Factors affecting post-exercise hypotension in normotensive and hypertensive humans

The acute effect of passively assisted trunk stretching on central arterial stiffness and blood pressure in middle-aged to older adults

PURPOSE

We examined the effects of acute trunk stretching on central arterial stiffness and central and peripheral blood pressure in middle-aged to older adults.

METHODS

Twenty-eight middle-aged to older adults (14M/14F, 72 ± 7 years, 28.5 ± 5.3 kg/m2) completed this randomized, controlled, crossover design trial. We measured carotid-femoral pulse wave velocity (cf-PWV) and central and peripheral blood pressures (BP) before and after a single bout of passively assisted trunk stretching (i.e., five rounds of six 30-s stretches) and a time-matched seated control visit (i.e., 30-min). Changes (Δ; post - pre) in cf-PWV and central and peripheral BP were compared between visits and sexes using separate linear mixed-effects models controlling for baseline values.

RESULTS

Compared with seated control, central (systolic: - 3 ± 7 mmHg; diastolic: - 2 ± 5 mmHg) and peripheral (systolic: - 2 ± 8 mmHg; diastolic: - 1 ± 4 mmHg) BP were reduced following acute trunk stretching (ps ≤ 0.001). Between-visit differences for ∆cf-PWV (stretch: 0.09 ± 0.61 m/s; control: 0.37 ± 0.68 m/s, p = 0.038) were abolished when controlling for change in mean arterial pressure (∆MAP) (p = 0.687). The main effects of sex were detected for changes in systolic BPs (ps ≤ 0.029); more males (n = 13) saw BP reductions than females (n = 7).

CONCLUSION

These findings demonstrate the superiority of acute trunk stretching over passive sitting of equated duration for BP in middle-aged to older adults, with an appreciable effect in males compared to females.

Reliability and Time Course of Postexercise Hypotension during Exercise Training among Adults with Hypertension

Postexercise hypotension (PEH), or the immediate decrease in blood pressure (BP) lasting for 24 h following an exercise bout, is well-established; however, the influence of exercise training on PEH dynamics is unknown. This study investigated the reliability and time course of change of PEH during exercise training among adults with hypertension. PEH responders (n = 10) underwent 12 weeks of aerobic exercise training, 40 min/session at moderate-to-vigorous intensity for 3 d/weeks. Self-measured BP was used to calculate PEH before and for 10 min after each session. The intraclass correlation coefficient (ICC) and Akaike Information Criterion (AIC) determined PEH reliability and goodness-of-fit for each week, respectively. Participants were obese (30.6 ± 4.3 kg∙m-2), middle-aged (57.2 ± 10.5 years), and mostly men (60%) with stage I hypertension (136.5 ± 12.1/83.4 ± 6.7 mmHg). Exercise training adherence was 90.6 ± 11.8% with 32.6 ± 4.2 sessions completed. PEH occurred in 89.7 ± 8.3% of these sessions with BP reductions of 9.3 ± 13.1/3.2 ± 6.8 mmHg. PEH reliability was moderate (ICC ~0.6). AIC analysis revealed a stabilization of maximal systolic and diastolic BP reductions at 3 weeks and 10 weeks, respectively. PEH persisted throughout exercise training at clinically meaningful levels, suggesting that the antihypertensive effects of exercise training may be largely due to PEH. Further studies in larger samples and under ambulatory conditions are needed to confirm these novel findings.

Effects of aerobic exercise on ambulatory blood pressure responses to acute partial sleep deprivation: impact of chronotype and sleep quality

Blood pressure (BP) follows a circadian rhythm intertwined with the sleep-wake cycle. Acute partial sleep deprivation (PSD; sleep ≤ 6 h) can increase BP, associated with increased cardiovascular risk. Acute exercise can reduce BP for up to 24 h, a phenomenon termed postexercise hypotension. The present study tested whether aerobic exercise could mitigate the augmented 24-h ambulatory BP caused by acute PSD. Twenty-four young otherwise healthy adults (22 ± 3 yr; 14 females; self-reported chronotypes: 6 early/10 intermediate/8 late; Pittsburgh sleep quality index: 17 good/7 poor sleepers) completed a randomized crossover trial in which, on different days, they slept normally (2300-0700), restricted sleep [0330-0700 (PSD)], and cycled for 50 min (70-80% predicted heart rate maximum) before PSD. Ambulatory BP was assessed every 30 min until 2100 the next day. Acute PSD increased 24-h systolic BP (control 117 ± 9 mmHg, PSD 122 ± 9 mmHg; P < 0.001) and prior exercise attenuated (exercise + PSD 120 ± 9 mmHg; P = 0.04 vs. PSD) but did not fully reverse this response (exercise + PSD, P = 0.02 vs. control). Subgroup analysis revealed that the 24-h systolic BP reduction following exercise was specific to late types (PSD 119 ± 7 vs. exercise + PSD 116 ± 6 mmHg; P < 0.05). Overall, habitual sleep quality was negatively correlated with the change in daytime systolic BP following PSD (r = -0.56, P < 0.01). These findings suggest that the ability of aerobic cycling exercise to counteract the hemodynamic effects of acute PSD in young adults may be dependent on chronotype and that habitual sleep quality can predict the daytime BP response to acute PSD.NEW & NOTEWORTHY We demonstrate that cycling exercise attenuates, but does not fully reverse, the augmented 24-h ambulatory blood pressure (BP) response caused by acute partial sleep deprivation (PSD). This response was primarily observed in late chronotypes. Furthermore, daytime BP after acute PSD is related to habitual sleep quality, with better sleepers being more prone to BP elevations. This suggests that habitual sleeping habits can influence BP responses to acute PSD and their interactions with prior cycling exercise.

Is postexercise hypotension a method-dependent phenomenon in chronic stroke? A crossover randomized controlled trial

BACKGROUND

This study assessed the reproducibility of postexercise hypotension (PEH) detection after two bouts of mixed circuit training (MCT) using three approaches that accounts the pre-exercise values and/or a control session (CTL) to calculate PEH [i.e., ( A 1 = post - exercise - pre - exercise ${A}_{1}=\text{post}{\rm{ \mbox{-} }}\text{exercise}-\text{pre}{\rm{ \mbox{-} }}\text{exercise}$ ); ( A 2 = post - exercise - post - CTL ) $({A}_{2}=\text{post}{\rm{ \mbox{-} }}\text{exercise}-\text{post}{\rm{ \mbox{-} }}\text{CTL})$ ; A 3 = ( post - exercise - pre - exercise ) - ( post - CTL - pre - CTL ) ] ${A}_{3}=(\text{post}{\rm{ \mbox{-} }}\text{exercise}-\text{pre}{\rm{ \mbox{-} }}\text{exercise})-(\text{post}{\rm{ \mbox{-} }}\text{CTL}-\text{pre}{\rm{ \mbox{-} }}\text{CTL})]$ in chronic stroke (i.e., ≥6 months poststroke). The proportion of PEH responders determined using different cut-off values for PEH was also compared (4 mmHg vs. minimal detectable difference).

METHODS

Seven participants (age: 56 ± 12 years; time post-stroke: 91 ± 55 months) performed two bouts of MCT and a CTL. The MCT involved 10 exercises with 3 sets of 15-repetition maximum, with each set interspersed with 45 s of walking. The systolic (SBP) and diastolic (DBP) blood pressures were assessed 10-min before and every 10-min along 40-min after CTL and MCT.

RESULTS

The two-way random intraclass correlation coefficient for single measurements (ICC_2,1 ) ranges for SBP were: A₁ : 0.580-0.829, A₂ : 0.937-0.994, A₃ : 0.278-0.774; for DBP: A₁ : 0.497-0.916, A₂ : 0.133-0.969, A₃ : 0.175-0.930. The proportion of PEH responders detected using 4 mmHg or the minimal detectable difference as cut-off values was not different in 97% of analyses (p > 0.05), and higher when using 4 mmHg in 3% of analyses (p = 0.031). The standard error of measurement was ≥4 mmHg in 47% of analyses for SBP, and 40% for DBP.

CONCLUSIONS

The most reliable approach for determining PEH in chronic stroke was to subtract the postexercise from the post-CTL values. The proportion of PEH responders was not affected by the cut-off values applied.

Comparing Post-Exercise Hypotension after Different Sprint Interval Training Protocols in a Matched Sample of Younger and Older Adults

This study assessed the post-exercise hypotension (PEH) effect in a sample of matched young and older adults after different sprint interval training (SIT) protocols. From forty-three participants enrolled in this study, twelve younger (24 ± 3 years) and 12 older (50 ± 7 years) participants, matched for the body mass index, systolic blood pressure, and VO₂max-percentiles, were selected. The participants completed two SIT protocols consisting of 4 × 30 s exercise bouts interspersed by either one (SIT1) or three minutes (SIT3) of active rest. The peripheral systolic (pSBP) and diastolic (pDBP) blood pressure, central systolic (cSBP) and diastolic (cDBP) blood pressure, pulse wave velocity (PWV), and heart rate (HR) were obtained before and at different measurement time points (t5, t15, t30, t45) after the exercise. No significant time × group interactions were detected in pSBP (p = 0.242, η² = 0.060), pDBP (p = 0.379, η² = 0.046), cSBP (p = 0.091, η² = 0.861), cDBP (p = 0.625, η² = 0.033), PWV (p = 0.133, η² = 0.076), and HR (p = 0.190, η² = 0.123) after SIT1. For SIT3 no significant time × group interactions could be detected for pSBP (p = 0.773, η² = 0.020), pDBP (p = 0.972, η² = 0.006), cSBP (p = 0.239, η² = 0.060), cDBP (p = 0.535, η² = 0.036), PWV (p = 0.402, η² = 0.044), and HR (p = 0.933, η² = 0.009). Matched samples of young and older adults reveal similar PEH effects after HIIT. Accordingly, age does not seem to affect PEH after SIT. These results show that rest interval length and age modulate the PEH effect after SIT.

Blood Pressure and Heart Rate Variability Responses to High-Intensity Interval Training in Untrained Postmenopausal Women

Purpose: The aim of this study was to analyze the blood pressure (BP) and heart rate variability (HRV) responses in untrained postmenopausal women submitted to acute single sessions of high-intensity interval training (HIT). Method: Sixteen postmenopausal women (59.9 ± 5.6 years, 26.7 ± 3.0 kg/m²) participated in a random order of two acute sessions in a balanced crossover format: control without exercise in sitting position or HIT session. BP and heart rate (HR) were recorded before and during 60 min following the sessions. Results: Diastolic (DBP), mean BP (MBP), and double product (DPO) showed interaction (p < .01). DBP, MBP, and DPO increased (p < .01) after HIT but not after the control session. The area under the curve (AUC) of DBP (p = .02) and DPO (p < .01) were different between conditions. Time and frequency indices of HRV presented interaction (p < .05) which impaired these indices post-HIT, but not post-control. The AUC of time and frequency HRV indices were different between conditions. Conclusions: A single session of HIT may increase BP and cardiac stress and cause perturbation of the autonomic function in untrained postmenopausal women.

Effects of exercise modalities on decreased blood pressure in patients with hypertension

This study aimed to evaluate the acute effects of aerobic and resistance exercises on blood pressure and endothelial blood markers. We also correlated post-exercise blood pressure response with baseline cardiovascular parameters in middle-aged patients with hypertension. This cross-sectional study randomized 54 volunteers into the aerobic exercise group (AG, n = 27; 45.6 ± 7.7 years) or dynamic resistance exercise group (RG, n = 27; 45.8 ± 8.4 years). Blood marker evaluation, cardiopulmonary exercise tests, resting blood pressure monitoring, ambulatory blood pressure monitoring (ABPM), flow-mediated dilatation monitoring, and body composition evaluation were carried out. Exercise sessions were performed to evaluate post-exercise hypotension (PEH) and endothelial marker responses, in addition to post-exercise ABPM (ABPMex). This study is an arm of the study which was approved by the local ethics committee (No. 69373217.3.0000.5347) in accordance with the Helsinki Declaration and was registered at ClinicalTrials.gov (NCT03282942). The AG performed walking/running at 60% of the reserve heart rate, while the RG performed 10 exercises with two sets of 15–20 repetitions. The mean 24 h ABPM and ABPMex values showed no significant statistical differences. Systolic and diastolic blood pressure hypotension after aerobic and dynamic resistance were −10.59 ± 5.24/−6.15 ± 6.41 mmHg and −5.56 ± 7.61/−6.20 ± 8.25 mmHg, respectively. For an up-to-7 h assessment of resting pressure, there was a positive effect in the aerobic group. The concentrations of nitrites/nitrates (NOx) and endothelin-1 (ET-1) did not change during hypotension. Moreover, PEH and ABPMex were significantly correlated with baseline health variables. Thus, when middle-aged patients with hypertension perform aerobic or resistance exercise, the NOx/ET-1 pathway does not provide the best explanation for PEH. Finally, we found associations between baseline cardiovascular variables and endothelial vasoconstrictors with PEH.

A Single Dosage of l-Arginine Oral Supplementation Induced Post-Aerobic Exercise Hypotension in Hypertensive Patients

Lowering of peripheral vascular resistance is one of the primary processes involved in blood pressure decrease. Nitric oxide plays a significant role in this process and the availability of l-arginine is a crucial element in nitric oxide biosynthesis. Oral l-arginine supplementation may therefore be a potentiating element in post-exercise hypotension, mediated by its vasodilator action. Thus, the purpose of this study was to investigate if a single dose of l-arginine oral supplementation might impact the post-aerobic exercise blood pressure responses in treated hypertensive individuals. A double-blind, randomized, placebo-controlled crossover trial was conducted. The sample included male (4) and female (6) subjects [62 ± 10 years]. The participants were randomized to ingest one sachet containing 8 grams of l-arginine or placebo (corn starch) dissolved in water (100 ml). The substances were self-administered 120 min before the experimental or control session. The exercise was conducted on a treadmill and consisted of: a 5 min warm-up (50-65% HRreserve); 40 min of running/walking at 60-70% HRreserve; and a 5 min progressive cooldown. After the exercise sessions, blood pressure was measured every 10 min for 60 min. The l-arginine supplementation arm led to significant post-exercise systolic hypotension (mean post-exercise) in relation to rest period (117 ± 12 vs 125 ± 15 mmHg - p = 0.004 [l-arginine] and 121 ± 11 vs 125 ± 15 - p = 0.341 [placebo]). In addition, a systolic net effect of -6.9 ± 3.6 mmHg [p = 0.046] was identified for the mean post-exercise values. Therefore, this study showed that a single dosage of l-arginine oral supplementation induced post-aerobic exercise hypotension in hypertensive patients.

Acute Aerobic Exercise Induces Short-Term Reductions in Ambulatory Blood Pressure in Patients With Hypertension: A Systematic Review and Meta-Analysis

[Figure: see text].

Postexercise hypotension due to resistance exercise is not mediated by autonomic control: A systematic review and meta-analysis

Changes in autonomic control have been suggested to mediate postexercise hypotension (PEH). We investigated through meta-analysis the after-effects of acute resistance exercise (RE) on blood pressure (BP) and autonomic activity in individuals with normal and elevated BP. Electronic databases were searched for trials including: adults; exclusive RE interventions; and BP and autonomic outcomes measured pre- and postintervention for at least 30 min. Analyses incorporated random-effects assumptions. Thirty trials yielded 62 interventions (N = 480). Subjects were young (33.6 ± 15.6 yr), with systolic BP (SBP)/diastolic BP (DBP) of 124.2 ± 8.9/71.5 ± 6.6 mm Hg. Overall, RE moderately reduced SBP (normal BP: ~1 to 4 mm Hg, p < 0.01; elevated BP: ~1 to 12 mm Hg, p < 0.01) and DBP (normal BP: ~1 to 4 mm Hg, p < 0.03; elevated BP: ~0.5 to 7 mm Hg, p < 0.01), which was in general parallel to sympathetic increase (normal BP: g = 0.49 to 0.51, p < 0.01; elevated BP: g = 0.41 to 0.63, p < 0.01) and parasympathetic decrease (normal BP: g = -0.52 to -0.53, p < 0.01; elevated BP: g = -0.46 to -0.71, p < 0.01). The meta-regression showed inverse associations between the effect sizes of BP vs. sympathetic (SBP: slope - 0.19 to -3.45, p < 0.01; DBP: slope - 0.30 to -1.60, p < 0.01), and direct associations vs. parasympathetic outcomes (SBP: slope 0.17 to 2.59, p < 0.01; DBP: slope 0.21 to 1.38, p < 0.01). In conclusion, changes in BP were concomitant to sympathetic increase and parasympathetic decrease, which questions the role of autonomic fluctuations as potential mechanisms of PEH after RE.

Effects of Isometric Biceps Exercise on Blood Pressure in Adults with Hypertension

We investigated the acute effects of isometric biceps exercise on resting and ambulatory blood pressure in hypertensive adults. A total of 12 medicated hypertensive adults (aged 47±7 years; body mass index 27.2±2.7 kg/m²; resting blood pressure 123±12/74±6 mmHg) performed an isometric biceps exercise session (bilateral biceps exercise; 4×1 min at 30% of 1-RM, 2 min recovery) and a control session (without exercise) in a randomized order separated by a 7 to 10-day period. Resting blood pressure, heart rate, and heart rate variability indexes (SDNN, RMSSD, LF, HF, and LF/HF) were measured pre- and up to 30 min post-sessions. Next, ambulatory blood pressure was monitored during 22-hour post-sessions (awake and asleep periods). No significant changes were observed for resting blood pressure, heart rate, or heart rate variability indexes up to 30 min post-sessions (p>0.05). Furthermore, no significant differences were observed in average ambulatory blood pressure values in 22-hour (126±11/71±6 mmHg vs. 126±15/71±9 mmHg), awake (127±10/74±6 mmHg vs. 130±14/75±10 mmHg), and asleep (123±15/68±6 mmHg vs. 120±17/66±9 mmHg) periods between the control and isometric sessions, respectively (p>0.05). In conclusion, an isometric biceps exercise session does not elicit an acute antihypertensive effect in adults with hypertension, which suggests that its prescription to improve the acute BP control is limited.

Hemodynamic and creatine kinase changes after a 12-week equipment-based Pilates training program in hypertensive women

Exercise therapy is a conservative strategy to manage hypertension. The aim of this study was to investigate the effects of a 12-week equipment-based Pilates training program on the hemodynamics of medication-controlled hypertensive women. Forty-five women were classified into two groups: medication-controlled hypertensive (n = 30) or control (n = 15). To be eligible for the hypertensive group, participants had to have a clinical diagnosis of hypertension, be taking medication to control their blood pressure and not to have done any exercise activity in the previous three months. In the control group, the participants needed to have normal blood pressure levels and not to have done any exercise activity in the previous three months. All women participated in a 12-week equipment-based Pilates training program (2 × 60min sessions per week). Systolic and diastolic blood pressure (SBP, DBP), heart rate (HR) and creatine kinase levels (CK) were assessed before and after the program. SBP, DBP and heart rate were also assessed before and after each session. There was no statistically significant difference after Pilates training for systolic (normotensive MD 4.1, 95%CI -9.2 to 17.5, hypertensive MD 3.8, 95%CI -5.3 to 13.1) and diastolic (normotensive MD 5.8, 95%CI -2.0 to 13.7, hypertensive MD 4.0, 95%CI -4.3 to 12.4) blood pressure. Heart rate was reduced after Pilates training in both normotensive (MD 4.5, 95%CI 1.1 to 7.8) and medication-controlled hypertensive (MD 7.9, 95%CI 4.4 to 11.4) women. Creatine kinase activity was reduced after Pilates training in medication-controlled hypertensive women (p = 0.019). Blood pressure was not altered, but heart rate and creatinine kinase activity were reduced following 12 weeks of Equipment-based Pilates training.

Ground golf-induced changes in the blood pressure of healthy elderly people

Background

Ground golf is a popular sport among the elderly in Japan. Several types of exercise can reduce the body's mean arterial pressure (MAP), but little is known about how ground golf affects the MAP. We investigated the effects of ground golf on the MAP and the oxygen uptake (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$\end{document}V˙O2) in a healthy elderly population.

Participants and methods

Thirteen elderly Japanese people (3 males and 10 females, mean age of 66 years) participated. All participants played 8 holes of ground golf 6 times, as game (G)1 to G6. The MAP, heart rate (HR), and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$\end{document}V˙O2 were measured at rest and every 5 min during each game.

Results

A linear trend analysis revealed that participants’ MAP values progressively decreased as each game proceeded with marginal differences (p = 0.054). There were no significant differences in HR between at rest and any of the games. The \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$\end{document}V˙O2 during the games (except for G6) were significantly higher than that at-rest (p < 0.05). The resting MAP values were negatively associated with the ground golf-induced changes in MAP (r = 0.786, p = 0.001). The participants with greater changes in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$\end{document}V˙O2 during the games showed significantly greater reductions in MAP (r = 0.276, p = 0.043).

Conclusions

Playing ground golf reduced the participants’ MAP and increased their \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$\end{document}V˙O2. Participants with higher resting MAP experienced greater reductions in MAP by playing ground golf, which suggests that ground golf can be a useful recreational sport for the elderly.

Acute blood pressure responses after different isometric handgrip protocols in hypertensive patients

OBJECTIVE

The present study analyzed blood pressure responses after a single session of isometric handgrip exercise performed with different volumes and intensities by patients with hypertension.

METHODS

This randomized crossover trial submitted 12 hypertensive patients (58±5 years old) to four isometric handgrip exercise sessions in a random order: 4 x 2 min at 30% of the maximal voluntary contraction (S30%); 4 x 2 min at 50% of the maximal voluntary contraction (S50%2min); 4 x 3 min at 30% of the maximal voluntary contraction (S30%3min); and a control session. The systolic and diastolic blood pressure, heart rate, and rate-pressure product were measured pre- and post-exercise (30th min).

RESULTS

No significant changes were observed in cardiovascular variables after any session (p>0.05 for all comparisons). Similarly, individual analyses revealed heterogeneity in the responses, including increases in blood pressure observed in some sessions. Patients with reduced blood pressure after an isometric handgrip exercise session exhibited a higher body mass index, diastolic blood pressure and heart rate (p<0.05). They also tended to be younger (p=0.07).

CONCLUSION

Isometric handgrip exercise performed with different intensities and volumes did not reduce the blood pressure of hypertensive patients.

The influence of physical training status on postexercise hypotension in patients with hypertension: a cross-sectional study

BACKGROUND

To date, few studies have analyzed postexercise hypotension (PEH) in hypertensive patients with different levels of physical fitness.

AIM

Therefore, this study aimed to compare PEH in trained and sedentary hypertensive individuals.

METHODS

Fifty-one well-controlled hypertensive patients of both sexes were assigned to a trained group [60.4±9.4 years; resting blood pressure (BP)=126.3±5.4/75.0±6.3 mmHg; VO2peak=27.3±4.6 ml kg/min] and 58 sedentary hypertensive patients of both sexes were assigned to a sedentary group (63.1±8.9 years; resting BP=134.1±4.2/82.9±5.8 mmHg; VO2peak=20.6±5.5 ml/kg/min). In a cross-sectional design, the individuals were randomized to perform an aerobic exercise session (treadmill; 40 min; 55% VO2peak) and a control session on two different days in the morning. After each session, participants wore an ambulatory BP device for 12 h.

RESULTS

Although no significant differences were identified in BP after the control session, after the experimental session, the trained participants presented lower values than the sedentary participants for systolic (124.1±6.3 vs. 133.4±5.2 mmHg, P<0.01) and diastolic BP (73.1±4.4 vs. 85.5±6.4 mmHg, P<0.01) over the course of 12 h monitoring. For the trained participants, significant correlations were also identified (P<0.05) between the VO2peak and systolic (R=-0.68) and diastolic BP (R=-0.61) 12 h monitoring.

CONCLUSION

In conclusion, the training level of hypertensive patients influences PEH.

Acute effects of cycling exercise on post-exercise blood pressure in individuals with down syndrome

Purpose. Studies have shown that even a single session of physical exercise lowers blood pressure after its completion. This phenomenon is called post-exercise hypotension (PEH) and has been considered as a non-pharmacological treatment to control blood pressure. However, there are no studies regarding the occurrence of PEH after acute exercise in individuals with Down syndrome (DS). This study aimed to analyse the occurrence of PEH in these subjects and the possible role of exercise intensity. Methods. Ten individuals with DS, of both genders, participated in the study (age, 29 ± 7 years; body mass, 60.7 ± 9 kg; height, 1.48 ± 0.11 m; BMI, 27.6 ± 2.4 kg/m2). The volunteers randomly underwent 2 sessions of exercise on a stationary bike for 20 minutes and 1 control session. Heart rate, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured after 15 minutes of resting, in the 20

Whole Red Grape Juice Reduces Blood Pressure at Rest and Increases Post-exercise Hypotension

OBJECTIVE

The objective of this study was to evaluate the effect of whole red grape juice (juice) on blood pressure (BP) at rest and on the magnitude of post-exercise hypotension (PEH).

METHODS

This double-blind, randomized controlled study was performed with 26 individuals with hypertension (40 to 59 years old) who were divided into experimental (n = 14) and control (n = 12) groups. Subsequently, the experimental group was subdivided according to the initial BP values. The subjects performed 2 sessions of aerobic exercise on a treadmill (60 minutes, 60%-85% maximum heart rate), separated by a 28-day period of supplementation with a daily dose of juice (150 ml for men and 100 ml for women) or a control drink. BP was measured before, during, and immediately after each exercise session as well as every 10 minutes during the 60-minute post-exercise recovery period.

RESULTS

The BP at rest did not change in the experimental group, but when this group was subdivided by initial BP, the subjects with controlled initial BP (EGCP) achieved a significant reduction (133.3 ± 5.6 to 114.6 ± 12.2 mmHg, p = 0.02); in contrast, the experimental group with borderline hypertensive BP values (EGBP) did not. Intervention with juice did not modify PEH in the experimental group, but when this group was divided as a function of the initial BP, PEH was potentiated at some times in EGCP.

CONCLUSIONS

We conclude that juice promotes a reduction in BP at rest and is also capable of improving PEH in individuals with hypertension, but these effects are dependent on the initial BP values.

Arginine and aerobic training prevent endothelial and metabolic alterations in rats at high risk for the development of the metabolic syndrome

Endothelial function is a key mechanism in the development of CVD. Arginine and exercise are important non-pharmacological strategies for mitigating the impact of metabolic changes in the metabolic syndrome, but the effect of their combined administration is unknown. Thus, the aim of this study was to investigate the isolated and combined effects of aerobic training and arginine supplementation on metabolic variables and vascular reactivity in rats at high risk for developing the metabolic syndrome. Wistar rats were divided into two groups: control and fructose (F – water with 10 % fructose). After 2 weeks, the F group was divided into four groups: F, fructose+arginine (FA, 880 mg/kg per d of l-arginine), fructose+training (FT) and fructose+arginine+training (FTA); treatments lasted for 8 weeks, and no difference was observed in body mass gain. Arginine did not improve the body protein content, and both the FA and FT groups show a reversal of the increase in adipose tissue. Insulin increase was prevented by training and arginine, without additive effect, and the increase in serum TAG was prevented only by training. The F group showed impaired endothelium-dependent vasodilation and hyperreactivity to phenylephrine, but arginine and training were capable of preventing these effects, even separately. Higher nitric oxide level was observed in the FA and FT groups, and no potentiating effect was detected. Thus, only training was able to prevent the increase in TAG and improve the protein mass, and training and arginine exert similar effects on fat content, insulin and endothelial function, but these effects are not additive.

IMPACTO DO EXERCÍCIO CONTÍNUO E INTERVALADO NA RESPOSTA AUTONÔMICA E PRESSÓRICA EM 24 HORAS

RESUMO Introdução: Exercícios físicos aeróbicos contínuos são os mais relacionados com a hipotensão pós-exercício. No entanto, são escassas as informações sobre o impacto do exercício intervalado sobre a resposta pressórica de 24 horas. Objetivo: Comparar as respostas pressóricas subagudas e agudas em uma sessão de exercício aeróbico contínuo e intervalado e identificar possíveis modulações em indicadores de atividade autonômica em adultos normotensos. Métodos: Submeteram-se 25 adultos normotensos saudáveis a três sessões experimentais: controle (30 minutos em repouso), exercício contínuo (30 min. - 60%-70% da FCres) e exercício intervalado (6 sessões de 5 minutos com intervalos de 2 min. - 60-70% da FCres) e seus parâmetros cardiovasculares foram monitorados por 24 horas após as sessões. Para comparação dos dados, foi utilizada a ANOVA para medidas repetidas, seguida de suas hipóteses. Resultados: No acompanhamento subagudo foi identificada redução significativa (P < 0,05) da pressão arterial sistólica somente após a sessão de exercício contínuo em comparação com a sessão de repouso (115 ± 2 mmHg vs. 112 ± 2 mmHg) e à sessão controle (119 ± 2 mmHg vs. 112 ± 2 mmHg). Não se identificou redução da pressão arterial ambulatorial em nenhuma das sessões experimentais. Os indicadores autonômicos parassimpáticos (RMSSD e pNN50) permaneceram reduzidos após 30 minutos em ambas as sessões de exercício. Conclusão: Uma única sessão de exercício aeróbico contínuo causa redução subaguda da pressão arterial em adultos normotensos. A sessão única de exercício aeróbico contínuo e intervalado não promove redução da pressão arterial ambulatorial na média nos períodos intermediários de sono e vigília.

The blood pressure-lowering effect of a single bout of resistance exercise: A systematic review and meta-analysis of randomised controlled trials

BACKGROUND

Current exercise guidelines recommend aerobic types of exercises on most days of the week, supplemented with dynamic resistance exercise twice weekly. Whereas the blood pressure (BP)-lowering effects of a single session of aerobic exercise have been well studied, less is known about the hypotensive effect of a single bout of resistance exercise.

OBJECTIVES

To evaluate the transient effect of resistance exercise on BP by means of meta-analytic techniques.

METHODS

A systematic electronic search in Medline, Scientific Electronic Library Online (SciELO), Latin American and Caribbean Health Sciences Literature (LILACS), Elton B Stephens Company (EBSCO), EMBASE and SPORTDiscus was completed in March 2015 identifying randomised controlled trials investigating the effect of a single bout of resistance exercise on resting or ambulatory BP in healthy adults. A subsequent meta-analysis was performed.

RESULTS

The meta-analysis involved 30 studies, 81 interventions and 646 participants (normotensive (n = 505) or hypertensive (n = 141)). A single bout of resistance exercise elicited small-to-moderate reductions in office systolic BP at 60 minutes postexercise [-3.3 (-4.0 to -2.6)/-2.7 (-3.2 to -2.1) mmHg (CI 95%)], 90 minutes postexercise [-5.3 (-8.5 to -2.1)/-4.7 (-6.9 to -2.4) mmHg (CI 95%)] and in 24-hour ambulatory BP [-1.7 (-2.8 to -0.67)/-1.2 (-2.4 to -0.022) mmHg (CI 95%)] compared to a control session. The reduction in office BP was more pronounced in hypertensive compared to normotensive individuals (p < 0.01), when using larger muscle groups (p < 0.05) and when participants were recovering in the supine position (p < 0.01).

CONCLUSION

A single bout of resistance exercise can have a BP-lowering effect that last for up to 24 hours. Supine recovery and the use of larger muscle groups resulted in greater BP reductions after resistance exercise.

Differential Post-Exercise Blood Pressure Responses between Blacks and Caucasians

Post-exercise hypotension (PEH) is widely observed in Caucasians (CA) and is associated with histamine receptors 1- and 2- (H1R and H2R) mediated post-exercise vasodilation. However, it appears that blacks (BL) may not exhibit PEH following aerobic exercise. Hence, this study sought to determine the extent to which BL develop PEH, and the contribution of histamine receptors to PEH (or lack thereof) in this population. Forty-nine (22 BL, 27 CA) young and healthy subjects completed the study. Subjects were randomly assigned to take either a combined H1R and H2R antagonist (fexofenadine and ranitidine) or a control placebo. Supine blood pressure (BP), cardiac output and peripheral vascular resistance measurements were obtained at baseline, as well as at 30 min, 60 min and 90 min after 45 min of treadmill exercise at 70% heart rate reserve. Exercise increased diastolic BP in young BL but not in CA. Post-exercise diastolic BP was also elevated in BL after exercise with histamine receptor blockade. Moreover, H1R and H2R blockade elicited differential responses in stroke volume between BL and CA at rest, and the difference remained following exercise. Our findings show differential BP responses following exercise in BL and CA, and a potential role of histamine receptors in mediating basal and post-exercise stroke volume in BL. The heightened BP and vascular responses to exercise stimulus is consistent with the greater CVD risk in BL.

The acute effect of maximal exercise on central and peripheral arterial stiffness indices and hemodynamics in children and adults

This study compared the effects of a bout of maximal running exercise on arterial stiffness in children and adults. Right carotid blood pressure and artery stiffness indices measured by pulse wave velocity (PWV), compliance and distensibility coefficients, stiffness index α and β (echo-tracking), contralateral carotid blood pressure, and upper and lower limb and central/aortic PWV (applanation tonometry) were taken at rest and 10 min after a bout of maximal treadmill running in 34 children (7.38 ± 0.38 years) and 45 young adults (25.22 ± 0.91 years) having similar aerobic potential. Two-by-two repeated measures analysis of variance and analysis of covariance were used to detect differences with exercise between groups. Carotid pulse pressure (PP; η(2) = 0.394) increased more in adults after exercise (p < 0.05). Compliance (η(2) = 0.385) decreased in particular in adults and in those with high changes in distending pressure, similarly to stiffness index α and β. Carotid PWV increased more in adults and was related to local changes in PP but not mean arterial pressure (MAP). Stiffness in the lower limbs decreased (η(2) = 0.115) but apparently only in those with small MAP changes (η(2) = 0.111). No significant exercise or group interaction effects were found when variables were adjusted to height. An acute bout of maximal exercise can alter arterial stiffness and hemodynamics in the carotid artery and within the active muscle beds. Arterial stiffness and hemodynamic response to metabolic demands during exercise in children simply reflect their smaller body size and may not indicate a particular physiological difference compared with adults.

An effective strategy to reduce blood pressure after forest walking in middle-aged and aged people

[Purpose] Forest walking may be effective for human health, but little information is available about effects of energy expenditure on blood pressure responses after forest walking. The aim of this study was to investigate the relationship between the activity energy expenditure and changes in blood pressure in individuals after forest walking. [Subjects] The subjects were 54 middle-aged and elderly people. [Methods] All subjects walked in the forest for approximately 90 min. Blood pressure, salivary amylase, and the Profile of Mood States were evaluated before and after forest walking, and activity energy expenditure was monitored throughout forest walking. Subjects were divided into two groups according to mean arterial pressure changes: a responder group (>5% decreases) and a nonresponder group (<5%). [Results] Forest walking significantly reduced the mean arterial pressure and improved the Profile of Mood States in both groups. Activity energy expenditure was related to changes in mean arterial pressure in the responder group, while this relation was not observed in the nonresponder group. Differential activity energy expenditure did not strongly affect improvement of the Profile of Mood States. [Conclusion] Greater walking-related greater activity energy expenditure might be required to accentuate physiological beneficial effects on in middle-aged and aged people. Furthermore, the forest environment per se can attenuate psychological stress.

The training and detraining effect of high-intensity interval training on post-exercise hypotension in young overweight/obese women

PURPOSE

Studies evaluating the response in blood pressure (BP) following high-intensity interval training (HIIT) are scant even though there has been extensive work done on the BP response following acute and chronic low- to moderate-intensity aerobic and resistance exercise in both hypertensive and normotensive individuals. The present study sought to investigate the training and detraining effects of short-term HIIT on the post-exercise hypotension (PEH) response in overweight/obese young women.

METHOD

Twenty young untrained women volunteered for the study. Participants performed six HIIT sessions on a treadmill within 2 weeks (week 1: 10 × 1 min and week 2: 15 × 1 min intervals at 90-95% HRmax, separated by 1 min active recovery at 70% HRmax each session) and detrained for 2 weeks. Post-exercise BP was measured for 1 h following the first and last HIIT sessions.

RESULTS

Participants were normotensive (SBP: 119.2 ± 5.60 mmHg; DBP: 78.8 ± 4.12 mmHg) and had a BMI greater than 25 kg m(-2). The magnitude of the systolic hypotensive response was slightly greater after the six sessions HIIT compared to pre-training (5.04 and 4.28 mmHg, respectively), and both would be considered clinically significant (>3 mmHg decrease). After 2 weeks, detraining the PEH response was not clinically significant (1.08 mmHg decrease). The magnitude of the DBP response was only clinically significant following post- and detraining (4.26 and 3.87 mmHg, respectively).

CONCLUSION

The findings suggest that six HIIT sessions is sufficient to affect clinically significant PEH responses in young, overweight/obese women; however, the training effects are lost within 2 weeks of detraining.

Recovery from exercise: vulnerable state, window of opportunity, or crystal ball?

Why should we study the recovery from exercise as a discrete phenomenon from exercise itself? We identify three distinct (but not mutually exclusive) rationales that drive the need to investigate the physiology of recovery from exercise. (1) Some individuals are at a heightened risk of clinical outcomes in the immediate post-exercise period; thus the potential negative outcomes of this “vulnerable state” must be weighed against the numerous benefits of exercise training, and may be mitigated to reduce risk. (2) Many of the signaling mechanisms responsible for the beneficial effects of exercise training remain amplified during the exercise recovery period, and may present a “window of opportunity” that can be exploited by interventions to enhance the beneficial adaptations to exercise training, especially in clinical populations. (3) On an individual level, exercise recovery responses may provide investigators with a “crystal ball” ability to predict future clinical outcomes even in apparently healthy individuals. In short, the physiology of recovery is a multi-faceted and complex process, likely involving systems and pathways that are distinct from the physiology of exercise itself. For these reasons, it merits ongoing study.

Effects of active recovery on autonomic and haemodynamic responses after aerobic exercise

The aim of this study was to examine the effect of active recovery on autonomic and haemodynamic responses after exercise in healthy adults. Nineteen healthy young male individuals underwent two experimental sessions: exercise with active recovery (AR) and exercise with passive recovery (PR). The exercise sessions comprised three phases: warm-up (5 min), exercise phase (cycle ergometer, 30 min, intensity between 60 and 70% of the heart rate reserve) and recovery (5 min). In the AR, the subjects remained cycling in the recovery phase at intensity between 30% and 35% of heart rate reserve, while in the PR, the subjects stopped the exercise after finishing the exercise phase. Blood pressure and heart rate were measured before and over the 30 min after the interventions. There were no differences for systolic and diastolic blood pressures, heart rate and rate pressure product between active and passive recovery sessions. Also, all heart rate variability parameters changed similarly after exercise with passive or active recovery sessions. In summary, exercise with active recovery does not affect the autonomic and haemodynamic responses after moderate-intensity aerobic exercise in healthy young male individuals.

Influence of population and exercise protocol characteristics on hemodynamic determinants of post-aerobic exercise hypotension

Due to differences in study populations and protocols, the hemodynamic determinants of post-aerobic exercise hypotension (PAEH) are controversial. This review analyzed the factors that might influence PAEH hemodynamic determinants, through a search on PubMed using the following key words: “postexercise” or “post-exercise” combined with “hypotension”, “blood pressure”, “cardiac output”, and “peripheral vascular resistance”, and “aerobic exercise” combined only with “blood pressure”. Forty-seven studies were selected, and the following characteristics were analyzed: age, gender, training status, body mass index status, blood pressure status, exercise intensity, duration and mode (continuous or interval), time of day, and recovery position. Data analysis showed that 1) most postexercise hypotension cases are due to a reduction in systemic vascular resistance; 2) age, body mass index, and blood pressure status influence postexercise hemodynamics, favoring cardiac output decrease in elderly, overweight, and hypertensive subjects; 3) gender and training status do not have an isolated influence; 4) exercise duration, intensity, and mode also do not affect postexercise hemodynamics; 5) time of day might have an influence, but more data are needed; and 6) recovery in the supine position facilitates systemic vascular resistance decrease. In conclusion, many factors may influence postexercise hypotension hemodynamics, and future studies should directly address these specific influences because different combinations may explain the observed variability in postexercise hemodynamic studies.

Post-exercise hypotension of normotensive young men through track running sessions

INTRODUCTION: After a single session of physical exercise the blood pressure is reduced (post-exercise hypotension, PHE) and it has been considered as a non-pharmacological mechanism to control the blood pressure. When the exercise is performed since youth it can prevent or avoid hypertension. However, it is important to consider studies with clear practical applications to optimize its reproducibility on a daily basis. OBJECTIVE: Analyze the PEH of normotensive and physically active young men after two track running sessions (maximum and submaximal). METHODS: Participated in this study 62 physically active young men (23.3 ± 4.2 years old; 75.5 ± 9.8 kg; 177.7 ± 5.5 cm; 12.0 ± 4.6% body fatF; 52.4 ± 4.0 mL.kg-1.min-1oxygen uptake), which performed a maximum laboratory exercise test for determination of maximal oxygen uptake (VO2max - aerobic power) and subsequently three randomly running sessions (maximum - T1600; submaximal - T20; control - CON), with 48h interval between themselves. Blood pressure (BP) was measured each 15min during a 60 min period after sessions. RESULTS: Both the maximum and the submaximal exercise lead to PEH. The post-exercise values of systolic blood pressure and diastolic blood pressure differed from resting value in session T20 (p<0.05). The same pattern occurred after T1600 (p<0.05), evidenced from 30th minute post-exercise. The CON did not result in PEH. The magnitude of decay for the mean BP at the 45th after maximum exercise was higher than the other sessions (p<0.05). CONCLUSION: We concluded that both maximum and submaximal exercises, performed on a track running condition, caused PEH in young normotensive and physically active men.

Effects of Organized Physical Activity on Selected Health Indices among Women Older than 55 Years

The main aim of this study was to determine health benefits among women older than 55 years who participated in organized, group-based physical activity (OPA). Thirty-five women aged 65.0 ± 7.3 years volunteered for this study. The classical and nonclassical cardiovascular (CVD) risk factors were measured before and after a 2-week OPA camp in a remote location and 3 months of OPA. Self-guided physical activity was analyzed 18 months after OPA. Two-week effects included significant decreases in body mass index, waist and hip circumferences, resting systolic and diastolic blood pressure (BP) and resting heart rate, improved exercise capacity (EC), improved low-density lipoprotein and high-density lipoprotein (HDL-C), cholesterol, and other atherogenic lipid indices (ALI), and a reduction in 10-year estimated risk of death from CVD. Three-month effects included a further decrease in systolic BP, improvements in EC and HDL-C, and maintenance of lower levels of ALI, as well as lower CVD risk. The implementation of the OPA programme had a positive impact on somatic features, exercise capacity, biochemical indices, and risk for death from CVD. The presented programme can be regarded as an effective element of primary prevention of cardiovascular diseases among women older than 55 years.

Blood pressure changes following aerobic exercise in Caucasian and Chinese descendants

Acute aerobic exercise produces post-exercise hypotension (PEH). Chinese populations have lower prevalence of cardiovascular disease compared to Caucasians. PEH may be associated cardiovascular disease through its influence on hypertension. The purpose of this study was to compare PEH between Caucasian and Chinese subjects following acute aerobic exercise. 62 (30 Caucasian and 32 Chinese, 50% male) subjects underwent measurement of peripheral and central hemodynamics as well as arterial and cardiac evaluations, 30 min and 60 min after 45 min of treadmill exercise. Caucasians exhibited significantly higher baseline BP than the Chinese. While the reduction in brachial artery systolic BP was greater in Caucasian than in the Chinese, there was no difference in changes in carotid systolic BP between the groups. The increase in cardiac output and heart rate was greater in the Chinese than Caucasians, but total peripheral resistance and leg pulse wave velocity decreased by a similar magnitude in the Chinese and Caucasian subjects. We conclude that acute aerobic exercise produces a greater magnitude of PEH in peripheral systolic BP in Caucasian compared to Chinese subjects. The different magnitude in PEH was caused by the greater increase in cardiac output mediated by heart rate, with no change in stroke volume. It is possible that initial BP differences between races influenced the findings.

Acute effects of continuous and interval low-intensity exercise on arterial stiffness in healthy young men

PURPOSE

To examine and compare systemic arterial stiffness responses in humans to acute continuous and interval low-intensity exercise.

METHODS

Fifteen healthy young men (21.2 ± 0.4 years) underwent non-exercise control (CON), continuous exercise (CE), and interval exercise trial (IE) in a randomized balanced self-control crossover design. Systemic arterial stiffness (Cardio-ankle vascular index, CAVI) was measured at baseline (BL), immediately after (0 min) and 40 min after exercise in CE and IE trials, and at corresponding time points in CON trial. Subjects cycled continuously for 30 min at 35 % heart rate reserve after BL measurement in CE trial, whereas in IE trial, subjects cycled two bouts of 15-min separated by a 20-min rest at the same intensity.

RESULTS

There were no significant CAVI changes with time in CON trial (6.7 ± 0.1, 6.7 ± 0.1, 6.6 ± 0.1 at BL, 0 and 40 min, respectively). In CE trial, CAVI decreased immediately after exercise (0 min) and returned to baseline after 40 min of recovery (6.5 ± 0.1, 5.5 ± 0.2, 6.4 ± 0.1 at BL, 0 and 40 min, respectively). IE elicited similar CAVI reduction from 6.7 ± 0.1 at baseline to 5.6 ± 0.2 at 0 min: however, CAVI at 40 min remained significantly low compared to that of CON trial at corresponding time point (6.0 ± 0.1 vs. 6.6 ± 0.1, P < 0.001).

CONCLUSION

Both acute continuous and interval low-intensity exercise elicits transient improvement in systemic arterial stiffness in humans. Despite equivalent exercise intensity and duration, interval exercise resulted in improved arterial stiffness for longer duration.

Treatment with nebivolol combined with physical training promotes improvements in the cardiovascular responses of hypertensive rats

The aim of this study was to determine whether exercise training combined with beta-blocker treatment promotes additional cardiovascular benefits compared with either intervention on its own. For this we used 76 Wistar rats distributed among different groups: normotensive sedentary (NS), normotensive trained (NT), normotensive sedentary treated with beta-blocker (NS_BB), normotensive trained treated with beta-blocker (NT_BB), hypertensive sedentary (HS), hypertensive trained (HT), hypertensive sedentary treated with a beta-blocker (HS_BB), and hypertensive trained rats treated with beta-blocker (HT_BB). Exercise training consisted of 4 weeks of swimming for 60 min a day, 5 days a week. Hypertension was induced with l-NAME (4 weeks), whereas the control rats received saline, and both the control and test rats received nebivolol. The animals underwent surgery to directly record their blood pressure. The HS group showed higher mean arterial pressure (MAP) (P = 0.000), systolic arterial pressure (P = 0.000), and diastolic arterial pressure (P = 0.000) compared with NS. MAP was higher in the HS compared with the HT (P = 0.002), HS_BB (P = 0.018), and HT_BB (P = 0.015) groups. Hearts from the HS group had a higher percentage of collagen compared with the NS and HS_BB groups. The HT_BB and HT groups only had a higher percentage of cardiac collagen by comparison with the HS_BB group. The HT_BB group showed higher levels of macrophages and neutrophils by comparison with the HT and HS_BB groups. Thus, treatment with a beta-blocker combined with physical training was associated with increased cardiovascular benefits over either intervention alone.

Exercise-training reduced blood pressure and improve placental vascularization in pregnant spontaneously hypertensive rats--pilot study

Assess the effects of exercise-training on resting arterial pressure and heart rate, placental fetuses morphologic alterations in pregnant spontaneously hypertensive rats (SHRs).Twenty SHRs and their respective control normotensive rats (WKY) were submitted or not to a swimming protocol during 9 weeks, resulting in four pregnant experimental groups: sedentary hypertensive (PSH), trained hypertensive (PTH), sedentary normotensive (PSN), and trained normotensive (PTN). Exercise-training by swimming attenuates arterial pressure in pregnant SHRs, and can contribute to an increase in the length of fetuses and the percentage of the vessels in the placenta.

[Hypertension and exercise]

Levels of physical activity in modern urbanized society are clearly insufficient to maintain good health, and to prevent cardiovascular and other disease. Aerobic exercise is almost completely free of secondary effects, and is a useful adjunctive therapy in treating hypertension. There are several possible mechanisms to account for the beneficial effects of exercise in reducing blood pressure, the resulting physiological effects usually being classified as acute, post-exercise or chronic. Variations in genetic background, hypertension etiology, pharmacodynamics and pharmacokinetics may explain the different blood pressure responses to exercise among hypertensive patients. The present review discusses the different pathophysiological aspects of the response to exercise in hypertensives, including its modulators and diagnostic and prognostic usefulness, as well as the latest guidelines on prescribing and monitoring exercise regimes and drug therapy in the clinical follow-up of active hypertensive patients.

Hypotensive response after water-walking and land-walking exercise sessions in healthy trained and untrained women

Background:

The aim of this study was to compare post-exercise hypotension after acute sessions of water-walking and land-walking in healthy trained and untrained women.

Methods:

Twenty-three untrained (n = 12) and trained (n = 11) normotensive women performed two walking sessions in water and on land at 40% of peak VO₂ for 45 minutes. Systolic and diastolic blood pressure and mean arterial pressure were measured 15, 30, 45, and 60 minutes after the exercise sessions.

Results:

No differences were found between the groups for age and anthropometric parameters, but peak VO₂ for the trained women (45 ± 8 mL/kg/minute) was higher than for the untrained women (31 ± 3 mL/kg/minute). No differences were found between the groups with regard to systolic and diastolic blood pressure and mean arterial pressure after water immersion. The heart rate in the trained group (62 ± 3 beats per minute [bpm]) was significantly lower (P < 0.05) than in the untrained group (72 ± 4 bpm) on land, and after water immersion, this difference disappeared (58 ± 5 bpm in the trained women and 66 ± 5 bpm in the untrained women). Sixty minutes after water-walking, systolic blood pressure (108 ± 8 mmHg vs 97 ± 3 mmHg), diastolic blood pressure (69 ± 5 mmHg vs 62 ± 5 mmHg), and mean arterial pressure (82 ± 6 mmHg vs 74 ± 4 mmHg) decreased significantly with rest in the untrained group, and no differences were found after land-walking. In the trained group, significant (P < 0.05) differences were found only for systolic blood pressure (110 ± 9 mmHg vs 100 ± 9 mmHg) after 60 minutes of water-walking; decreases in systolic blood pressure were found after 45 minutes (99 ± 7 mmHg) and 60 minutes (99 ± 6 mmHg) compared with rest (107 ± 5 mmHg) after land-walking.

Conclusion:

Single water-walking and land-walking sessions induced important hypotension following exercise. Additionally, walking performed in chest-deep water has a better effect on exercise-induced hypotension in untrained healthy women than walking at a similar intensity on land.

Influência da cafeína na resposta pressórica ao exercício aeróbio em sujeitos hipertensos

A redução da pressão arterial (PA) promovida pelo exercício físico é evidente segundo a literatura atual. Mecanismos neuro-humorais explicam essa resposta hipotensora, em que a diminuição da atividade simpática apresenta-se como um dos principais mecanismos. Porém, a ingestão de alimentos ricos em cafeína (CA) pode suprimir esta atenuação simpática. O objetivo desse estudo foi elucidar o impacto da ingestão de CA na resposta pressórica ao exercício em pessoas hipertensas. Sete hipertensos (52,3 ± 3,3 anos), sendo cinco mulheres, realizaram duas sessões de caminhada com 40 minutos de duração, em dois dias de treinamento, tendo previamente ingerido CA (4mg/kg de peso corporal) ou placebo (PL). A PA e a frequência cardíaca foram verificadas anteriormente a ingestão, após 15, 30, 45, 60 minutos da ingestão em estado de repouso e com 10, 20 e 30 minutos após o exercício. Os dados foram tratados por meio de estatística descritiva, e pelo teste não paramétrico de Wilcoxon (p < 0,05). A média da PA aumentou de 124,9/80,9mmHg antes da ingestão de CA para 129,4/84,3mmHg 60 minutos após, ainda no repouso (p < 0,05). Trinta minutos após o exercício observou-se resposta hipotensora no procedimento PL (queda da PA de 122,6/79,4mmHg para 115,7/78,6mmHg), enquanto que no procedimento com CA, a PA mostrou-se significativamente mais alta em relação aos valores de repouso (aumento de 124,9/80,9mmHg para 136,9/90,9mmHg, p < 0,05). Conclui-se que a ingestão de CA não só suprime a resposta hipotensora do exercício, como provoca uma hipertensão pós-exercício.

Acute and chronic effects of aerobic and resistance exercise on ambulatory blood pressure

Hypertension is a ubiquitous and serious disease. Regular exercise has been recommended as a strategy for the prevention and treatment of hypertension because of its effects in reducing clinical blood pressure; however, ambulatory blood pressure is a better predictor of target-organ damage than clinical blood pressure, and therefore studying the effects of exercise on ambulatory blood pressure is important as well. Moreover, different kinds of exercise might produce distinct effects that might differ between normotensive and hypertensive subjects.The aim of this study was to review the current literature on the acute and chronic effects of aerobic and resistance exercise on ambulatory blood pressure in normotensive and hypertensive subjects. It has been conclusively shown that a single episode of aerobic exercise reduces ambulatory blood pressure in hypertensive patients. Similarly, regular aerobic training also decreases ambulatory blood pressure in hypertensive individuals. In contrast, data on the effects of resistance exercise is both scarce and controversial. Nevertheless, studies suggest that resistance exercise might acutely decrease ambulatory blood pressure after exercise, and that this effect seems to be greater after low-intensity exercise and in patients receiving anti-hypertensive drugs. On the other hand, only two studies investigating resistance training in hypertensive patients have been conducted, and neither has demonstrated any hypotensive effect. Thus, based on current knowledge, aerobic training should be recommended to decrease ambulatory blood pressure in hypertensive individuals, while resistance exercise could be prescribed as a complementary strategy.

Hipotensão pós-exercício aeróbio: uma revisão sistemática

Diversos estudos investigaram os efeitos hipotensores após uma sessão de exercício aeróbio em humanos. No entanto, vários aspectos permanecem obscuros em relação à hipotensão pós-exercício (HPE), uma vez que diversas variáveis podem influenciar a resposta hipotensora, como intensidade, duração, tipo de exercício, estado clínico, faixa etária, etnia, sexo e estado de treinamento. Nesse sentido, o objetivo do presente estudo foi revisar sistematicamente a literatura, relacionando as principais variáveis da prescrição de uma sessão de exercício aeróbio e a HPE, assim como apresentar os possíveis mecanismos envolvidos. Foram encontrados 55 estudos que abrangeram a temática HPE e exercício aeróbio em humanos. A ocorrência da HPE está bem estabelecida na literatura, já que vários estudos identificaram reduções da pressão arterial em normotensos e hipertensos. Porém, os possíveis moduladores das respostas hipotensoras, como intensidade e duração da sessão de exercício, ainda são contraditórios. Em relação ao tipo de exercício, porém, existem indicativos de que os realizados de forma intermitente e que utilizam maior massa muscular podem acarretar maior HPE. Além disso, hipertensos devem apresentar maior magnitude e duração da HPE. Contudo, existem lacunas em relação aos diversos mecanismos fisiológicos envolvidos, que parecem ser diferentes entre normotensos e hipertensos.