The aftereffects of dynamic exercise on ambulatory blood pressure

Pescatello, Linda S.; Kulikowich, Jonna M.

doi:10.1097/00005768-200111000-00009

Cited by 158 publications

(123 citation statements)

References 33 publications

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“…[5][6][7] Higher levels of physical activity 8,9 and cardiorespiratory fitness 9 have been shown to reduce the risk of HPT in healthy normotensive persons. Acute 10,11 and chronic [12][13][14] exercise can also reduce resting blood pressure (BP) in hypertensive adults. Moreover, exercise training has been shown to improve several factors involved in the pathophysiology of HPT, including sympathetic activity, 15 endothelial function, 16 pulse wave velocity (PWV) 14 and insulin sensitivity.…”

Section: Introductionmentioning

confidence: 99%

Effects of high-intensity aerobic interval training vs. moderate exercise on hemodynamic, metabolic and neuro-humoral abnormalities of young normotensive women at high familial risk for hypertension

et al. 2010

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Exercise training has an important role in the prevention and treatment of hypertension, but its effects on the early metabolic and hemodynamic abnormalities observed in normotensive offspring of hypertensive parents (FH+) have not been studied. We compared high-intensity interval (aerobic interval training, AIT) and moderate-intensity continuous exercise training (CMT) with regard to hemodynamic, metabolic and hormonal variables in FH+ subjects. Forty-four healthy FH+ women (25.0 ± 4.4 years) randomized to control (ConFH+) or to a three times per week equal-volume AIT (80-90% of VO 2MAX ) or CMT (50-60% of VO 2MAX ) regimen, and 15 healthy women with normotensive parents (ConFHÀ; 25.3 ± 3.1 years) had their hemodynamic, metabolic and hormonal variables analyzed at baseline and after 16 weeks of follow-up. Ambulatorial blood pressure (ABP), glucose and cholesterol levels were similar among all groups, but the FH+ groups showed higher insulin, insulin sensitivity, carotid-femoral pulse wave velocity (PWV), norepinephrine and endothelin-1 (ET-1) levels and lower nitrite/nitrate (NOx) levels than ConFHÀ subjects. AIT and CMT were equally effective in improving ABP (Po0.05), insulin and insulin sensitivity (Po0.001); however, AIT was superior in improving cardiorespiratory fitness (15 vs. 8%; Po0.05), PWV (Po0.01), and BP, norepinephrine, ET-1 and NOx response to exercise (Po0.05). Exercise intensity was an important factor in improving cardiorespiratory fitness and reversing hemodynamic, metabolic and hormonal alterations involved in the pathophysiology of hypertension. These findings may have important implications for the exercise training programs used for the prevention of inherited hypertensive disorder. Keywords: arterial stiffness; endothelial function; exercise; nervous system, sympathetic; prevention INTRODUCTION Essential arterial hypertension (HPT) is the most common risk factor for cardiovascular morbidity and mortality and is associated with substantial health-care expenditures. 1,2 Consequently, primary prevention for individuals at high risk for HPT has been emphasized. 3 Among the population at high risk for HPT, those who have hypertensive parents (FH+) are worthy of special attention. It has been well established that a positive family history of HPT is a strong risk factor for future HPT in nonhypertensive offspring, independent of other risk factors. 4 Moreover, hemodynamic, metabolic and hormonal abnormalities, as well as concentrations of biomarkers that may have a key role in the development of HPT, are increased in nonhypertensive offspring of parents with HPT. [5][6][7]

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Section: Introductionmentioning

confidence: 99%

Effects of high-intensity aerobic interval training vs. moderate exercise on hemodynamic, metabolic and neuro-humoral abnormalities of young normotensive women at high familial risk for hypertension

et al. 2010

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“…Data are available from a previous meta-analysis on both the acute and chronic effects of exercise on BP. 10 Baseline BP was also included as a predictor in this study and found to be a strong correlate of PEH magnitude. Nevertheless, mathematical coupling and regression to the mean would also be predicted to exert spurious influences in such analyses.…”

Section: Discussionmentioning

confidence: 99%

“…Previous researchers 10,11 have indicated that pre-exercise BP is a more important moderator of PEH than age, body mass index, waist circumference and maximal oxygen uptake. These findings have also been cited in the American College of Sports Medicine position stand on exercise and hypertension 12 to evidence the claim that the effectiveness of exercise in reducing BP would appear to be greatest in people with generally high BP status.…”

Section: Introductionmentioning

confidence: 96%

Blood pressure status and post-exercise hypotension: an example of a spurious correlation in hypertension research?

et al. 2010

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A single bout of exercise lowers blood pressure (BP) for up to 24 h afterwards. The magnitude of this post-exercise hypotension (PEH) has been reported to be correlated most strongly to pre-exercise BP, and this apparent relationship has influenced position statements about the value of exercise in arterial hypertension. Nevertheless, this correlation could be adversely affected by mathematical coupling and regression-to-the-mean artefacts. Therefore, we aimed to examine the degree to which BP status moderates PEH while, for the first time, controlling for these statistical artefacts. A total of 32 participants, with preexercise mean arterial pressures of 65-110 mm Hg, cycled for 30 min at 70% peak oxygen uptake. Systolic BP and diastolic BP were measured (Portapres) before exercise and for 20 min after exercise. Changes in BP were regressed against pre-exercise values, and against the mean of pre-and post-exercise BP, among other indices that are also known not to be prone to artefacts. Correlations between pre-exercise BP and the exercisemediated reductions were typical of those previously reported (r ¼ 0.37-0.62, Po0.05), but not large enough to rule out spuriousness (P40.05). Artefact-free indices of BP status (pre-and post-exercise mean as well as an earlier independent measurement) did not correlate with reductions in BP (P40.05), which were moderated more by peak oxygen uptake and time of day (Po0.05). These data indicate that, if statistical artefacts are not controlled for, the influence of BP status on the degree of PEH can be spuriously exaggerated to the extent that other more important moderators of BP change are masked.

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“…An additional inclusion criterion involved demonstrating (PEH), which was defined as at least a 3% reduction in mean arterial pressure (MAP) following acute exercise. 2 The protocol was split into three separate days. The first day consisted of medical screening, explanation of the protocol, and a peak oxygen uptake test ( .…”

Section: Methodsmentioning

confidence: 99%

“…1 The reduction in blood pressure (BP) following a single bout of exercise has been reported to persist for up to 11-12 h during ambulatory monitoring under freeliving conditions. 2 Postexercise hypotension (PEH) has therefore been implicated as a key mechanism in relation to the antihypertensive effects of exercise. 3 Although a well-established phenomenon, there is a wide variation in the magnitude of PEH response and differences in hemodynamic mechanisms between different populations.…”

Section: Introductionmentioning

confidence: 99%

Impact of moderate overweight and body composition on postexercise hemodynamic responses in healthy men

Hamer

Boutcher

2006

J Hum Hypertens

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Postexercise hypotension (PEH) is a well-established phenomenon that may contribute to the antihypertensive mechanisms of exercise. The purpose of this study was to examine the impact of moderate overweight on postexercise hemodynamic responses in a group of healthy nonobese men (n ¼ 16, aged 20.471.8 years) with apparently normal cardiovascular function at rest. Forearm blood flow, using strain gauge plethysmography, blood pressure, using a Finapres device, and cardiac output (CO), using impedance cardiography, were measured on a control day and on a separate day following a bout of moderate intensity exercise (20 min at 75% heart rate reserve). Linear regression analysis, adjusted for exercise intensity, revealed that body mass index (BMI) was associated with specific postexercise hemodynamic responses. Higher BMI was associated with greater reductions in CO and stroke volume, but lower reductions in total peripheral resistance. These findings suggest body composition impacts on mechanisms of PEH and should therefore be considered as an important confounding variable in future studies.

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The aftereffects of dynamic exercise on ambulatory blood pressure

Abstract: The ABP difference after exercise is a function of initial values such that groups with the highest baseline BP experience the greatest postexercise ABP reductions. The ABP dynamic exercise studies raise important methodological considerations that should be attended to in future work.

Cited by 158 publications

References 33 publications

Effects of high-intensity aerobic interval training vs. moderate exercise on hemodynamic, metabolic and neuro-humoral abnormalities of young normotensive women at high familial risk for hypertension

Effects of high-intensity aerobic interval training vs. moderate exercise on hemodynamic, metabolic and neuro-humoral abnormalities of young normotensive women at high familial risk for hypertension

Blood pressure status and post-exercise hypotension: an example of a spurious correlation in hypertension research?

Impact of moderate overweight and body composition on postexercise hemodynamic responses in healthy men

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