Combined Aerobic and Resistance Exercises Evokes Longer Reductions on Ambulatory Blood Pressure in Resistant Hypertension: A Randomized Crossover Trial

Pires, Nayara Fraccari; Coelho-Júnior, Hélio José; Gambassi, Bruno Bavaresco; Faria, Ana Paula; Ritter, Alessandra Mileni Versuti; Barboza, Cristina A.; Ferreira-Melo, Sílvia Elaine; Rodrigues, Bruno; Júnior, Heitor Moreno

doi:10.1155/2020/8157858

Cited by 21 publications

(25 citation statements)

References 57 publications

(96 reference statements)

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“…Ten studies ( N = 380 participants, 51% female , age range 52 to 67 years) were included in the review, of which four ( 15 , 16 , 27 , 28 ) ( N = 58, 50% female) assessed the short-term (≤ 24 h) effects of acute physical exercise and six ( 17 , 18 , 20 , 29 – 31 ) ( N = 322, 51% female) assessed the mid-term (up to 6 months) effects of exercise training intervention ( Table 1 , Flowchart available as Supplementary Figure 1 ). Participants of two studies ( 19 , 32 ) were enrolled in a larger RCT ( 18 ).…”

Section: Resultsmentioning

confidence: 99%

“…Available evidence on the effects of exercise intervention in individuals with RH shows promising results, as confirmed by some non-systematic reviews ( 11 – 14 ). Different trials have reported a beneficial effect of acute ( 15 , 16 ) or regular exercise ( 17 – 20 ) on office BP or ABP in patients with RH. However, to the best of our knowledge there has been no previous attempts to systematically synthesize the evidence available on the effects of acute or regular exercise on BP measures in patients with RH.…”

Section: Introductionmentioning

confidence: 99%

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Physical Exercise in Resistant Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Saco-Ledo

Ruilope

Lucía

2022

Front. Cardiovasc. Med.

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Physical exercise reduces blood pressure (BP) in patients with hypertension in general but more evidence is needed specifically for a high-risk phenotype associated with intensive medication, resistant hypertension (RH). In this systematic review and meta-analysis, we aimed to summarize current evidence of the exercise effects on BP in patients with RH. A systematic search was conducted in PubMed, Web of Science and Cochrane Library (from inception to 3rd November, 2021). A random effects meta-analysis was performed when at least two trials assessed the effect of either acute or regular exercise (vs. a control condition) on the same outcome. Ten studies (N = 380 participants; 51% female; mean age 52 to 67 years) were included in the review, of which four (N = 58) and six (N = 322) assessed the effects of acute and regular exercise, respectively. Evidence overall suggests that a single bout of acute exercise results in a short-term (≤ 24 h) reduction of BP, although no meta-analysis could be performed. As for regular exercise, three randomized controlled trials (N = 144, 50% female) could be meta-analyzed, which showed that exercise training intervention (8–12 weeks, 3 sessions/week) significantly reduces 24-h (−9.9 mmHg, 95% confidence interval −15.4−4.4 for systolic BP; and −5 mmHg, −7.0−3.0 for diastolic BP) and daytime ambulatory BP (−11.7 mmHg, −17.8−5.7; and −7.4 mmHg, −11.9−2.9). In summary, physical exercise appears as an effective option to reduce BP in patients with RH, although more research is needed to confirm these findings as well as to determine the most effective exercise characteristics.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Physical Exercise in Resistant Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Saco-Ledo

Ruilope

Lucía

2022

Front. Cardiovasc. Med.

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“…Our subjects were not taking anti-hypertensive medications, whereas most studies of PEH in hypertensive individuals have included subjects on blood pressure medications ( Melo et al, 2006 ; Brito et al, 2011 ; Cunha et al, 2016 ; Cunha et al, 2017 ; Ferrari et al, 2017 ; Imazu et al, 2017 ; Cunha et al, 2018 ; Goessler et al, 2018 ; de Freitas Brito et al, 2019 ; Costa et al, 2020 ; Pires et al, 2020 ). Thus, our results may not be applicable to those taking anti-hypertensive medications.…”

Section: Discussionmentioning

confidence: 99%

“…The magnitude of PEH is positively related to the baseline BP prior to exercise (Brito et al, 2018). Indeed, PEH has been repeatedly demonstrated in hypertensive populations (Legramante et al, 2002;Melo et al, 2006;Brito et al, 2011;Dos Santos et al, 2014;Cunha et al, 2016;Cunha et al, 2017;Ferrari et al, 2017;Imazu et al, 2017;Cunha et al, 2018;Goessler et al, 2018;de Freitas Brito et al, 2019;Pires et al, 2020;Iellamo et al, 2021). However, in virtually all of these studies the hypertensive populations included individuals with and without obesity, with mean BMI < 30 kg/m 2 in most instances.…”

Section: Introductionmentioning

confidence: 99%

Postexercise Hypotension Is Delayed in Men With Obesity and Hypertension

et al. 2022

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BackgroundPostexercise hypotension (PEH) can play a major role in the daily blood pressure management among individuals with hypertension. However, there are limited data on PEH in persons with obesity and hypertension, and no PEH data in this population beyond 90 min postexercise.PurposeThe purpose of this study was to determine if PEH could be elicited in men with obesity and hypertension during a 4-h postexercise measurement period.MethodsSeven men [age = 28 ± 4 years; body mass index = 34.6 ± 4.8 kg/m2; brachial systolic blood pressure (SBP): 138 ± 4 mmHg; brachial diastolic BP (DBP): 80 ± 5 mmHg; central SBP: 125 ± 4 mmHg; central DBP: 81 ± 8 mmHg] performed two exercise sessions on a cycle ergometer, each on a separate day, for 45 min at ∼65% VO2max. One exercise session was performed at a cadence of 45 RPM and one at 90 RPM. Blood pressure was monitored with a SunTech Oscar2 ambulatory blood pressure monitor for 4 h after both exercise sessions, and during a time-matched control condition.ResultsBoth brachial and central SBP were not changed during the first h postexercise but were reduced by ∼5–11 mmHg between 2 and 4 h postexercise (p < 0.05) after both exercise sessions. Brachial and central DBP were elevated by ∼5 mmHg at 1 h postexercise (p < 0.05) but were ∼2–3 mmHg lower compared to control at 4 h postexercise, and ∼2–4 mmHg lower at 3 h postexercise compared to baseline. Mean arterial pressure (MAP) was elevated compared to control at 1 h postexercise after both exercise sessions, but was ∼2–3 mmHg lower compared to control at 2, 3, and 4 h postexercise, and ∼4–7 mmHg lower at 3 h postexercise compared to baseline.ConclusionDespite the small sample size and preliminary nature of our results, we conclude that PEH is delayed in men with obesity and hypertension, but the magnitude and duration of PEH up to 4 h postexercise is similar to that reported in the literature for men without obesity and hypertension. The PEH is most pronounced for brachial and central SBP and MAP. The virtually identical pattern of PEH after both exercise trials indicates that the delayed PEH is a reproducible finding in men with obesity and hypertension.

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“…Physical exercise has been highlighted among the many available alternatives due to evidence supporting the beneficial effects of exercise training programs on BP in NON-RH [ 3 ]. The beneficial effects of physical exercise are not restricted to chronic programs, and low BP levels are also observed after an acute session of exercise, which is called postexercise hypotension [ 4 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Autonomic Responses to Aerobic, Resistance and Combined Exercises in Resistance Hypertensive Patients

Fraccari-Pires

Coelho-Júnior

Gambassi

et al. 2022

BioMed Research International

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Here, we report the acute effects of aerobic (AER), resistance (RES), and combined (COM) exercises on blood pressure, central blood pressure and augmentation index, hemodynamic parameters, and autonomic modulation of resistant (RH) and nonresistant hypertensive (NON-RH) subjects. Twenty participants (10 RH and 10 NON-RH) performed three exercise sessions (i.e., AER, RES, and COM) and a control session. Hemodynamic (Finometer®, Beatscope), office blood pressure (BP), and autonomic variables (accessed through spectral analysis of the pulse-to-pulse BP signal, in the time and frequency domain-Fast Fourrier Transform) were assessed before (T0), one-hour (T1), and twenty-four (T2) hours after each experimental session. There were no changes in office BP, pulse wave behavior, and hemodynamic parameters after (T0 and T1) exercise sessions. However, AER and COM exercises significantly reduced sympathetic modulation in RH patients. It is worth mentioning that more significant changes in sympathetic modulation were observed after AER as compared to COM exercise. These findings suggest that office blood pressure, arterial stiffness, and hemodynamic parameters returned to baseline levels in the first hour and remained stable in the 24 hours after the all-exercise sessions. Notably, our findings bring new light to the effects of exercise on RH, indicating that RH patients show different autonomic responses to exercise compared to NON-RH patients. This trial is registered with trial registration number NCT02987452.

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Combined Aerobic and Resistance Exercises Evokes Longer Reductions on Ambulatory Blood Pressure in Resistant Hypertension: A Randomized Crossover Trial

Cited by 21 publications

References 57 publications

Physical Exercise in Resistant Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Physical Exercise in Resistant Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Postexercise Hypotension Is Delayed in Men With Obesity and Hypertension

Cardiovascular Autonomic Responses to Aerobic, Resistance and Combined Exercises in Resistance Hypertensive Patients

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