Anti-hypertensive Therapy and Exercise Treatment to Improve Vascular Health in Patients With Hypertension.

Arterial hypertension is a global health burden that affects the structure and function of large and small blood vessels and induces disease-specific end-organ damage. Exercise therapy is highly recommended in the treatment of arterial hypertension to reduce blood pressure and ameliorate hypertension-induced vascular damage. Previous exercise intervention studies have shown that exercise treatment improves vascular dysfunction independently of changes in blood pressure. Several sensitive vascular biomarkers exist that could optimize risk stratification and therapeutic decisions based on the progression of individual vascular damage in patients with arterial hypertension. However, individualized vascular assessment during anti-hypertensive treatment is not yet part of routine clinical practice. In order to improve clinical decision making from a personalized medicine perspective, it is essential to better understand which vascular biomarkers have the best sensitivity in detecting therapy-induced vascular adaptations and whether anti-hypertensive therapy with or without additional exercise improves vascular health in patients with hypertension. The proposed study will evaluate the effects of guideline-directed anti-hypertensive therapy with or without individualized exercise training intervention in 60 patients with hypertension and no previous medical treatment for one year. Regular outpatient assessments of blood pressure and large and small blood vessels will be performed every two months. Anti-hypertensive therapy will be based on the current guidelines of the European Society of Hypertension. The investigators aim to achieve the target blood pressure after six months of treatment. A further six-month follow-up is planned to assess the long-term effects of anti-hypertensive therapy, with or without additional individualized exercise training intervention, on blood pressure and macro- and microvascular health. In addition, the investigators will investigate the effect of metabolic changes induced by anti-hypertensive treatment or individualized exercise training intervention on vascular health.

• The additional effect of an anti-hypertensive treatment plus an individualizes exercise therapy on the systolic and diastolic blood pressure compared to a guideline based anti-hypertensive treatment with general lifestyle recommendations. [Срок оценки: From enrollment to the end of treatment after six month.]
• Effect of an guideline based anti-hypertensive therapy on the systolic and diastolic blood pressure. [Срок оценки: From enrollment to the end of treatment after six month.]
• The additional effect of an anti-hypertensive treatment plus an individualizes exercise therapy on the microvascular endothelial function compared to a guideline based anti-hypertensive treatment with general lifestyle recommendations. [Срок оценки: From enrollment to the end of treatment after six month.]
• Effect of an guideline based anti-hypertensive therapy on the microvascular endothelial function. [Срок оценки: From enrollment to the end of treatment after six month.]
• The additional effect of an anti-hypertensive treatment plus an individualizes exercise therapy on the arterial stiffness compared to a guideline based anti-hypertensive treatment with general lifestyle recommendations. [Срок оценки: From enrollment to the end of treatment after six month.]
• Effect of an guideline based anti-hypertensive therapy on arterial stiffness. [Срок оценки: From enrollment to the end of treatment after six month.]
• The additional effect of an anti-hypertensive treatment plus an individualizes exercise therapy on physical fitness compared to a guideline based anti-hypertensive treatment with general lifestyle recommendations. [Срок оценки: From enrollment to the end of treatment after six month.]
• Effect of an guideline based anti-hypertensive therapy on physical fitness. [Срок оценки: From enrollment to the end of treatment after six month.]
• The additional effect of an anti-hypertensive treatment plus an individualizes exercise therapy on the NO metabolism of stored blood samples compared to a guideline based anti-hypertensive treatment with general lifestyle recommendations. [Срок оценки: From enrollment to the end of treatment after six month.]
• Effect of a guideline based anti-hypertensive therapy on the NO metabolism of stored blood samples. [Срок оценки: From enrollment to the end of treatment after six month.]
• The additional effect of an anti-hypertensive treatment plus an individualizes exercise therapy on the metabolic profile of stored blood samples compared to a guideline based anti-hypertensive treatment with general lifestyle recommendations. [Срок оценки: From enrollment to the end of treatment after six month.]
• Effect of a guideline based anti-hypertensive therapy on the metabolic profile of stored blood samples. [Срок оценки: From enrollment to the end of treatment after six month.]