Aerobic Exercise Training Response in Preterm-Born Young Adults with Elevated Blood Pressure and Stage 1 Hypertension: A Randomized Clinical Trial

• Published in: American journal of respiratory and critical care medicine Vol. 207; no. 9; pp. 1227 - 1236
• Main Authors: Burchert, Holger, Lapidaire, Winok, Williamson, Wilby, McCourt, Annabelle, Dockerill, Cameron, Woodward, William, Tan, Cheryl M J, Bertagnolli, Mariane, Mohamed, Afifah, Alsharqi, Maryam, Hanssen, Henner, Huckstep, Odaro J, Leeson, Paul, Lewandowski, Adam J
• Format: Journal Article
• Language: English
• Published: United States American Thoracic Society 01-05-2023
• Subjects: Aerobics; Blood Pressure; Clinical trials; Exercise - physiology; Exercise Test; Female; Humans; Hypertension; Infant, Newborn; Intervention; Original; Oxygen Consumption - physiology; Pregnancy; Premature babies; Premature birth; Young Adult; Young adults; preterm birth; exercise intervention; randomized clinical trial; aerobic training; cardiopulmonary
• ISSN: 1073-449X; 1535-4970
• DOI: 10.1164/rccm.202205-0858OC

Premature birth is an independent predictor of long-term cardiovascular risk. Individuals affected are reported to have a lower rate of [Formula: see text]o
at peak exercise intensity ([Formula: see text]o
) and at the ventilatory anaerobic threshold ([Formula: see text]o
), but little is known about their response to exercise training.
The primary objective was to determine whether the [Formula: see text]o
response to exercise training differed between preterm-born and term-born individuals; the secondary objective was to quantify group differences in [Formula: see text]o
response.
Fifty-two preterm-born and 151 term-born participants were randomly assigned (1:1) to 16 weeks of aerobic exercise training (
 = 102) or a control group (
 = 101). Cardiopulmonary exercise tests were conducted before and after the intervention to measure [Formula: see text]o
and the [Formula: see text]o
. A prespecified subgroup analysis was conducted by fitting an interaction term for preterm and term birth histories and exercise group allocation.
For term-born participants, [Formula: see text]o
increased by 3.1 ml/kg/min (95% confidence interval [CI], 1.7 to 4.4), and the [Formula: see text]o
increased by 2.3 ml/kg/min (95% CI, 0.7 to 3.8) in the intervention group versus controls. For preterm-born participants, [Formula: see text]o
increased by 1.8 ml/kg/min (95% CI, -0.4 to 3.9), and the [Formula: see text]o
increased by 4.6 ml/kg/min (95% CI, 2.1 to 7.0) in the intervention group versus controls. No significant interaction was observed with birth history for [Formula: see text]o
(
 = 0.32) or the [Formula: see text]o
(
 = 0.12).
The training intervention led to significant improvements in [Formula: see text]o
and [Formula: see text]o
, with no evidence of a statistically different response based on birth history. Clinical trial registered with www.clinicaltrials.gov (NCT02723552).