Sex Differences in Post-exercise Hypotension, Ambulatory Blood Pressure Variability, and Endothelial Function After a Power Training Session in Older Adults

Abstract

Background: The efficacy of power training (PT) to acutely reduce blood pressure (BP) in participants with hypertension is controversial, and no studies have assessed the influence of sex on post-exercise hypotension and its mechanisms in older adults.Purpose: The aims of this secondary, exploratory analysis were to compare the effects of a single bout of PT on post-exercise hypotension, BP variability, and endothelial function between older men and women with hypertension.Methods: Twenty-four participants with hypertension (12 men and 12 women aged to >60 years old) took part in this crossover study and randomly performed two experimental sessions: power exercise training (PT) and non-exercising control session (Con). The PT protocol was composed of 3 sets of 8–10 repetitions of five exercises performed in the following order: leg press, bench press, knee extension, upright row, and knee flexion, using an intensity corresponding to 50% of one repetition maximal test (1RM) and 2-min intervals between sets and exercises. The concentric phase of exercises during each repetition was performed “as fast as possible,” while the eccentric phase lasted 1 to 2 s. During Con, the participants remained at seated rest on the same exercise machines, but without any exercise. Each protocol lasted 40 min. Office BP, flow-mediated dilatation (FMD), 24-h ambulatory BP, and the average real variability (ARV) of systolic and diastolic BP were assessed before and after experimental sessions.Results: Comparing PT with Con, a reduced office BP after exercise was found in men (systolic BP—average post 1 h: −14 mmHg, p < 0.001; diastolic BP—average post 1 h: −8 mmHg, p < 0.001) and only a reduced systolic BP in women (average post 1 h: −7 mmHg, p = 0.04). Comparing men and women, a reduced systolic BP (post 60': −15 mmHg, p = 0.048; average post 1 h: −7 mmHg, p = 0.046) and diastolic BP (post 60': −9 mmHg, p = 0.049) after the first hour were found in men. In relation to 24-h ambulatory BP, ARV, and FMD, no statistically significant differences were found between men and women.Conclusion: In older adults with hypertension, the office BP response after the experimental sessions was different in men and women, showing that the PT protocol is more effective to acutely reduce BP in men. Additionally, the mechanisms behind this reduction remain unclear. This finding suggests that sex cannot be combined to analyze post-exercise hypotension.Clinical Trial Registration: ClinicalTrials.gov, Identifier: NCT03615625.

Influence of resistance training on ambulatory blood pressure monitoring: a brief review

“…The temporal distribution of publications included in this article was as follows: 1 article from 1998, 1 from 2001, 1 from 2004, 1 from 2006; 1 from 2009, 1 from 2011, 1 from 2013, 1 from 2015, 1 from 2016, 2 from 2017, 1 from 2018, 4 from 2020, 2 from 2021, totaling 18 articles. Among these, 10 articles were conducted with hypertensive patients [6,[9][10][11][12][13][14][15][16][17], 6 with normotensives [7,[18][19][20][21][22], 2 with hypertensives and normotensives [15,23], 7 studies researched older people [10,11,[14][15][16][17]23], 11 studies were conducted with adults (young and middle-aged) [6, 7, 9, 12, 13, 18-21, 24, 25], 1 study evaluated children and adolescents [22] and 2 studies investigated other complications (diabetes and metabolic syndrome) [24,25]. The summary of the main findings is described in Table 1.…”

“…When compared to differences between the sexes, older men presented better results in reducing blood pressure (reduction of systolic and diastolic blood pressure in the laboratory, reduction of 24-hour diastolic blood pressure and blood pressure at night) than older women after power training [16]. We can associate the magnitude and duration of responses to the manipulation of strength training variables, because, although the volume of training protocols being the same (sets and repetitions), the absolute load for men was significantly higher and, perhaps, this explained the differences between the sexes [16]. Regarding this topic, the literature has already demonstrated differences in hypotensive mechanisms between genders, with men lowering blood pressure www.ah.viamedica.pl by lowering cardiac output and women by lowering peripheral vascular resistance [38].…”

“…With respect to the above information, we can consider that the fast execution speed restricts the number of cross-bridges that can establish a connection (actin-myosin interaction) [33] and consequently a smaller vascular network would be active in the post-exercise period. Although other experiments have corroborated the effectiveness of power training in reducing laboratory blood pressure in older hypertensive people [16,30], more studies should be conducted analyzing power training in older people and the possible physiological responses in reducing blood pressure.…”

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

“…Apart from different exercise protocols, the characteristics of the study population may influence the magnitude and duration of the PEH effect [ 4 , 21 , 22 ]. Especially age [ 23 , 24 , 25 ], sex [ 26 , 27 ], training status [ 23 , 28 ], and cardiovascular risk factors [ 23 , 29 ], have been reported as influencing factors for PEH and may thus be responsible for the conflicting results.…”

Effects of a single beach tennis session on short-term blood pressure variability in individuals with hypertension: a randomized crossover trial

“…The efficacy of a single bout of exercise in reducing BP variability is controversial [16][17][18][19]. A reduction in shortterm BP variability following a single bout of combined exercise was found in older adults with hypertension [17,19]; however, the benefits were not confirmed after a Pilates exercise session [16] and a power training session [18] in hypertensive individuals.…”