Response of proinflammatory cytokine, tumor necrosis factor-alpha to moderate physical activity in nondiabetic hypertensives and type 2 diabetic hypertensives
Barkha Gupta1, Sonali Sharma1, Sudhir Bhandari2, Sonal Bhardwaj1, Asrar Ahmed3
1 Department of Biochemistry, RUHS College of Medical Sciences and Associated Groups of Hospitals, Jaipur, Rajasthan, India
2 Department of Internal Medicine, SMS Medical College and Associated Group of Hospitals, Jaipur, Rajasthan, India
3 Department of General Medicine, RUHS College of Medical Sciences and Associated Groups of Hospitals, Jaipur, Rajasthan, India
Department of Biochemistry, RUHS College of Medical Sciences and Associated Groups of Hospitals, Sector 11, Kumbha Marg, Pratap Nagar, Jaipur - 302 033, Rajasthan
Source of Support: None, Conflict of Interest: None
Introduction: Hypertension is a multifactorial disease and is a major risk factor for cardiovascular disease, particularly in patients of diabetes mellitus. Management of hypertension is one of the critical components of comprehensive clinical management of diabetics. Aim: The aim of this study is to evaluate the effect of physical activity on systemic inflammation in patients with hypertension and type 2 diabetes mellitus in patients with hypertension. Methods: A total of 100 participants of either gender aged 40–69 years of Stage 2 essential hypertension were included in the study and assigned to 12 weeks of moderate physical activity (walking 10,000 steps/day). These study participants were further divided into two groups: type 2 diabetic (n =66) and nondiabetic (n = 34) hypertensives. Anthropometric parameters were noted and biochemical variables estimated at baseline and postintervention and evaluated statistically. Results: Twelve weeks of walking resulted in improved levels of inflammatory cytokine tumor necrosis factor-alpha (TNF-α). Systolic and diastolic blood pressure (BP) were reduced from 168.98 ± 3.76 to 154.29 ± 7.48 mmHg and from 103.38 ± 2.46s to 89.08 ± 3.62 mmHg, respectively. Body weight and body mass index were reduced from 69.8 ± 7.09 to 68.3 ± 6.53 kg and 23.21 ± 3.35 to 22.70 ± 3.16 kg/m2, respectively. A significant decrease in glycated hemoglobin (Group 1: 8.36% ± 1.83% vs. 7.74% ± 1.82%; Group 2: 5.56% ± 0.4% vs. 5.09% ± 0.19%) was found. A significant reduction in TNF-α levels in hypertensives with diabetes and a significant (P < 0.0001) decrease in nondiabetic hypertensive participants (Group 1: 1.38 ± 0.701 vs. 1.068 ± 0.657 pg/ml; Group 2: 1.341 ± 0.749 vs. 0.894 ± 0.601 pg/ml, respectively; pre vs. post P < 0.0001) were observed, respectively. Conclusion: Regular moderate physical activity induces anti-inflammatory state in hypertensives by reducing levels of proinflammatory marker TNF-α. It also resulted in good glycemic control and improvement in BP and has health beneficial effects.