Next Article in Journal
The Motivational Level of Performance Swimmers and Its Impact on the Risk of Sports Dropout
Next Article in Special Issue
Characterization of Load Components in Resistance Training Programs for Kidney Transplant Recipients: A Scoping Review
Previous Article in Journal
Effects of Physical Exercise on Executive Function in Schizophrenia: Systematic Review and Meta-Analysis
Previous Article in Special Issue
Physical Responses During Matches of International Female Football Players with Cerebral Palsy According to Their Sport Classes
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
Sports
Volume 13
Issue 4
10.3390/sports13040124
sports-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Article

Association of Controlled Physical Activity with Weight Loss and Less Limitations for Hypertensive Patients

by
Roxana Cristina Rad Bodan
1,2,3,*,
Adina Octavia Dușe
4,
Eniko Gabriela Papp
2,
Răzvan Marian Melinte
5 and
Minodora Andor
3,6
1
Doctoral School, “Victor Babeș” University of Medicine and Pharmacy Timișoara, No.2 Eftimie Murgu Square, 300041 Timisoara, Romania
2
Department of Balneofiziokinetotherapy and Medical Recovery, Faculty of Medicine, “Dimitrie Cantemir” University Târgu-Mureș, No.3-5 Bodoni Sandor, 540545 Târgu-Mureș, Romania
3
Multidisciplinary Heart Research Center, “Victor Babeş” University of Medicine and Pharmacy, 2 E. Murgu Square, 300041 Timisoara, Romania
4
Department of Physical Medicine, Balneology and Rheumatology, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy Timisoara, No.2 Eftimie Murgu Square, 300041 Timisoara, Romania
5
Department of Orthopedics and Traumatology, Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, No. 8 Victor Babes, 400012 Cluj-Napoca, Romania
6
Department of Internal Medicine I, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, No.2 Eftimie Murgu Square, 300041 Timisoara, Romania
*
Author to whom correspondence should be addressed.
Sports 2025, 13(4), 124; https://doi.org/10.3390/sports13040124
Submission received: 13 March 2025 / Revised: 11 April 2025 / Accepted: 15 April 2025 / Published: 17 April 2025
(This article belongs to the Special Issue Benefits of Physical Activity and Exercise to Human Health)
Browse Figures
Versions Notes

Abstract

:
Background: The overweight population is a major public health problem which is typical for the 21st century, considering the peak of the noncommunicable diseases (NCDs). The connection between hypertension—the number-one risk factor of cardiovascular diseases (CVDs)—and the body mass index (BMI), which is growing worldwide, needs to be taken into consideration. Methods: Four homogeneous groups of twenty-five patients each with hypertension degree 1 benefited from different 8-week recovery programs: recommendation for a healthy lifestyle (all groups—A, B, C and D), antihypertensive medication (groups B, C and D), physical therapy program (group C), and hydrotherapy program (group D). Four parameters were pursued: body mass index (BMI), waist circumference (Wcir.), and systolic and diastolic blood pressure (SBP-DBP). Results: Intragroup comparison between initial and final testing registered a statistically significant decrease in all parameters for group C: BMI (p = 0.001), Wcir, SBP and DBP (p < 0.0001). Additionally, parameters of group D decreased significantly: BMI (p = 0.0005), Wcir, SBP and DBP (each p < 0.0001). Group A registered a statistical increase in the DPB parameter (p = 0.03), and group B had a significant decrease in SBP (p = 0.03). Conclusions: Implication in established physical therapy and hydrotherapy had a better outcome in diminishing all four parameters compared to the recommendations for a healthy lifestyle when patients had to improve their lifestyle by themselves, unsupervised.

1. Introduction

In the last 10 years, medical science has placed hypertension on the top of the list of cardiovascular risks, with hyperlipidemia and diabetes second and third, which are linked, in most cases, to nutritional habits; the fourth and fifth are obesity and bad diets, and then the last is smoking [1,2,3]. Not more than five years ago, statistics showed that Europe had 30 million patients with CVDs, and the estimated number of new cases for each year passing is 13 million [4].
Almost 30 years ago, cardiovascular diseases were described as an epidemic for developing countries, and today they are presented as a global burden. Because CVDs were named a silent pandemic, the interventions become imminent. Even with all precautions, the number of hypertensive patients is constantly increasing, and it appears to be nearly impossible to stop; by 2015, it reached 1.13 billion globally [5,6,7]. In the 2021 ESC guide, there is no topic focused on hypertension, but we do observe it mentioned in the top risk factors for arterial fibrillation, along with obesity, both marked in red [8]. Three years later, in 2024, the newest guidelines underlined the acute need to intervene from as many directions as possible regarding the hypertensive population [9].
Millions of new cardiovascular patients are registered every year around the world, and approximately 50% of them have hypertension as diagnosis. Today, obesity is more often associated with cardiovascular diseases. BMI has been the first concern among the risk factors in cardiovascular diseases, especially because in some countries, in 2021, 54% of the adult population was overweight or obese. From the perspective of new CVD cases, in 2021, a majority of patients were from urban areas, and also, regarding gender, most of the patients were women, but in rural areas and among men, mortality was more prevalent [10,11,12].
It is alarming that, in the last decade, groundwork showed the connection between modified BMI and high blood pressure even among children and young adults [13,14]. The data show an annual growth rate for obesity between 0.2% and 7.7%, predominant in most countries [15]. The estimated data for the next five years indicate continuously raising values for blood pressure and BMI. Nowadays, the number-one concern is to reduce the mortality rate of NCDs (noncommunicable diseases) in general and specifically in CVDs (cardiovascular diseases) in order to stop the predicted sequence for 2030 [16,17,18] with simple and effective measures which will be easily accepted by populational groups at risk.
Current studies that investigated the effects on physical activities have shown conflicting results of hypertensive patients. A study based on recommendations for physical activity showed no impact from reducing blood pressure values on hypertensive patients [19]. A high-intensity training program registered limited decreases in blood pressure values in hypertensive patients with no scientific relevance, while a study based on a functional training revealed diminished blood pressure values after the program [20,21]. Further research is needed to provide proper intervention for hypertensive patients.
Therefore, this study pursued the impact of four different interventional approaches, i.e., recommendations for a healthy lifestyle, antihypertensive medication, physical therapy program and hydrotherapy, on body mass index, waist circumference and blood pressure values for hypertensive patients.
The main purpose was to evaluate whether changes in the two anthropometric parameters and, implicitly, the applied program will influence the BP values. According to the hypothesis, the 8-week interventional programs are expected to decrease BMI and waist circumference, leading to a decrease in blood pressure values as well. Recognizing the potential importance of training and professional interventions in BMI, Wcir, DBP and SPB can help in the identification of contributing factors and the clinical interpretation of the parameters for hypertensive patients.

2. Materials and Methods

2.1. Study Design

More than 250 patients diagnosed with degree 1 hypertension were selected from the cardiologist’s records of the county, at the beginning of 2023. Their personal clinical files were analyzed, informed consent was obtained and inclusion criteria were met.
Patients were eligible for the study if they met the following inclusion and exclusion criteria. Criteria that determinate inclusion: (1) age between 30 and 60 years old; (2) hypertension degree 1 with SBP 140–159 mmHg and DBP 90–99 mmHg [22,23], recently cardiology diagnosed and without previous treatments, neither pharmaceutical nor non-pharmaceutical; and (3) written consent signed for both sections ((a) analysis of the medical records; and (b) active implication in the recovery program and assessments during the study). Criteria determining exclusion: (1) pregnant or postpartum period for woman; (2) SBP or DPB values with a higher difference of 15 mmHg between arms; (3) dermatological or other skin pathology that may be contraindicated in physical therapy or hydrotherapy; (4) chronic diseases associated; (5) inflammatory diseases that may influence their physical implication in the recovery program; and (6) medication treatment that may influence the BP values—other than antihypertensive drug treatment recently prescribed, only if required.
The patients meeting the inclusion and exclusion criteria were divided into 4 homogenized groups subsequent to age, and nine homogeneity criteria were fulfilled. Consequently, this prospective interventional study was conducted with 100 patients divided into four homogeneous groups, named A, B, C and D, with 25 individuals each (Table 1).

2.2. Intervention

Each of the four groups had a different interventional approach:
→
Group A benefited from recommendations for a healthy lifestyle.
→
Group B, besides counseling for a healthy lifestyle, started administering antihypertensive medication prescribed by the cardiologist.
→
Group C had both interventions described previously, i.e., healthy lifestyle counseling and medication, along with an interventional program based on physical therapy.
→
Group D received both the interventions that were previously described, i.e., healthy lifestyle counseling and medication, along with an interventional program based on hydrotherapy.

2.2.1. Recommendations for a Healthy Lifestyle

The counseling based on the WHO recommendation aims to improve health by explaining the behavioral risk factors for the cardiovascular system that need to be reduced or excluded if possible. All patients from groups A, B, C and D were instructed to fulfill changes in four directions: unhealthy diet, sedentarism, smoking and alcohol consumption.
Regarding diet, the number-one concern was the salt consumption, which was recommended to be diminished as much as possible. Processed food was highly recommended to be substituted with fresh vegetables, fruits, white meat and fish. Adequate water intake, in addition to avoiding juice and especially fizzy drinks, was also recommended.
Smoking needs to be reduced or excluded if possible, taking into consideration the patient’s addiction, type and number of cigarettes per day in order to estimate the nicotine withdrawal timeline for these patients. We strongly recommend avoiding alcohol, especially the refined type; for optimal results, abstinence for several weeks, during the implemented program, is recommended.
Sedentarism is a constant struggle that needs to be combatted. Recommendations sought to initiate more physical activity in their free time or at work, if possible, in order to have moderate activity daily and 2–3 sessions of intense exercise weekly. If none of this is possible, due to lack of time or interest in any physical activity, walks are the most beneficial alternative, combined with gardening or cycling. An observation needs to be made regarding life nowadays: daily chores are no longer considered physical activity [24,25].

2.2.2. Antihypertensive Medication

Based on patients’ anamnestic data, the cardiologist prescribed the most suitable antihypertensives for the patients of groups B, C and D. The latest studies’ outcomes sustain prescription of pharmaceutical therapy for lowering blood pressure, based on the practical algorithm that sustains starting the treatment with angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) in combination with diuretics or low-dose non-dihydropyridines calcium channel blockers [26].

2.2.3. Physical Therapy Program

Twenty sessions of physical activity coordinated by specialists in kinetic recovery were implemented for group C. There was an 8-week program conducted in group sessions of 5 to 8 patients, with a frequency of 2–3 sessions weekly. Each session was organized following kinesiotherapy criteria: preparation of the body for the effort with static stretching exercise (10–15 poses sustained for 30 s each), active part with progressive overload constituted in a varied circuits type and adequate recovery post-exercises. From the total time of a session, 50–70 min, the main active part may reach up to 45 min in order to enhance cardiovascular endurance. This dominant section was subdivided into two parts: one represented by a circuit with varied exercise and another one compounded by cycling or walking on a treadmill, using an individualized speed and time ratio for each patient [27,28].

2.2.4. Hydrotherapy Program

Hydrothermal therapy, implemented for group D, consists of 20 sessions of 50–70 min each, with a frequency of 2 to 3 meetings weekly for 8 weeks in a row. To prepare the body for exertion, a few techniques from the physiotherapy section were chosen, i.e., electrotherapy, magnetotherapy, four cellular galvanic baths, paraffin and mud applications. The predominate active part reaches up to 45 min, and it is represented by exercise in the pool combined with walking and climbing stairs by using the resistance of water at different submersion levels. The recovery after the effort was also carried out in the pool, under the recommendations of freestyle swimming and flouting. All patients benefited from floating devises during practice in order to keep them safe and secure [29].

2.3. Evaluation

Participants who were enrolled were required to visit the laboratory twice during the prospective interventional study: first, for an initial assessment, before implementing the program; and then for a final assessment after 8 weeks of the predetermined program.
All visits were performed during the same daytime hours, in the afternoon, between 14 and 15 to avoid differences that may be induced by diurnal variation. Upon arrival at the laboratory, the anthropometrics measurements of the patients—BMI and waist circumference—were obtained by trained research assistants respecting standardized protocols. For height measurement, a moveable anthropometer was used, and patients were in an orthostatic position, with bare feet on a flat surface, with the weight equally distributed on both feet and the head in the Frankfort Horizontal Plane. A certified standard scale was used with accuracy within 50 g [30].
Monitoring and measuring blood pressure took place in the same conditions for all patients, taking into consideration the impact of the white-coat phenomenon and the training needed for both patients and specialists. Several measurements have been made to obtain the most accurate value: blood pressure measurement is made after 5 min of physical and psychological rest; three measurements in a row are made, and the value obtained from the arithmetic average of the last two is written down [31,32].
BMI formula and classification did not change over time and remain an important parameter for the health in general and for the morbidity risks: BMI = weight (kg) ÷ height2 (meters). Interpretation BMI: underweight, <18.5 kg/m2; healthy, 18.5–24.9 kg/m2’ overweight, 25–29.9 kg/m2; obesity, 30–39.9 kg/m2; and severe obesity, >40 kg/m2 [33,34].
For waist circumference measurements, a flexible steel tape calibrated in centimeters within millimeter graduation will be placed comfortably but still tight around the lateral aspect of each ilium at the mid-axillary line, with the patients standing with their arms crossed on opposite shoulders from the orthostatic position [35].
Waist circumference has gained its place alongside BMI as an indicator that comes to underline potential cardiovascular risks. Studies suggest that BMI analysis completed with waist circumference will bring a superior view regarding obesity in general, but mostly in correlation with cardiovascular diseases. Optimal waist circumference is <94 cm for men and <80 cm for women; measurements that register a waist circumference higher than 102 cm for men and higher than 88 cm for women are corelated with a major cardiovascular risk [36].

2.4. Statistical Analysis

Statistical analysis was performed using GraphPad Prism V.9. To evaluate the data normality, the Shapiro–Wilk test was used. To make comparisons between groups’ data with a normal distribution, we used Student’s t-test for dependent data, and the Wilcoxon test when data were not normally distributed. In both cases, in order to compare the initial result with the final ones within each group, the outcomes with a p ≤ 0.05 were considered statistically significant.
For the comparison between multiple groups, we used the ANOVA test for numeric values with normal distribution and the Kruskal–Wallis test for values not normally distributed. Also, for the post hoc analysis, we applied Tukey’s multiple comparisons test and Dunn’s multiple comparisons test. The results are expressed as arithmetic mean ± standard deviation and as median (IQR). The level of statistical significance was set for p ≤ 0.05.

3. Results

3.1. Initial and Final Intergroup Testing

In regard to age, the groups had no statistical differences: group A had an age mean of 46.12 ± 7.78, group B had an age mean of 45.96 ± 7.27, group C had an age mean of 46.32 ± 7.50 and group D had an age mean of 46.08 ± 7.83. Additionally, ANOVA analysis disclosed no significant statistical difference among groups, p = 0.99.
All patients of groups A, B, C and D registered similar outcomes at the initial assessment, with no statistically significant differences for body mass index (BMI p = 0.66; Figure 1a), waist circumference (Wcir p = 0.98, Figure 2a), and systolic and diastolic blood pressure (SBP, p = 0.83; DBP, p = 0.7; Figure 3a and Figure 4a). Before the interventional programs, the baseline parameters analyzed using the statistical ANOVA test showed homogeneity among all four groups for all parameters, p > 0.05.
Statistically significant differences were observed among groups in all parameters, such as body mass index, waist circumference, and systolic and diastolic blood pressure, when analyzed via the ANOVA test following 8 weeks of the implemented programs (p < 0.05).
Figure 1a presents the initial assessment for body mass index, which had no statistically significant intergroup differences: A (32.46 (30.44–35.01)), B (32.45 (29.02–34.97)), C (32 (30.35–34.68)) and (D 31.77 (28.9–33.55)); BMI p = 0.66.
Figure 1b shows the body mass index of groups A, B, C and D after 8 weeks of the final assessment, where the best outcome was registered by the hydrotherapy program of group D, with (29.33 ± 3.96), which, compared to group A (32.10 ± 4.07), showed a statistically significant decrease, p = 0.03. Group B (32.10 ± 4.07) registered the same values as group A. Group C’s mean (31.27 ± 4.17) was lower than that of groups A and B, and it was higher than the mean of group D, but there are no statistically significant differences between any of them.
Figure 2a shows that the initial assessment for waist circumference (Wcir) had no statistically significant intergroup differences: A (89 (84.5–99.5), B (89 (85.5–101.5), C (89 (85–99.5) and D (89 (85–99.5); Wcir p = 0.98.
Sports 13 00124 g002
Figure 2. (a) Initial assessment of waist circumference for groups A, B, C and D. (b) Final assessment of waist circumference for groups A, B, C and D. p ≤ 0.5 was considered significant.
Figure 2. (a) Initial assessment of waist circumference for groups A, B, C and D. (b) Final assessment of waist circumference for groups A, B, C and D. p ≤ 0.5 was considered significant.
Sports 13 00124 g002
After 8 weeks of final assessment, Figure 2b presents the second anthropometric parameter, waist circumferences (Wcir), of groups, B, C and D. The hydrotherapeutic program of group D, once again, was the most effective: Wcir = 85 (81–94) when compared to group B, which registered Wcir = 89 (85–101.5) with statistically significant difference p = 0.03. The Wcir results of group A, 89 (85–97), were similar to the group B, and the results of group C, 85 (81.5–96), were similar to the results of group D, but there were no statistically significant differences between any of them.
Figure 3a shows that the initial assessment for systolic blood pressure had no statistically significant intergroup differences: A (148 (143.5–151.5), B (150 (145–154.5), C (151 (144–155) and D (150 (144–156.5), SBP p = 0.83.
Sports 13 00124 g003
Figure 3. (a) Initial assessment of systolic blood pressure (SBP) for groups A, B, C and D. (b) Final assessment of systolic blood pressure (SBP) for groups A, B, C and D; p ≤ 0.5 was considered significant.
Figure 3. (a) Initial assessment of systolic blood pressure (SBP) for groups A, B, C and D. (b) Final assessment of systolic blood pressure (SBP) for groups A, B, C and D; p ≤ 0.5 was considered significant.
Sports 13 00124 g003
According to the 8-week final evaluation, systolic blood pressure revealed that the hydrotherapy program in group D (143 (140–147) and the physical therapy in group C (144 (141–148) both showed a statistically significant decrease when compared to group A (151 (143–157), SBP p = 0,002, Figure 3b. Group B’s outcome registered SBP (144 (141–148) values close to those of group A, but there were no statistically significant differences between them or between group B and groups C and D.
Figure 4a shows the initial assessment for diastolic blood pressure had no statistically significant differences intergroup: A (94 (92–96), B (93 (90–95), C (94 (93–96.5) and (D94 (92–96), DBP p = 0.7.
Sports 13 00124 g004
Figure 4. (a) Initial assessment of diastolic blood pressure (DBP) for groups A, B, C and D. (b) Final assessment of diastolic blood pressure (DBP) for groups A, B, C and D. p ≤ 0.5 was considered significant.
Figure 4. (a) Initial assessment of diastolic blood pressure (DBP) for groups A, B, C and D. (b) Final assessment of diastolic blood pressure (DBP) for groups A, B, C and D. p ≤ 0.5 was considered significant.
Sports 13 00124 g004
Figure 4b reveals the 8-week outcome of diastolic blood pressure (DBP) for both interventional programs, i.e., physical therapy of group C (92 (90–94)) and hydrotherapy of group D (91 (89.5–92)), indicated a statistically significant difference in the final assessment compared to the other two groups: group A (95 (93–97.5))—benefited from recommendation for healthy lifestyle; and group B (94 (93–96.5))—received antihypertensive medication, along with recommendation for healthy lifestyle; both comparisons showed DBP p < 0.0001.
All in all, the hydrotherapy program combined with recommendations for a healthy lifestyle and antihypertensive medication for group D achieved the lowest means and medians for all parameters at the final assessments, when comparing with the other three groups: BMI p = 0.03, Wcir p = 0.03, SBP p = 0.002 and DBP p < 0.0001 when compared with groups A and B. The physical therapy combined with recommendations for a healthy lifestyle and antihypertensive medication made group C’s values close to group D’s values: SBP p = 0.002 and DBP p < 0.0001 when compared with groups A and B. At this point, there was no statistically significant difference between hydrotherapy programs and physical therapy programs.
Furthermore, both groups A and B registered higher means and medians in two different parameters. Group A registered higher values for systolic and diastolic blood pressure, showing that the recommendation for a healthy lifestyle may have an impact on body mass index and waist circumference but not on blood pressure values. Group B recommended a healthy lifestyle in combination with antihypertensive medication that had the highest values for body mass index and waist circumference, indicating that medication has a positive impact on blood pressure values but may not bring any improvements regarding anthropometrics parameters. Nevertheless, there was no statistically significant difference between groups A and B.

3.2. Comparisons of Initial and Final Assessment in Intragroup A, B, C and D

Intragroup comparison of initial and final assessments revealed that groups A and B had a statistically significant difference for only one parameter each, while groups C and D had statistically significant differences for all of their parameters (Table 2).
Group A registered a statistically significant increase in DBP with p = 0.03, and for the other three parameters, BMI, waist circumference and SBP, the group indicated non-statistically significant values. Group B, which benefited from recommendations for a healthy lifestyle and antihypertensive medication, registered decreased blood pressure values, but only the systolic blood pressure (SBP) was statistically significant, with p = 0.03; further, a small decrease in waist circumference meant a slight increase in BMI, but it was not statistically significant (Table 2).
Group C, which, besides receiving recommendations for a healthy lifestyle and pharmaceutical intervention, had a specialized physical recovery program, registered a decrease in all four parameters, with all being statistically significant: BMI (p = 0.001), Wcir, SBP and DBP (each had p < 0.0001). Group D, which participated in a hydrotherapy program, along with receiving recommendations for a healthy lifestyle and pharmaceutical antihypertensive treatment, achieved a statistically significant decrease in all parameters: BMI had p = 0.0005, and each Wcir, SBP and DBP had p < 0.0001 (Table 2).
The outcome of group D is to be taken into consideration given the fact that it registered better results compared to all other groups—A, B and C. The mean of BMI dropout was 1.28 points after the 8-week hydrotherapy program—group D; and with 0.73 points after the 8-week physical therapy—group C. The difference noticed for the DBP parameter was a decrease of 3 units mmHg for group D and 2 units mmHg for group C. Regarding the means of waist circumference and systolic blood pressure, both recovery programs registered the same dropout after the 8-week interventions: 4 cm for Wcir and 7 units mmHg for SBP (Table 2).

4. Discussion

The study aims to demonstrate BMI and waist circumference reduction with a therapeutic intervention consisting of directions on how to obtain a healthy lifestyle, antihypertensive medication, and specialized programs of physical therapy and hydrotherapy, along with self-control of regular blood pressure values, in an 8-week period for a group of hypertensive patients.
The results of this study show that active implication in established physical therapy or hydrotherapy had a better outcome compared with only recommendation for a healthy lifestyle when the patients needed to do all by themselves unsupervised. Regardless of the expectations, online programs of physical activity proved to be ineffective; for instance, a thermoneutral-water home program did not reach the expected results [37,38]. Therefore, recovery programs based on the direct implication of the trained specialists are most likely irreplaceable.
The recommendation for a healthy lifestyle did not bring any benefits to the patients of group A after the 8-week period; the DBP median, which was higher at the end than the beginning of the implementation of the program, indicated progression of hypertension.
B group, besides receiving the healthy lifestyle recommendations, initiated pharmaceutical treatment, and the results are statistically significant for one parameter: the SBP median was lower after the 8-week program. The cases in which lifestyle changes are related to weight loss and controlled BP values are isolated. At this point, in our study, antihypertensive medication brought additional benefits to the patients that most likely will reduce cardiovascular risks.
The association of medication with physical therapy or hydrotherapy programs had a better outcome for groups C and D in comparison with groups A and B. Both programs brought statistically significant changes for all documented parameters. Once more, it is underlined that systematic and specialized supervised programs are more likely to bring better results in comparison to a free-will program based on theoretical recommendations that the patients need to implement by themselves. Periodical assessments and theoretical recommendations may not be sufficient; a direct implementation and specialized supervision, like in the two recovery-group programs described in this study, represent a more effective path for hypertensive patients.
The current research assessed the impact of four different approaches to controlling the body mass index, waist circumference and blood pressure values of hypertensive patients. The relation between obesity, expressed by high BMI, and hypertension has often been pointed out in studies over the last 5 years [39,40,41]. It is alarming that more studies take into consideration the connection mentioned above, regardless of the age population [42,43]. The interventions are yet to be discussed to determine the best outcome and how hypertension may be prevented, along with achieving a normalized BMI [44,45,46,47].
At this point, the results show that the combination of pharmaceutical and non-pharmaceutical direction should be taken into consideration regarding the treatment of hypertension. Antihypertensive treatments may be postponed when there is no healthy lifestyle implementation before the hypertension diagnostic and if the patients are willing to intervene in this matter. In these cases, the cardiologist will make such a recommendation if there are no high cardiovascular risks and if hypertension is not higher than degree 1. Several national epidemiological studies, SEPHAR I-IV, present the preponderance of arterial hypertension as the main cause of cardiovascular mortality. In 2005, the prevalence of arterial hypertension was higher in rural populations and for men (49.47% countryside vs. 41.58% city and 50.17% men vs. 41.11% women). The prevalence in 2011 was the opposite of the previous data, with most hypertensive patients coming from the city (59.59%), and the number of female patients was higher (54.9%) [48,49]. However, our study focused on the impact of interventional programs upon mixed groups in regard to gender and social environment.
Both physical therapy and hydrotherapy registered significant results, but between the two interventional programs, there are no significant differences at this point. We managed to improve cardiovascular health by increasing calorie burn with these programs based on time efficiency, variety and flexibility. In addition, a full-body workout has an afterburn effect, so calories continue to be burnt even after the session.
An unexpected outcome is to be taken into consideration for the hydrotherapy program, which registered better results for weight loss and diastolic blood pressure compared to all other groups, even compared to the program with physical therapy. Exercises in the pool provide a full-body workout and have a bigger impact on the cardiovascular system without putting stress on the body. If the hydrotherapy program can sustain a better outcome in regard to improving cardiovascular strength, in comparison with the physical program, further investigation and a more detailed analysis need to be performed in order to confirm this theory.
Worldwide, in 2019, around 18.6 million deaths were allocated to CVDs [50]. One year later, in 2020, the numbers increased, reaching 19.1 million deaths due to CVDs. The rise continued, and in 2021, there were 20.5 million registered deaths due to cardiovascular diseases. We must underline the fact that the number-one disease responsible for 60% of CVDs and around 50% of coronary heart disorders is hypertension. Increased BMI was registered for 2.4 million people globally [51]. Intervention is imminent because the predictive statistics data show a continuous increase for BMI, until 2030, for most of the world’s population.
The study has several limitations. Firstly, it used a small sample size of patients (n. 25 for each group) from a restricted area. The reason for not including social factors in the baseline was that it would limit the number of participants further; maintaining homogeneity within groups would have been challenging with more criteria included. As a result, an analysis that relied on social factors was not taken into consideration at this point. Our study did not prioritize gender analysis, and as the study progressed, we came to realize that it was not relevant because gender homogeneity was only achieved at the intergroup level; intragroup patients were 64% women and 36% men. While analyzing waist circumference separately for men and women would have been more substantial, our findings indicate that interventional programs have decreased values, resulting in diminished cardiovascular risk. Current research has led to this limitation, but extent research should emphasize gender differences. Additionally, physical and hydrotherapy programs implemented should be tailored to the effort capacity of each gender. Secondly, the 8-week period may be short according to some points of view, especially for the implementation of a healthy lifestyle, where patients had full control over the rate of accomplished tasks. Future studies should have extended follow-ups to sustain this study’s outcomes. Lastly, more parameters may also be pursued regarding overweight and hypertension markers. Despite this limitation, our findings underscore the importance of supervised physical activity programs to control BMI, waist circumference and blood pressure values, thus contributing to lowering CVD risks.

5. Conclusions

Our study revealed improvements in BMI, waist circumference and blood pressure values after both physical therapy and hydrotherapy programs. Controlled and guided physical therapy and hydrotherapy had better outcomes compared to the recommendations for a healthy lifestyle alone, even when patients needed to do programs by themselves, unsupervised. The recommendations for a healthy lifestyle as a single method of treatment did not bring significant benefits and is not enough, but when associated with antihypertensive medication, improvements in SBP values were noticed. At this point, we give credit to medication for the progress. Hydrotherapy programs were more efficient in lowering three parameters (BMI, SBP and DBP) than the single physical program, but the results were not statistically significant, so an expendability of the research is needed in this direction to determine which therapeutic intervention or combination of interventions is more effective in lowering the parameters and diminishing cardiovascular risks.

Author Contributions

Conceptualization R.C.R.B., E.G.P., A.O.D., R.M.M. and M.A.; methodology, R.C.R.B., E.G.P. and A.O.D.; software, R.C.R.B., E.G.P. and A.O.D.; validation, R.C.R.B., E.G.P., A.O.D., R.M.M. and M.A.; resources, R.C.R.B., E.G.P. and M.A.; data curation, R.C.R.B., E.G.P. and A.O.D.; writing—original draft preparation, R.C.R.B.; writing—review and editing, R.C.R.B., E.G.P. and M.A.; visualization, R.C.R.B., E.G.P., A.O.D., R.M.M. and M.A.; supervision, R.C.R.B., E.G.P. and M.A. All authors have read and agreed to the published version of the manuscript.

Funding

We would like to acknowledge VICTOR BABES UNIVERSITY OF MEDICINE AND PHARMACY TIMIȘOARA for their support in covering the costs of publication for this research paper.

Institutional Review Board Statement

The study was designed and conducted in accordance with international ethical standards on biomedical research with human beings, The Helsinki Declaration, and approved by the Scientific Research Ethics Committee from Medicine department of University of Medicine and Pharmacy Victor Babeș, Timisoara, Romania. (Approval No. 01, Approval date: 9 January 2023).

Informed Consent Statement

Written informed consent has been obtained from the patient (s) to publish this paper.

Data Availability Statement

The data that support the findings of this study are available on reasonable request from the corresponding author R.C.R.B, upon reasonable request. The data are not publicly available due to privacy and ethical restrictions.

Acknowledgments

We would like to thank all study participants for their implication in the program and assessments. Furthermore, we thank to the cardiologist’s offices for their commitment to this study and organizational support during recruitment and to the facilities that sustained the rehabilitation programs.

Conflicts of Interest

The authors declare no conflict of interest.

Abbreviations

The following abbreviations are used in this manuscript:
BMIbody mass index
Wcirwaist circumference
SBPsystolic blood pressure
DBPdiastolic blood pressure
NCDsnoncommunicable diseases
CVDscardiovascular diseases

References

  1. Bowry, A.D.; Lewey, J.; Dugani, S.B.; Choudhry, N.K. The Burden of Cardiovascular Disease in Low- and Middle-Income Countries: Epidemiology and Management. Can. J. Cardiol. 2015, 31, 1151–1159. [Google Scholar] [CrossRef]
  2. Mendis, S.; Puska, P.; Norrving, B. (Eds.) Global Atlas on Cardiovascular Disease Prevention and Control; World Health Organization: Geneva, Switzerland, 2011; ISBN 9789241564373. [Google Scholar]
  3. Byrne, J.; Eksteen, G.; Crickmore, C. Cardiovascular Disease Statistics Reference Document; Heart and Stroke Foundation South Africa: Cape Town, South Africa, 2016. [Google Scholar]
  4. European Heart Network; European Society of Cardiology. Fighting Cardiovascular Disease—A Blueprint for EU Action; European Society of Cardiology: Sophia Antipolis, France, 2020. [Google Scholar]
  5. Di Cesare, M.; Bixby, H.; Gaziano, T.; Hadeed, L.; Kabudula, C.; McGhie, V.D.; Mwangi, J.; Pervan, B.; Perel, P.; Piñeiro, D.; et al. Confronting the World’s Number One Killer; World Heart Federation: Geneva, Switzerland, 2023. [Google Scholar]
  6. Baptista, E.A.; Queiroz, B.L. Mortality from Cardiovascular Diseases Around the Globe—N-IUSSP. 27 May 2024. Available online: https://www.niussp.org/health-and-mortality/mortality-from-cardiovascular-diseases-around-the-globe/ (accessed on 5 March 2025).
  7. Reddy, K.S.; Yusuf, S. Emerging Epidemic of Cardiovascular Disease in Developing Countries. Circulation 1998, 97, 596–601. [Google Scholar] [CrossRef] [PubMed]
  8. Baigent, C.; Abdelhamid, M.; Aboyans, V.; Arbelo, E.; Asteggiano, R.; Baumbach, A.; Borger, M.; Celutkiene, J.; Cikes, J.; Collet, J.P.; et al. Cardiovascular medicine. In European Society of Cardiology (ESC) Committee of Medical Practice Guidelines; Media Med Publicis: Bucharest, Romania, 2021; p. 58. [Google Scholar]
  9. McEvoy, J.W.; McCarthy, C.P.; Bruno, R.M.; Brouwers, S.; Canavan, M.D.; Ceconi, C.; Christodorescu, R.M.; Daskalopoulou, S.S.; Ferro, C.J.; Gerdts, E.; et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur. Heart J. 2024, 45, 3912–4018. [Google Scholar] [CrossRef] [PubMed]
  10. Ministry of Health; National Center for Surveillance of Noncommunicable Diseases; National Institute of Public Health. Analysis of the Situation Regarding the Problem of Cardiovascular Diseases. Give a Healthy Heart to Your Love Ones! Know Yourself and Prevent the Rosk of Cardiovascular Diseases! 2023. Available online: https://insp.gov.ro/wp-content/uploads/2024/01/Analiza-situatie-BCV-2023.pdf (accessed on 4 February 2025).
  11. Mahdavi-Roshan, M.; Rezazadeh, A.; Joukar, F.; Naghipour, M.; Hassanipour, S.; Mansour-Ghanaei, F. Comparison of anthropometric indices as predictors of the risk factors for cardiovascular disease in Iran: The PERSIAN Guilan Cohort Study. Anatol. J. Cardiol. 2021, 25, 120–128. [Google Scholar] [CrossRef]
  12. National Institute of Public Health. Situation Analysis Regarding the Issue of Cardiovascular Diseases 2024. The Campaign, Choose the Right Eythmn for Your Heart: Live Healthy! 2024. Available online: https://insp.gov.ro/wp-content/uploads/2024/12/Analiza-de-situatie-BCV-2024.pdf (accessed on 4 February 2025).
  13. Rolland-Cachera, M.F.; Akrout, M.; Péneau, S. History and Meaning of the Body Mass Index. Interest of Other Anthropometric Measurements. In The ECOG’s eBook on Child and Adolescent Obesity; Frelut, M.L., Ed.; 2015. Available online: https://ebook.ecog-obesity.eu/wp-content/uploads/2015/02/ECOG-Obesity-eBook-History-and-Meaning-of-the-Body-Mass-Index.-Interest-of-Other-Anthropometric-Measurements-.pdf (accessed on 1 February 2025).
  14. Sadeghi, M.; Talaei, M.; Gharipour, M.; Oveisgharan, S.; Nezafati, P.; Dianatkhah, M.; Sarrafzadegan, N. Anthropometric indices predicting incident hypertension in an Iranian population: The Isfahan cohort study. Anatol. J. Cardiol. 2019, 22, 33–43. [Google Scholar] [CrossRef] [PubMed]
  15. Lobstein, T.; Brinsden, H.; Neveux, M.; Cavalcanti, O.B.; Baquera, S.; Baur, L.; Busch, V.; Buse, K.; Dietz, B.; French, A.; et al. World Obesity Atlas 2022; World Obesity Federation: London, UK, 2022. [Google Scholar]
  16. Zeng, X.Y.; Li, Y.C.; Liu, J.M.; Liu, Y.N.; Liu, S.W.; Qi, J.L.; Zhou, M.G. Estimation of the impact of risk factors control on non-communicable diseases mortality, life expectancy and the labor force lost in China in 2030. Zhonghua Yu Fang Yi Xue Za Zhi/Chin. J. Prev. Med. 2017, 51, 1079–1085. [Google Scholar] [CrossRef]
  17. Bennett, J.E.; Stevens, G.A.; Mathers, C.D.; Bonita, R.; Rehm, J.; Kruk, M.E.; Riley, L.M.; Dain, K.; Kengne, A.P.; Chalkidou, K.; et al. NCD Countdown 2030: Worldwide trends in non-communicable disease mortality and progress towards Sustainable Development Goal target 3.4. Lancet 2018, 392, 1072–1088. [Google Scholar] [CrossRef]
  18. Watkins, D.A.; Msemburi, W.T.; Pickersgill, S.J.; Kawakatsu, Y.; Gheorghe, A.; Dain, K.; Johansson, K.A.; Said, S.; Renshaw, N.; Tolla, M.T.; et al. NCD Countdown 2030: Efficient pathways and strategic investments to accelerate progress towards the Sustainable Development Goal target 3.4 in low-income and middle-income countries. Lancet 2022, 399, 1266–1278. [Google Scholar] [CrossRef]
  19. Junior, A.E.S.; Macêdo, G.A.D.; Schwade, D.; Sócrates, J.; Alves, J.W.; Farias-Junior, L.F.; Freire, Y.A.; Lemos, T.M.A.M.; Browne, R.A.V.; Costa, E.C. Physical Activity Counseling for Adults with Hypertension: A Randomized Controlled Pilot Trial. Int. J. Environ. Res. Public Health 2020, 17, 6076. [Google Scholar] [CrossRef]
  20. Romero-Vera, L.; Ulloa-Díaz, D.; Araya-Sierralta, S.; Guede-Rojas, F.; Andrades-Ramírez, O.; Carvajal-Parodi, C.; Muñoz-Bustos, G.; Matamala-Aguilera, M.; Martínez-García, D. Effects of High-Intensity Interval Training on Blood Pressure Levels in Hypertensive Patients: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Life 2024, 14, 1661. [Google Scholar] [CrossRef]
  21. Pinheiro, J.K.; Bezerra, M.A.A.; Santos, B.R.S.; de Resende-Neto, A.G.; Wichi, R.B. The Effects of Functional Training on the Ambulatory Blood Pressure and Physical Fitness of Resistant Hypertensive Elderly People: A Randomized Clinical Rehearsal with Preliminary Results. Int. J. Environ. Res. Public Health 2024, 21, 1015. [Google Scholar] [CrossRef] [PubMed]
  22. Williams, B.; Mancia, G.; Spiering, W.; Rosei, E.A.; Azizi, M.; Burnier, M.; Clement, D.L.; Coca, A.; De Simone, G.; Dominiczak, A.F.; et al. The Task Force for the management ofarterial hypertension of the European Society of Cardiology and the European Society of Hypertension. ESC/ESH Guidelines for the management of arterial hypertension. J. Hypertens. 2018, 36, 1953–2041. [Google Scholar]
  23. Stergiou, G.S.; Palatini, P.; Parati, G.; O’brien, E.; Januszewicz, A.; Lurbe, E.; Persu, A.; Mancia, G.; Kreutz, R. European Society of Hypertension practice guidelines for office and out-of-office blood pressure measurement. J. Hypertens. 2021, 39, 1293–1302. [Google Scholar] [CrossRef] [PubMed]
  24. Unger, T.; Borghi, C.; Charchar, F.; Khan, N.A.; Poulter, N.R.; Prabhakaran, D.; Ramirez, A.; Schlaich, M.; Stergiou, G.S.; Tomaszewski, M.; et al. 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension 2020, 75, 1334–1357. [Google Scholar] [CrossRef] [PubMed]
  25. AIMS-Academy Italian Specialist Doctors. Cardiology. In Vascular Surgery and Cardiac Surgery, 8th ed.; AIMS-Academia Italian Medici Specializzandi: Bari, Italy, 2022. [Google Scholar]
  26. Cappello, B.; Chowdhury, N.; Dorji, G.; Farrington, J.; Khan, T.; Ordunez, P.; Shongwe, S.; Slama, S.; Varghese, C.; Vitoria, M.; et al. Guideline for the Pharmacological Treatment of Hypertension in Adults; World Health Organization: Geneva, Switzerland, 2021; ISBN 978-92-4-003398-6. [Google Scholar]
  27. Pop, D.; Zdrenghea, D.; Roșu, R.; Gușteu, G.; Mureșan, L.; Cismaru, G.; Caloian, B.; Comşa, H. Cardiovascular Recovery; University Medical Iuliu Hațieganu: Cluj-Napoca, Romania, 2016; pp. 24–26. ISBN 978-973-693-721-7. [Google Scholar]
  28. Cinteza, D.; Marcu, V. Cardiovascular Medical Recovery; Balneră: Bucharest, Romania, 2011; pp. 51–62, 54–59. ISBN 978-606-92826-2-5. [Google Scholar]
  29. Dumitrașcu, M.; Muntean, C.; Lazarescu, H. Hydrotherapy. Balneo-Res. J. 2012, 3, 22–27. [Google Scholar] [CrossRef]
  30. Lohman, T.G.; Roche, A.F.; Martorell, R. Anthropometric Standardization Reference Manual; Human Kinetics Books: Champaign, IL, USA, 1988. [Google Scholar]
  31. Güler, Y.; Genç, Ö.; Yıldırım, A.; Halil, U.S.; Çapar, G.; Özdoğan, C.G.; Erdoğan, A.; Güler, A.; Kırma, C. A Metric Shedding Light on the Relationship Between White Coat Hypertension and Anxiety: The Hospital Anxiety and Depression Scale-Anxiety. Anatol. J. Cardiol. 2024, 29, 2–10. [Google Scholar] [CrossRef]
  32. Şirin, H.; Arslan, A.; Güneş, I.S.; Öcal, A.; Konyalıoğlu, F.S.; Ketrez, G.; Şimşek, A.Ç.; Yaşar, S.; Barçın, C. Comparison of Home Blood Pressure Monitoring with and without Training: Does Adherence to the Recommended Instructions Overlook Hypertension? Anatol. J. Cardiol. 2024, 28, 499–506. [Google Scholar] [CrossRef]
  33. Akram, D.S.; Astrup, A.V.; Atinmo, T.; Boissin, J.L.; Bray, G.A.; Carroll, K.K.; Chunming, C.; Dietz, W.H.; Hill, J.O.; Jequier, E.; et al. Obesity Preventing and Managing the Global Epidemic; Worlds Health Organization: Geneva, Switzerland, 2000; Reprinted 2004; ISBN 92-4-120894-5. ISSN 0512-3054. [Google Scholar]
  34. Shekar, M.; Popkin, B. (Eds.) Obesity Health and Economic Consequences of an Impending Global Challenge. In Human Development Perspectives; International Bank for Reconstruction and Development/The World Bank: Washington, DC, USA, 2020. [Google Scholar]
  35. Gavriilidou, N.N.; Pihlsgård, M.; Elmståhl, S. Anthropometric reference data for elderly Swedes and its disease-related pattern. Eur. J. Clin. Nutr. 2015, 69, 1066–1075. [Google Scholar] [CrossRef]
  36. Alberti, G.; Azizi, F.; Chan, J.; Huxely, R.; James, P.; Kadowaki, T.; Khaw, K.T.; Ko, G.T.C.; Kumanyika, S.; Lear, S.; et al. Waist Circumference and Waist-Hip Ratio; WHO Expert Consultation: Geneva, Switzerland, 2008; ISBN 978-92-4-150149 1. [Google Scholar]
  37. Múzquiz-Barberá, P.; Ruiz-Cortés, M.; Herrero, R.; Vara, M.D.; Escrivá-Martínez, T.; Baños, R.M.; Rodilla, E.; Lisón, J.F. “Own doctor” presence in a web-based lifestyle intervention for adults with obesity and hypertension: A randomized controlled trial. Front. Public Health 2023, 11, 1115711. [Google Scholar] [CrossRef]
  38. Naumann, J.; Sadaghiani, C.; Bureau, N.; Schmidt, S.; Huber, R. Outcomes from a three-arm randomized controlled trial of frequent immersion in thermoneutral water on cardiovascular risk factors. BMC Complement. Altern. Med. 2016, 16, 250. [Google Scholar] [CrossRef]
  39. Litwin, M.; Kułaga, Z. Obesity, metabolic syndrome, and primary hypertension. Pediatr. Nephrol. 2021, 36, 825–837. [Google Scholar] [CrossRef] [PubMed]
  40. Jayedi, A.; Rashidy-Pour, A.; Khorshidi, M.; Shab-Bidar, S. Body mass index, abdominal adiposity, weight gain and risk of developing hypertension: A systematic review and dose-response meta-analysis of more than 2.3 million participants. Obes. Rev. 2018, 19, 654–667. [Google Scholar] [CrossRef] [PubMed]
  41. Landi, F.; Calvani, R.; Picca, A.; Tosato, M.; Martone, A.M.; Ortolani, E.; Sisto, A.; D’angelo, E.; Serafini, E.; Desideri, G.; et al. Body Mass Index is Strongly Associated with Hypertension: Results from the Longevity Check-up 7+ Study. Nutrients 2018, 10, 1976. [Google Scholar] [CrossRef]
  42. Kosami, K.; Kuwabara, M.; Okayama, A.; Ae, R. Body Mass Index and Weight Change as Predictors of Hypertension Development: A Sex-Specific Analysis. Nutrients 2024, 17, 119. [Google Scholar] [CrossRef]
  43. Zhong, Y.; Zhang, Z.; Hu, Y. The combined effects of overweight/obesity and dietary antioxidant quality score on hypertension in children and adolescents. BMC Pediatr. 2023, 23, 584. [Google Scholar] [CrossRef]
  44. Cunha, R.M.; Arsa, G.; Neves, E.B.; Lopes, L.C.; Santana, F.; Noleto, M.V.; Rolim, T.I.; Lehnen, A.M. Water aerobics is followed by short-time and immediate systolic blood pressure reduction in overweight and obese hypertensive women. J. Am. Soc. Hypertens. 2016, 10, 570–577. [Google Scholar] [CrossRef]
  45. Lu, Q.; Lu, J.; Li, C.; Huang, P.; Jiang, F.; Zhao, X.; Zhang, J.; Huang, Y.; Chu, Z. Cardiopulmonary Exercise Testing-Guided Exercise Therapy in Hypertensive Patients: A Single Center Study. Cardiovasc. Ther. 2024, 2024, 8476971. [Google Scholar] [CrossRef] [PubMed]
  46. Gorostegi-Anduaga, I.; Corres, P.; MartinezAguirre-Betolaza, A.; Pérez-Asenjo, J.; Aispuru, G.R.; Fryer, S.M.; Maldonado-Martín, S. Effects of different aerobic exercise programmes with nutritional intervention in sedentary adults with overweight/obesity and hypertension: EXERDIET-HTA study. Eur. J. Prev. Cardiol. 2018, 25, 343–353. [Google Scholar] [CrossRef]
  47. Baruki, S.B.; Montebello, M.I.D.L.; Pazzianotto-Forti, E.M. Physical training in outdoor fitness gym improves blood pressure, physical fitness, and quality of life of hypertensive patients: A randomized controlled trial. J. Sports Med. Phys. Fit. 2022, 62, 997–1005. [Google Scholar] [CrossRef]
  48. Dorobantu, M.; Darabont, R.O.; Badila, E.; Ghiorghe, S. Prevalence, Awareness, Treatment, and Control of Hypertension in Romania: Results of the SEPHAR Study. Int. J. Hypertens. 2010, 2010, 970694. [Google Scholar] [CrossRef]
  49. Dorobanţu, M.; Darabont, R.; Ghiorghe, S.; Babes, K.; Pop, D.; Toma, D.; Vasilescu, M.; Dobreanu, M.; Tăutu, O. Profile of the Romanian hypertensive patient data from SEPHAR II study. Rom. J. Intern. Med. 2012, 50, 285–296. [Google Scholar] [PubMed]
  50. Rittiphairoj, T.; Reilly, A.; Reddy, C.L.; Barrenho, E.; Colombo, F.; Atun, R. The State of Cardiovascular Disease in G20+ Countries; Health Systems Innovation Lab, Harvard University: Boston, MA, USA, 2022. [Google Scholar] [CrossRef]
  51. Tsao, C.W.; Aday, A.W.; Almarzooq, Z.I.; Alonso, A.; Beaton, A.Z.; Bittencourt, M.S.; Boehme, A.K.; Buxton, A.E.; Carson, A.P.; Commodore-Mensah, Y.; et al. Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association. Circulation 2022, 145, e153–e639. [Google Scholar] [CrossRef] [PubMed]
Sports 13 00124 g001
Figure 1. (a) Initial assessment of body mass index (BMI) for groups A, B, C and D. (b) Final assessment of body mass index (BMI) for groups A, B, C and D. p ≤ 0.5 was considered significant.
Figure 1. (a) Initial assessment of body mass index (BMI) for groups A, B, C and D. (b) Final assessment of body mass index (BMI) for groups A, B, C and D. p ≤ 0.5 was considered significant.
Sports 13 00124 g001
Table 1. Patient groups’ baseline subsequent to homogenized criteria.
Table 1. Patient groups’ baseline subsequent to homogenized criteria.
ABCD
n (%)n (%)n (%)n (%)
Sex
F16 (64)16 (64)16 (64)16 (64)
M9 (36)9 (36)9 (36)9 (36)
Menstruating
Not applicable9 (36)9 (36)9 (36)9 (36)
Yes4 (16)4 (16)4 (16)4 (16)
No12121212
Menopause early
Not applicable9 (36)9 (36)9 (36)9 (36)
Yes10 (40)10 (40)10 (40)10 (40)
No6 (24)6 (24)6 (24)6 (24)
Familial history of HBP
Yes 20 (80)20 (80)20 (80)20 (80)
No5 (20)5 (20)5 (20)5 (20)
Smoking
Yes7 (28)7 (28)7 (28)7 (28)
No18 (72)8 (72)8 (72)8 (72)
Overweight
Yes21 (84)21 (84)21 (84)21 (84)
No4 (16)4 (16)4 (16)4 (16)
Active lifestyle
Yes6 (24)6 (24)6 (24)6 (24)
No19 (76)19 (76)19 (76)19 (76)
Active work
Yes8 (32)8 (32)8 (32)8 (32)
No17 (68)17 (68)17 (68)17 (68)
Difference BP value between arms
Yes4 (16)4 (16)4 (16)4 (16)
No21 (84)21 (84)21 (84)21 (84)
A, B, C and D: groups of patients. BP: blood pressure.
Table 2. Initial and final assessment, comparison of intragroup A, B, C and D.
Table 2. Initial and final assessment, comparison of intragroup A, B, C and D.
InitialFinalp Value
Group A
BMI32.0 ± 4.1832.10 ± 4.070.12
Wcir91.52 ± 8.9291.6 ± 8.480.7989
SBP148.6 ± 5.30149.9 ± 10.120.45
DPB94.16 ± 2.5295.2 ± 2.730.03
Group B
BMI32 ± 4.1832.1 ± 4.070.12
Wcir91.88 ± 8.3791.80 ± 8.490.8184
SBP149.8 ± 6.18149 ± 5.620.03
DPB94.72 ± 2.4294.4 ± 2.440.33
Group C
BMI32 (30.35–34.68)31.55 (29.64–33.97)0.001
Wcir91.96 ± 8.8688.72 ± 8.46<0.0001
SBP151 (144–155)144 (141–148)<0.0001
DPB94 (93–96.5)92 (90–94)<0.0001
Group D
BMI31.77 (28.9–33.55)30.49 (27.89–32.16)0.0005
Wcir91.56 ± 8.8286.56 ± 7.61<0.0001
SBP150 (144–156.5)143 (140–147)<0.0001
DPB94 (92–96)91 (89.5–92)<0.0001
BMI, body mass index; Wcir, waist circumference; SBP, systolic blood pressure; DBP, diastolic blood pressure; p ≤ 0.5 was considered significant.
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

MDPI and ACS Style

Rad Bodan, R.C.; Dușe, A.O.; Papp, E.G.; Melinte, R.M.; Andor, M. Association of Controlled Physical Activity with Weight Loss and Less Limitations for Hypertensive Patients. Sports 2025, 13, 124. https://doi.org/10.3390/sports13040124

AMA Style

Rad Bodan RC, Dușe AO, Papp EG, Melinte RM, Andor M. Association of Controlled Physical Activity with Weight Loss and Less Limitations for Hypertensive Patients. Sports. 2025; 13(4):124. https://doi.org/10.3390/sports13040124

Chicago/Turabian Style

Rad Bodan, Roxana Cristina, Adina Octavia Dușe, Eniko Gabriela Papp, Răzvan Marian Melinte, and Minodora Andor. 2025. "Association of Controlled Physical Activity with Weight Loss and Less Limitations for Hypertensive Patients" Sports 13, no. 4: 124. https://doi.org/10.3390/sports13040124

APA Style

Rad Bodan, R. C., Dușe, A. O., Papp, E. G., Melinte, R. M., & Andor, M. (2025). Association of Controlled Physical Activity with Weight Loss and Less Limitations for Hypertensive Patients. Sports, 13(4), 124. https://doi.org/10.3390/sports13040124

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop