Effects of Exercise and Weight Loss on Cardiac Risk Factors Associated With Syndrome X | Cardiology | JAMA Internal Medicine | JAMA Network
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Original Investigation
September 8, 2003

Effects of Exercise and Weight Loss on Cardiac Risk Factors Associated With Syndrome X

Author Affiliations

From the Departments of Psychiatry and Behavioral Sciences (Drs Watkins, Sherwood, Babyak, Gullette, and Blumenthal) and Medicine (Drs Feinglos and Waugh), Duke University Medical Center, Durham, NC; and the Department of Medicine, University of North Carolina, Chapel Hill (Dr Hinderliter). The authors have no relevant financial interest in this article.

Arch Intern Med. 2003;163(16):1889-1895. doi:10.1001/archinte.163.16.1889

Background  Patients with high blood pressure (BP) often exhibit syndrome X, an aggregation of abnormalities in carbohydrate and lipoprotein metabolism associated with increased risk of coronary heart disease (CHD). The present study evaluated the effects of a 6-month intervention involving either aerobic exercise training alone (EX only) or exercise combined with a structured weight loss program (EX + WL) on CHD risk factors associated with syndrome X.

Methods  A total of 53 men and women were selected from a larger behavioral intervention trial, who showed the hyperinsulinemia, dyslipidemia, and high BP characteristic of syndrome X. Participants were randomly assigned to EX only (n = 21), EX + WL (n = 21), or a waiting list control group (n = 11). Before and following treatment, participants underwent measurement of glucose tolerance, lipid levels, and clinical BP.

Results  Hyperinsulinemic responses to glucose challenge were significantly reduced in both the EX + WL group (P<.001) and the EX-only group (P = .003). Participants who showed the largest amount of weight loss showed the most robust improvements in abnormal insulin responses (EX + WL group, 47% reduction; EX-only group, 27% reduction). Diastolic BP was significantly reduced in the EX + WL group (96 ± 4 to 87 ± 5 mm Hg [mean ± SD]; P = .01), but not in the EX-only group (93 ± 4 to 89 ± 5 mm Hg [mean ± SD]; P = .08). Lipid profile was not significantly improved by either intervention.

Conclusion  These results suggest that EX + WL is an effective treatment for hyperinsulinemia and lowering of diastolic BP in patients with the syndrome X.