Clinical study: Cardiovascular outcomes after a 14-week exercise intervention in young adults born preterm

Preterm birth has long-term consequences including higher cardiovascular disease risk. We previously reported the effect of an exercise intervention on cardiorespiratory fitness in young adults born preterm at <30 weeks' gestational age) and term. This article reports on cardiovascular outcomes.

This single-arm clinical trial tested a 14-week exercise program: two 90-min in-person sessions/week (cardio, resistance, flexibility) and one 30-min at-home cardio session/week. Cardiovascular parameters were measured pre- and post-intervention. Term-born individuals were included to validate the intervention.

Sixteen preterm and 30 term participants completed pre- and post-visits. Both groups improved peak circulatory power and cardiac output index (COi) and COi reserve during cardiopulmonary exercise testing (CPET). Nocturnal blood pressure (BP) dipping and other CPET-related hemodynamic improvements occurred only in term participants. Reductions in 24-hour and awake BP, heart rate, and hypertensive loads were observed in preterm participants, but not the term participants, who exhibited elevated or hypertensive BP values pre-intervention.

An exercise intervention can improve cardiovascular health in preterm and term born individuals. Additional BP benefits were observed in preterm participants with elevated or hypertensive BP. These indicate that cardiovascular changes associated with preterm birth are, at least partially, amenable to improvement through lifestyle intervention.

gov ID: NCT03504215 URL: https://clinicaltrials.gov/study/NCT03504215 .

A structured exercise intervention improves cardiovascular function and blood pressure in young adults born very preterm. This study demonstrates that cardiovascular alterations associated with preterm birth are not fixed in early adulthood and can be improved through exercise. Notably, individuals born preterm with elevated or hypertensive blood pressure experienced significant blood pressure reductions following the intervention. Exercise-based lifestyle interventions may represent an effective, non-pharmacological strategy to reduce long-term cardiovascular risk in adults born preterm.