Sex differences in resting hemodynamics and arterial stiffness following 4 weeks of resistance versus aerobic exercise training in individuals with pre-hypertension to stage 1 hypertension

Background: Hypertension (HTN) exhibits sexual dimorphism; the incidence for women surpasses men during the sixth decade of life, while the pharmacological treatments are less effective and produce more side-effects in women than in men. Aerobic exercise (AE) has been shown to prevent and treat HTN; however, resistance exercise (RE) is not recommended as a strategy to treat HTN. In this study, we investigated the potential sex differences of AE versus RE in a cohort of unmedicated patients with hypertension. Methods: In total, 40 moderately active, pre-hypertensive or stage 1 essential hypertensive male (M) and female (F) participants aged 40 to 60 years were randomly divided into four groups: M AE, M RE, F AE, and F. Each group exercised at moderate intensity, 3 days/week for 4 weeks. Hemodynamic, vascular and blood-flow data were collected before and after exercise training. Results: Men showed a significant increase in central pulse wave velocity following RE while females showed no significant changes (12 ± to 13.9 ± vs. 9.2 ± to 9.6 ± m/s, respectively). RE showed significantly greater increases in peak blood flow when compared to AE (F RE 15 ± to 20 ± vs. F AE 17.5 ± to19.5 ±, M RE 19 ± to 24 ± vs M AE 21 ± to 25 ± ml* 100 ml*min, respectively). In addition, systolic and diastolic BP decreased greater for women following RE when compared to AE whereas men showed comparable decreases in BP following either exercise mode. Conclusion: Moderate-intensity RE training may be a more favorable for women as a treatment option for hypertension because of greater decreases in diastolic BP and significant increases in flow-mediated dilation without concomitant increases in arterial stiffness, compared with their male counterparts.