Hemodynamics and cardiac autonomic modulation after an acute concurrent exercise circuit in older individuals with pre- to established hypertension

Cordeiro, Ricardo; Mira, Pedro Augusto de Carvalho; Monteiro, Walace David; Cunha, Felipe; Laterza, Mateus Camaroti; Pescatello, Linda S.; Martinez, Daniel Godoy; Farinatti, Paulo

doi:10.6061/clinics/2021/e1971

Cited by 4 publications

(3 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The mechanisms underlying PEH have been widely investigated, but there is little data on acute hemodynamic changes occurring after RAE and HIIE, particularly in patients with cardiac diseases. The acute hemodynamic response to RAE has been assessed in healthy subjects [25] and in patients with hypertension [26] with variable results produced. In partial disagreement with our findings, another study [26] showed that compared to pre-session measurements, HR increased, systemic vascular resistance remained unchanged and CO was reduced.…”

Section: Discussionmentioning

confidence: 99%

“…The acute hemodynamic response to RAE has been assessed in healthy subjects [25] and in patients with hypertension [26] with variable results produced. In partial disagreement with our findings, another study [26] showed that compared to pre-session measurements, HR increased, systemic vascular resistance remained unchanged and CO was reduced. Regarding hemodynamic changes occurring after HIIE, the data from the present study differ from those obtained in a previous study, [27], which evaluated patients with mild non-ischemic HF using cardiac magnetic resonance imaging before and after a session of HIIE.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Central Hemodynamic Adjustments during Post-Exercise Hypotension in Hypertensive Patients with Ischemic Heart Disease: Concurrent Circuit Exercise versus High-Intensity Interval Exercise. A Preliminary Study

Caminiti

Iellamo

Perrone

et al. 2021

JCM

View full text Add to dashboard Cite

Concurrent aerobic plus resistance exercise (RAE) and high-intensity interval exercise (HIIE) are both effective at inducing post-exercise hypotension (PEH) in patients with hypertension. However, central hemodynamic changes associated with PEH in hypertensive subjects with underlying ischemic heart disease (IHD) have been poorly investigated. The study aim was to compare the acute effects produced by these two exercise modalities on left ventricular diastolic function and left atrial function. Twenty untrained male patients with a history of hypertension and IHD under stable pharmacological therapy were enrolled. Each patient underwent three exercise sessions: RAE, HIIE and a control session without exercise, each lasting 45 min. An echocardiography examination was performed before and between 30 min and 40 min from the end of the exercise sessions. Following the exercise sessions, BP values decreased in a similar way in RAE and HIIE and were unchanged after the control session. Compared to pre-session, the ratio between early filling velocity (E) and mitral annulus early diastolic velocity (E’). E/E’ increased after HIIE and remained unchanged after both RAE and control sessions (between-sessions p 0.002). Peak atrial longitudinal strain (PALS) increased slightly after RAE (+1.4 ± 1.1%), decreased after HIIE (−4.6 ± 2.4%) and was unchanged after the control session (between-sessions p 0.03). Peak atrial contraction strain (PACS) was mildly increased after RAE, was reduced after HIIE and was unchanged after the control session. Atrial volume was unchanged after both exercise sessions. Left ventricular and left atrial stiffness increased significantly after HIIE, but remained unchanged after the RAE and control sessions. Stroke volume and cardiac output increased after RAE, decreased after HIIE, and were unchanged after the control session. In conclusion, single session of RAE and HIIE brought about similar PEH in hypertensive subjects with IHD, while they evoked different central hemodynamic adjustments. Given its neutral effects on diastolic and atrial functions, RAE seems more suitable for reducing blood pressure in hypertensive patients with IHD.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Central Hemodynamic Adjustments during Post-Exercise Hypotension in Hypertensive Patients with Ischemic Heart Disease: Concurrent Circuit Exercise versus High-Intensity Interval Exercise. A Preliminary Study

Caminiti

Iellamo

Perrone

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…Although sympathoinhibition likely occurs postexercise, its role in prolonged BP reductions is unclear. Primary trials across diverse populations reported increased sympathetic and/or reduced vagal activity with PEH [15,18,19,[55][56][57][58][59][60]. Recent meta-analyses observed parallel increases in sympathetic and/or decreases in parasympathetic modulation after both aerobic and resistance exercise, contrary to expectations, irrespective of resting BP [52,35].…”

Section: Potential Central Mechanisms Of Postexercise Hypotensionmentioning

confidence: 94%

Central and peripheral mechanisms underlying postexercise hypotension: a scoping review

Brasil,

Silva,

Pescatello

et al. 2024

Journal of Hypertension

Self Cite

View full text Add to dashboard Cite

Blood pressure (BP) reduction occurs after a single bout of exercise, referred to as postexercise hypotension (PEH). The clinical importance of PEH has been advocated owing to its potential contribution to chronic BP lowering, and as a predictor of responders to exercise training as an antihypertensive therapy. However, the mechanisms underlying PEH have not been well defined. This study undertook a scoping review of research on PEH mechanisms, as disclosed in literature reviews. We searched the PubMed, Web of Science, Scopus, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and Sport Discus databases until January 2023 to locate 21 reviews – 13 narrative, four systematic with 102 primary trials, and four meta-analyses with 75 primary trials involving 1566 participants. We classified PEH mechanisms according to major physiological systems, as central (autonomic nervous system, baroreflex, cardiac) or peripheral (vascular, hemodynamic, humoral, and renal). In general, PEH has been related to changes in autonomic control leading to reduced cardiac output and/or sustained vasodilation. However, the role of autonomic control in eliciting PEH has been challenged in favor of local vasodilator factors. The contribution of secondary physiological outcomes to changes in cardiac output and/or vascular resistance during PEH remains unclear, especially by exercise modality and population (normal vs. elevated BP, young vs. older adults). Further research adopting integrated approaches to investigate the potential mechanisms of PEH is warranted, particularly when the magnitude and duration of BP reductions are clinically relevant. (PROSPERO CRD42021256569).

show abstract

Effect of Physical Exercise on Cardiac Autonomic Modulation in Hypertensive Individuals: A Systematic Review and Meta-analysis

Abidi

Mujaddadi

Raza

et al. 2023

CHYR

View full text Add to dashboard Cite

Background: Cardiac autonomic dysfunction is associated with hypertension and exercise training (ET) in healthy individuals is found to improve cardiac autonomic modulation (CAM). However, the effects of physical exercise on CAM in hypertensive individuals are under debate. Objective: The aim of the review is to systematically evaluate the literature on the effects of physical exercise on CAM in hypertensive individuals and analyse comparative differences in the effects of exercise between hypertensive and normotensive individuals Methods: Electronic databases, such as Pubmed, PEDro, Scopus, and Web of Science, were systematically searched from inception up to February, 2022, evaluating the effect of ET on CAM either by heart rate variability (HRV), baroreflex sensitivity or heart rate recovery. Fifteen studies were included in the review. The risk of bias was assessed using the Cochrane risk of bias tool version 2 and the risk of bias in studies of intervention (ROBINS-I) tool. The overall quality of evidence was assessed using the grading of recommendations, assessment, development, and evaluation approach. Ten studies were included in the quantitative analysis. The meta-analysis and sensitivity analysis were performed using a review manager 5.4.1; publication bias was assessed using Jamovi 2.2.5 software. Results: The qualitative analysis revealed low to moderate certainty of evidence for ET and moderate for aerobic training. For the effect of overall ET, the analysis revealed that the standardized mean differences (SMD) showed a significant effect of ET on HF (SMD 1.76, p = 0.04) and RMSSD (SMD 1.19, p < 0.0001) and a significant decrease in LF (SMD -1.78, p = 0.04). Aerobic training revealed nonsignificant improvement in HRV parameters. In the comparative analysis, ET did not show a significant difference in improvement between HT and NT individuals. Conclusion: This review suggests an improvement in CAM with physical exercise in HT individuals, but the overall effect of ET in HT individuals must be interpreted with caution as the robustness of the data is compromised in the sensitivity analysis of the trials. High-quality future trials focusing on different modes of ET interventions are needed to strengthen the findings of the present review.

show abstract

Hemodynamics and cardiac autonomic modulation after an acute concurrent exercise circuit in older individuals with pre- to established hypertension

Cited by 4 publications

References 50 publications

Central Hemodynamic Adjustments during Post-Exercise Hypotension in Hypertensive Patients with Ischemic Heart Disease: Concurrent Circuit Exercise versus High-Intensity Interval Exercise. A Preliminary Study

Central Hemodynamic Adjustments during Post-Exercise Hypotension in Hypertensive Patients with Ischemic Heart Disease: Concurrent Circuit Exercise versus High-Intensity Interval Exercise. A Preliminary Study

Central and peripheral mechanisms underlying postexercise hypotension: a scoping review

Effect of Physical Exercise on Cardiac Autonomic Modulation in Hypertensive Individuals: A Systematic Review and Meta-analysis

Contact Info

Product

Resources

About