Evaluating the Methodological Quality of Postexercise Hypotension Aerobic Exercise Interventions

Abstract

BackgroundPostexercise hypotension (PEH) is the immediate reduction in blood pressure (BP) of 5–8 mmHg that occurs after a single bout of aerobic exercise among adults with hypertension. Across PEH studies, there are variations in the level of rigor of the study designs and methods that limit the conclusions that can be made about PEH.ObjectiveTo develop and then apply a methodological study quality evaluation checklist to aerobic exercise PEH studies to provide methodological guidance.MethodsWe developed a PEH checklist (PEH√list) based upon contemporary methodological study quality standards. The PEH√list contains 38 items divided into three categories: sample (n = 10 items), study (n = 23 items), and intervention characteristics (n = 5 items). We then systematically searched six databases to January 2019 to identify and then evaluate studies that: (1) enrolled adults ≥18 years with hypertension and without other chronic diseases or conditions; (2) included a bout of aerobic exercise and a non-exercise control session; and (3) were published in English.ResultsOf 17,149 potential studies, 64 qualified. Participants (N = 1,489) were middle-aged (38.6 ± 15.6 year), overweight (26.1 ± 2.5 kg/m2) mostly men (64.4%) with elevated BP (systolic BP 129.5 ± 15.2/diastolic BP 81.0 ± 10.1 mmHg). Overall, the qualifying studies satisfactorily reported 53.9 ± 13.3% (24.2–82.8%) of the relevant items on the PEH√list. Of note, only 20.3% of the studies disclosed BP was measured following professional guidelines, 18.8% reported BP was taken by the same assessor pre- and post-intervention, and 35.5% stated participants abstained from caffeine, alcohol, and physical activity prior to testing. Half (51.5%) indicated they statistically controlled for pre-exercise/baseline BP. Meanwhile, 100% of the studies reported the setting in which the BP measurements were taken, time from the end of the exercise to the start of the BP measurements, and if relevant, the length of the ambulatory BP monitoring period.ConclusionOverall, the PEH√list items were not well satisfied; especially items with potential confounding effects on PEH. We contend the PEH√list provides guidance to investigators on the important methodological study considerations in PEH aerobic exercise studies that should be attended to in the future.Systematic Review Registration[https://www.crd.york.ac.uk/PROSPERO/], identifier [#CRD42020221996].

The Effect of Submaximal Exercise on Cutaneous Blood Flow, Thermoregulation and Recovery Hemodynamics Following Endurance Exercise

“…2). These results are consistent with the findings of other authors who report that post-exercise hypotension can persist for up to 24 hours (23,30,31).…”

Comparative Study on the Effect of Various Aerobic Exercises on College Students’ Weight Loss Based on Deep Learning Analysis

“…irty subjects who volunteered to participate in the weight loss experiment and research were selected from a university, including 16 men and 14 women [23]. Depending on advertising and execution, the number of courses in the next step will increase further.…”

Central and peripheral mechanisms underlying postexercise hypotension: a scoping review

“…BP reductions resulting from exercise training of 5-8 mmHg in patients with elevated BP [3][4][5][6][7][8][9] are equivalent in magnitude to the effects of antihypertensive medications [3,4,10]. Acute exercise [11][12][13][14][15][16][17][18][19][20][21][22] also lowers BP by 5-8 mmHg for up to 24 h after a single session of exercise, referred to as postexercise hypotension (PEH) [23]. Several investigative teams have proposed that BP reductions resulting from exercise training rely on the accumulated effects of acute exercise [24][25][26][27][28][29][30].…”

“…The results from experimental trials are mixed because of methodological variability in aspects such as BP assessment (measurement time, body position, and so on), type of intervention (exercise modality, intensity, volume, and so on), sample characteristics (BP level, age, and so on), and outcomes associated with BP regulation [17,30,[33][34][35]. The current literature suggests that PEH results from a combination of central, peripheral, or a combination of the two BP regulatory mechanisms [22,29,36,37].…”

“…There is a lack of studies providing a synthesis of PEH mechanisms and, therefore, an interpretation of their relative contributions. Many reviews have focused on moderators of PEH such as resting BP, ethnic or genetic factors, exercise characteristics (modality, duration, intensity, volume, ambient temperature, and so on), population conditions (trained vs. untrained, normal vs. elevated BP; young and older adults, and so on), or assessment protocols (time of follow up, body position, and so on) [16][17][18]22,29,34,[37][38][39][40][41][42][43]. On the contrary, the influence of those moderators on physiological mechanisms underlying BP reduction after acute exercise has been neglected.…”