Plasma Fibrinogen Level and Fibrinogen/Albumin Ratio Decreased More After Gym Training Compared to Home Training in Hypertensive Men: A Randomized Controlled Parallel-Group Trial

Abstract

Background: Elevated plasma fibrinogen may promote atherosclerotic disease in patients with essential hypertension, contributing to endothelial dysfunction and thrombotic events. While exercise is recommended for hypertension management, the differential effects of structured gym-based training (GBT) versus home-based programs on cardiovascular biomarkers remain unclear. Objectives: This randomized controlled trial aimed to compare the effects of 10 weeks of GBT versus home-based training (HBT) on biochemical markers linked to cardiovascular disease (CVD) in men with primary hypertension. Methods: This was a randomized controlled parallel-group trial with a 1:1:1 allocation ratio. Randomization was performed using permuted block randomization with online software. Sixty men with primary hypertension aged 30 - 70 years [(Body Mass Index (BMI): 30.06 ± 4.53 kg/m2] were randomly divided into three groups (n = 20) including GBT [resistance training (RT) at 60 - 80% of one-repetition maximum (1-RM), aerobic training (AT) at 40 - 60% heart rate reserve (HRR), and stretching training (ST)], HBT (RT at 12 - 15 of Borg’s Rating of Perceived Exertion (RPE) Scale, AT at 11 - 13 of RPE Scale, and ST), and control (CR). Plasma levels of superoxide dismutase (SOD) activity, fibrinogen, albumin, fibrinogen to albumin ratio (FAR), plasminogen activator inhibitor-1 (PAI-1), and apelin were measured before and after the training program. Statistical analyses were performed using analysis of covariance (ANCOVA) and non-parametric tests, with pre-test values as covariates. Results: The fibrinogen and FAR levels were significantly lower in the GBT group compared with the HBT and CR groups. Also, the albumin level was significantly lower in the HBT compared with the GBT and CR groups. No significant changes were observed in the levels of SOD activity, PAI-1, and apelin after GBT and HBT compared to the CR group. The systolic blood pressure (BP) was negatively correlated with fibrinogen and FAR, was positively correlated with PAI-1, and the diastolic BP was positively correlated with SOD. Conclusions: The GBT and HBT reduce some cardiovascular risk factors in hypertensive men. Although trainer-supervised GBT can be more effective, HBT may be considered as an alternative for individuals facing barriers to gym attendance.