structure with training at simulated altitude. International journal of sports medicine. Int J Sports Med. 2001;22(08):579-585.