Soccer Improves Fitness and Attenuates Cardiovascular Risk Factors in Hypertensive Men PETER KRUSTRUP 1,2 , MORTEN B. RANDERS 2 , LARS J. ANDERSEN 2,3 , SARAH R. JACKMAN 1 , JENS BANGSBO 2 , and PETER R. HANSEN 3 1 Sport and Health Sciences, College of Life and Environmental Sciences, St. Luke’s Campus, University of Exeter, Exeter, UNITED KINGDOM; 2 Department of Nutrition, Exercise, and Sports Section of Human Physiology, University of Copenhagen, Copenhagen, DENMARK; and 3 Department of Cardiology, Gentofte University Hospital, Copenhagen, DENMARK ABSTRACT KRUSTRUP, P., M. B. RANDERS, L. J. ANDERSEN, S. R. JACKMAN, J. BANGSBO, and P. R. HANSEN. Soccer Improves Fitness and Attenuates Cardiovascular Risk Factors in Hypertensive Men. Med. Sci. Sports Exerc., Vol. 45, No. 3, pp. 553–560, 2013. Introduction: The present study investigated the fitness and health effects of medium-term soccer training for untrained hypertensive middle-age men. Methods: Thirty-three untrained males (31–54 yr) with mild-to-moderate hypertension were randomized 2:1 to a soccer training group (STG, two 1-h sessions per week, n = 22, 68% on medication) and a doctor advice group receiving traditional physician- guided recommendations on cardiovascular risk factor modification (DAG, n = 11, 73% on medication). Two-way repeated-measures ANOVA time–group statistics was applied. Results: During soccer training, average HR was 155 T 9 bpm or 85% T 7% HR max . In STG, systolic and diastolic blood pressures decreased (P G 0.01) over 6 months from 151 T 10 to 139 T 10 mm Hg and from 92 T 7 to 84 T 6 mm Hg, respectively, with smaller (P G 0.05) decreases in DAG (from 153 T 8 to 145 T 8 mm Hg and from 96 T 6 to 93 T 6 mm Hg, respectively). In STG, V ˙ O 2max increased (P G 0.01) from 32.6 T 4.9 to 35.4 T 6.6 mLImin j1 Ikg j1 and relative V ˙ O 2 during cycling at 100 W was lowered (P G 0.05) from 55% T 7% to 50% T 8% V ˙ O 2max over 6 months, with no changes in DAG. In STG, resting HR was lowered by 8 T 11 bpm (P G 0.05), and the augmentation index (a measure of arterial stiffness) was lowered (P G 0.05) by 7.3 T 14.0 over 6 months, with no change in DAG. Conclusions: Six months of soccer training improved aerobic fitness, reduced blood pressure, and resulted in an array of other favorable effects on cardiovascular risk profile for untrained middle-age hypertensive men. Soccer training, therefore, may be a better nonpharmacological treatment for hypertensive men than traditional physician-guided advice. Key Words: MAXIMAL OXYGEN UPTAKE, BLOOD PRESSURE, ENDOTHELIAL FUNCTION, FAT PERCENTAGE, EXERCISE RESPONSE, ASSOCIATION FOOTBALL A rterial hypertension is associated with increased risk of cardiovascular diseases including stroke, coro- nary heart disease, atrial fibrillation, and renal fail- ure (25). Furthermore, arterial hypertension is associated with a higher all-cause and cardiovascular mortality (25). Physical activity is considered to be a cornerstone in pre- vention and treatment of mild hypertension (33), and it is well documented that aerobic physical activity lowers arterial blood pressure (BP) and results in a variety of favorable effects on cardiovascular risk factors (32). To date, a clear relationship between the exercise intensity and the reduc- tion in BP has not been established (9). However, aerobic high-intensity training appears to be more effective than moderate-intensity continuous exercise training for improving heart function, maximal oxygen uptake (V ˙ O 2max ), muscle oxi- dative capacity, and risk factors for the metabolic syndrome in healthy men as well as patients experiencing hypertension and severe obesity (28,29,37,38). Recent studies from our research group have shown that recreational soccer is an intense intermittent sport activity that causes marked reductions in BP and improvement of peripheral arterial function after short-term interventions for untrained normotensive young men and women (21,22), as well as habitually active men with mild untreated hyper- tension and untrained middle-age men with mild-to-moderate hypertension (2,17). Furthermore, short- and long-term soccer training studies have shown that regular soccer training has broad spectrum effects on physical fitness as well as favorable effects on cardiovascular risk factors such as maximal oxygen uptake, heart function, body fat mass, and LDL cholesterol levels in healthy untrained young men and women (20–22,35). However, it remains to be investigated whether regular medium- term (6 months) soccer training for untrained middle-age men with mild-to-moderate hypertension is more effective for reduction of BP than standard physician-guided advice on Address for correspondence: Peter Krustrup, Ph.D., Sport and Health Sci- ences, College of Life and Environmental Sciences, St. Luke’s Campus, University of Exeter, Heavitree Road, Exeter, EX1 2LU, United Kingdom; E-mail: P.Krustrup@exeter.ac.uk. Submitted for publication May 2012. Accepted for publication September 2012. 0195-9131/13/4503-0553/0 MEDICINE & SCIENCE IN SPORTS & EXERCISE Ò Copyright Ó 2013 by the American College of Sports Medicine DOI: 10.1249/MSS.0b013e3182777051 553 APPLIED SCIENCES Copyright © 2013 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.