Combined exercise circuit session acutely attenuates stress-induced blood pressure reactivity in healthy adults

The effects of acute exercise on stress reactivity assessed via a multidimensional approach: a systematic review

Psychological stress is associated with numerous deleterious health effects. Accumulating evidence suggests acute exercise reduces stress reactivity. As stressors activate a wide array of psychological and physiological systems it is imperative stress responses are examined through a multidimensional lens. Moreover, it seems prudent to consider whether stress responses are influenced by exercise intervention characteristics such as modality, duration, intensity, timing, as well as participant fitness/physical activity levels. The current review therefore examined the role of acute exercise on stress reactivity through a multidimensional approach, as well as whether exercise intervention characteristics and participant fitness/physical activity levels may moderate these effects. Stress reactivity was assessed via heart rate, blood pressure, cortisol, catecholamines, and self-report. A systematic search following PRISMA guidelines of five databases was updated in November 2022. Reviewed studies met the following criteria: English language, participants aged ≥ 18, use of acute exercise, use of a validated stress-inducing task, and assessment(s) of stress reactivity. Thirty-one studies (1386 participants) were included. Acute exercise resulted in reliable reductions to blood pressure and cortisol. Acute exercise yielded mostly negligible effects on heart rate reactivity and negligible effects on self-report measures. As for exercise intervention characteristics, intensity-dependent effects were present, such that higher intensities yielded larger reductions to reactivity measures, while limited evidence was present for duration, modality, and timing-dependent effects. Regarding participant fitness/physical activity levels, the effects on stress reactivity were mixed. Future work should standardize the definitions and assessment time points of stress reactivity, as well as investigate the interaction between physiological and psychological stress responses in real-world contexts.

A single session of exercise reduces blood pressure reactivity to stress: a systematic review and meta-analysis

Stressful situations are common in everyday life and disturb homeostasis. So, an exercise session is a strategy to mitigate blood pressure (BP) peaks in response to stress (i.e., BP reactivity), decreasing the cardiovascular risk. This is a systematic review and meta-analysis that aims to verify the effects of a single session of physical exercises on BP reactivity to stress in adults. The searches were performed in digital databases (MEDLINE, LILACS, EMBASE, SPORTDiscus, and PsycInfo) and 29 studies were included, totaling 795 individuals (quantitative analysis: k = 25, n = 659). As for exercise characteristics, 21 of the 29 studies focused on aerobic exercises, and 23 studies focused on low to moderate intensities. As for the stress tests, we have them in the following order from the most to the least frequent: stroop color and word test, cold pressor test, arithmetic test, public speaking, handgrip, trier social stress test, and study task. Favorable metanalytic results (standardized mean differences through random-effects approach) for the exercises were found, with attenuated reactivity in systolic BP (pooled effect size = - 0.38 [- 0.49; - 0.27], representing average reductions of 3.7 ± 3.8 mmHg), diastolic BP (pooled effect size = - 0.51 [- 0.70; - 0.33], representing average reductions of 2.9 ± 3.7 mmHg), and mean BP (pooled effect size = - 0.51 [- 0.72; - 0.31], representing average reductions of 4.1 ± 3.3 mmHg). So, acute physical exercise lowers systolic, diastolic, and mean blood pressure reactivity in response to stressor tasks. However, given the small magnitude of effects, the clinical relevance of this result must be interpreted with caution and be better explored.

Can Acute Exercise Lower Cardiovascular Stress Reactivity? Findings from a Scoping Review

Exaggerated cardiovascular reactivity to and delayed recovery from stress increase the risk of cardiovascular diseases in the future. While exercise training has been shown to attenuate stress-induced cardiovascular reactivity and enhance recovery from stress, the effects with acute exercise are less characterized. The aim of this scoping review was to explore the range and characteristics of published evidence regarding acute exercise on cardiovascular reactivity and stress recovery. The secondary objective was to highlight research gaps and implications for future research. A total of 36 articles met the review inclusion/exclusion criteria, involving 1200 participants from various age groups, fitness and health status. Blood pressure (BP) reactivity was the most measured outcome, followed by heart rate (HR) reactivity, and to some extent, heart rate variability. Overall, acute exercise particularly of the moderate-intensity aerobic type effectively reduced stress-induced BP reactivity in the general population. The effects on HR reactivity and cardiovascular recovery were inconclusive. Further research would be recommended to establish if other forms of exercise intensity or type are equally beneficial to lower exaggerated cardiovascular responses to stress. Despite methodological differences and limitations, the available evidence supports the therapeutic potential of acute exercise in addressing the ill effects of stress on cardiovascular health.

Attenuation of stress-induced cardiovascular reactivity following high-intensity interval exercise in untrained males

Exaggerated cardiovascular (CV) reactivity to stress is associated with negative cardiovascular outcomes. This study aimed to investigate the effects of acute high-intensity interval exercise (HIIE) and moderate-intensity exercise (MIE) on CV reactivity in response to a stress challenge in untrained males. Thirteen, normotensive males (age: 22.8 ± 2 years, BMI: 21.9 ± 3.6 kg/m²) underwent three conditions in counterbalanced order: HIIE (bodyweight exercises; 80-90% HRR), MIE (treadmill-jog; 55-60% HRR) and seated rest (CON) separated by 7-10 days. Thirty minutes after performing HIIE, MIE or CON, subjects underwent a 2-min cold pressor task (CPT). Blood pressure (BP) and heart rate (HR) were measured before, during, and after CPT. CV reactivity, i.e., the change in BP and HR responses were compared across conditions. Systolic BP reactivity were attenuated following HIIE (-60%, p = 0.015) and MIE (-42%, p = 0.033) compared to CON, but no differences were observed between HIIE and MIE. HR reactivity was not different across all conditions. We conclude that performing HIIE or MIE 30 minutes prior to acute stress exposure lowers BP reactivity compared to rest in untrained males. These findings highlight the potential benefits of HIIE in lowering stress-induced elevations in blood pressure.

Driving in an urban environment, the stress response and effects of exercise

Driving may be detrimental to health, with one hypothesis suggesting that driving may elicit an acute stress response and, with repeated exposures, may become a chronic stressor. The present study examined the stress response to driving and the effectiveness of a prior exercise bout in dampening this response. Twenty healthy adults performed three tasks: control, driving and exercise plus driving. Heart rate (HR), heart rate variability (HRV), blood pressure (BP) and cortisol were measured to quantify the acute stress response to each condition. Data indicated a stress response to driving: HR was elevated and HRV was reduced during the driving task compared with control. HR was elevated and HRV was reduced comparing the exercise plus driving with the driving condition. BP and cortisol were not different among conditions. The potential of interventions, such as exercise, to counter daily stressors should be evaluated to safeguard long-term health. Practitioner Summary: this study confirms that driving induces a stress response, with the exercise intervention providing mixed results (an increase in cardiovascular measures and a decrease in cortisol measure trending significance). Given the known consequences of stress and evidence that exercise can mitigate acute stress, further evaluation of exercise interventions is recommended.

Blood pressure reactivity to mental stress is attenuated following resistance exercise in older hypertensive women

PURPOSE

This study aimed to investigate the effects of resistance exercise (RE) on autonomic control and blood pressure (BP) reactivity during mental stress (MS) in treated older hypertensive women.

METHODS

Ten older hypertensive women (age =71.1±5.5 years; body mass index =24.2±3.9; mean BP [MBP] =85.4±3.5) underwent a protocol consisting of BP and heart rate variability (HRV) output assessments at baseline and during MS, and these measurements were taken before and 60 minutes after two bouts of RE (traditional and circuit). MS was induced through a computerized 3-minute Stroop color-word test before and 1 hour after each exercise session; BP was measured every minute during MS, and HRV was monitored as a measure of cardiac autonomic control.

RESULTS

A significant effect of time on systolic BP (Δpre =17.4±12.8 versus Δpost =12.5±9.6; P=0.01), diastolic BP (Δpre =13.7±7.1 versus Δpost =8.8±4.5; P=0.01), and MBP (Δpre =14.0±7.7 versus Δpost =9.3±5.4; P<0.01) after RE was observed, with no differences between the two sessions. In addition, a significant effect of time on log-normalized low-frequency component of HRV (ms2; 5.3±0.8 pre-exercise MS versus 4.8±1.0 baseline value; P=0.023) was also observed, showing a significant change from baseline to MS before RE, but not after RE sessions. These results may be related to a lessened RE-mediated cardiac sympathetic activity during MS.

CONCLUSION

RE is an effective tool to reduce BP reactivity to MS, which could therefore be associated with an acute reduction in cardiovascular risk. This result presents relevant clinical implications, combining previous evidence that recommends this exercise modality as an important component of an exercise program designed for the older and hypertensive subjects.

Fractionated Concurrent Exercise throughout the Day Does Not Promote Acute Blood Pressure Benefits in Hypertensive Middle-aged Women

Hypertension is a chronic disease that affects about 30% of the world’s population, and the physical exercise plays an important role on its non-pharmacological treatment. Anywise, the dose–response of physical exercise fractionation throughout the day demands more investigation, allowing new exercise prescription possibilities. Therefore, this study aimed to analyze the acute blood pressure (BP) kinetics after 1 h of exercises and the BP reactivity after different concurrent exercise (CE) sessions and its fractioning of hypertensive middle-aged women. In this way, 11 hypertensive women voluntarily underwent three experimental sessions and one control day [control session (CS)]. In the morning session (MS) and night session (NS), the exercise was fully realized in the morning and evening, respectively. For the fractionized session (FS), 50% of the volume was applied in the morning and the remaining 50% during the evening. The MS provided the greatest moments (p ≤ 0.05) of post-exercise hypotension (PEH) for systolic BP (SBP) and highest reduction of BP reactivity for SBP (~44%) and diastolic BP (DBP) (~59%) compared to CS (p ≤ 0.05). The findings of the present study have shown that MS is effective for PEH to SBP, as well as it promotes high quality of attenuation for BP reactivity, greater than the other sessions.

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.

Effects of exercise training on stress-induced vascular reactivity alterations: role of nitric oxide and prostanoids

BACKGROUND

Physical exercise may modify biologic stress responses.

OBJECTIVE

To investigate the impact of exercise training on vascular alterations induced by acute stress, focusing on nitric oxide and cyclooxygenase pathways.

METHOD

Wistar rats were separated into: sedentary, trained (60-min swimming, 5 days/week during 8 weeks, carrying a 5% body-weight load), stressed (2 h-immobilization), and trained/stressed. Response curves for noradrenaline, in the absence and presence of L-NAME or indomethacin, were obtained in intact and denuded aortas (n = 7-10).

RESULTS

None of the procedures altered the denuded aorta reactivity. Intact aortas from stressed, trained, and trained/stressed rats showed similar reduction in noradrenaline maximal responses (sedentary 3.54 ± 0.15, stressed 2.80 ± 0.10*, trained 2.82 ± 0.11*, trained/stressed 2.97 ± 0.21*, *P < 0.05 relate to sedentary). Endothelium removal and L-NAME abolished this hyporeactivity in all experimental groups, except in trained/stressed rats that showed a partial aorta reactivity recovery in L-NAME presence (L-NAME: sedentary 5.23 ± 0,26#, stressed 5.55 ± 0.38#, trained 5.28 ± 0.30#, trained/stressed 4.42 ± 0.41, #P < 0.05 related to trained/stressed). Indomethacin determined a decrease in sensitivity (EC50) in intact aortas of trained rats without abolishing the aortal hyporeactivity in trained, stressed, and trained/stressed rats.

CONCLUSIONS

Exercise-induced vascular adaptive response involved an increase in endothelial vasodilator prostaglandins and nitric oxide. Stress-induced vascular adaptive response involved an increase in endothelial nitric oxide. Beside the involvement of the endothelial nitric oxide pathway, the vascular response of trained/stressed rats involved an additional mechanism yet to be elucidated. These findings advance on the understanding of the vascular processes after exercise and stress alone and in combination.