Comparative effects of three 48-week community-based physical activity and exercise interventions on aerobic capacity, total cholesterol and mean arterial blood pressure

AIM Insufficient research examines the treatment effectiveness of real-world physical activity (PA) interventions. PURPOSE We investigated the effects of 3 interventions on directly measured cardiovascular variables. All treatments and measures were administered in community settings by fitness centre staff. METHODS Participants were sedentary individuals receiving no medication to reduce cardiovascular disease (CVD) risk (n=369, age 43 ±5 years). In a semirandomised design, participants were allocated to a structured gym exercise programme (STRUC), unstructured gym exercise (FREE), physical activity counselling (PAC) or a measurement-only control condition (CONT). Measures were: predicted aerobic capacity (VO2: mL kg min), mean arterial blood pressure (MAP: mm Hg) and total cholesterol (TC: mmol/L), and were taken at baseline and 48 weeks. RESULTS Data analysis indicated a statistically significant deterioration in TC in CONT (0.8%, SD=0.5, p=0.005), and a statistically significant improvement in MAP in STRUC (2.5%, SD=8.3, p=0.004). Following a median split by baseline VO2, paired-sample t tests indicated significant improvements in VO2 among low-fit participants in STRUC (3.5%, SD=4.8, p=0.003), PAC (3.3%, SD=7.7, p=0.050) and FREE (2.6%, SD=4.8, p=0.006), and significant deterioration of VO2 among high-fit participants in FREE (-2.0%, SD=5.6, p=0.037), and PAC (-3.2%, SD=6.4, p=0.031). CONCLUSIONS Several forms of PA may offset increased cholesterol resulting from inactivity. Structured PA (exercise) might be more effective than either unstructured PA or counselling in improving blood pressure, and community-based PA interventions might be more effective in improving VO2 among low-fit than among high-fit participants.