The effect of prolonged endurance exercise upon blood pressure regulation during a postexercise orthostatic challenge

Privett, Sheena E.; George, Keith; Middleton, Natalie; Whyte, Gregory; Cable, N. Timothy

doi:10.1136/bjsm.2008.051078

Cited by 7 publications

(4 citation statements)

References 19 publications

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“…In the present study, we demonstrated that HUT following 60 minutes of moderate‐intensity cycling exercise resulted in larger reductions in SV, Q, MCAv, and TVC compared to pre‐exercise HUT similar to those found in previous studies . This is the first known study to investigate the use of CS as a modality to attenuate cardio‐ and cerebrovascular responses to orthostasis following exercise.…”

Section: Discussionsupporting

confidence: 87%

“…In the present study, we demonstrated that HUT following 60 minutes of moderate-intensity cycling exercise resulted in larger reductions in SV, Q, MCAv, and TVC compared to pre-exercise HUT similar to those found in previous studies. 6,[8][9][10]23 This is the first known study to investigate the use of CS as a modality to attenuate cardioand cerebrovascular responses to orthostasis following (Figure 1). Additionally, CS minimized the maximal HUT-induced changes in HR, SV, Q, and MCAv (Table 2), as well as, increased SV, Q, and MCAv near the end of the postexercise HUT test ( Figure S2).…”

Section: Post-exercise Hutmentioning

confidence: 99%

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Knee‐high compression socks minimize head‐up tilt‐induced cerebral and cardiovascular responses following dynamic exercise

Dorey

O’Brien

Robinson

et al. 2018

Scandinavian Med Sci Sports

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In healthy individuals during a non-exercised state, knee-high compression socks (CS) may reduce the magnitude of lower limb venous pooling during orthostasis but are not effective at minimizing the incidence of pre-syncopal symptoms. However, exaggerated reductions in cerebral blood flow velocity (CBV) and cardiac stroke volume (SV) occur during passive head-up tilt (HUT) testing following dynamic exercise. It is unknown if CS can minimize post-exercise HUT-induced decrements in CBV and SV in this population. To test the hypothesis that CS will attenuate the reductions in SV and CBV during 60° HUT following 60 minutes of moderate-intensity (60% VO peak) cycling exercise. Ten healthy volunteers (22.6 ± 2.1 years, 24.1 ± 2.5 kg/m ) completed pre- and post-exercise 15-minute HUT tests during randomized CS and Control (no CS) conditions. Changes in blood pressure (finger plethysmography), SV (Modelflow® method), and CBV (Transcranial Doppler) were measured during HUT and preceding supine rest periods. Pre-exercise HUT-induced similar (all, P > .47) reductions in SV (Control; -23.1 ± 11.5%, CS; -20.5 ± 10.9%) and CBV (Control; -18.1 ± 6.3%, CS; -15.3 ± 9.0%). However, larger post-exercise decreases in SV and CBV during HUT were observed in the Control versus CS condition. Specifically, CS attenuated the drop in SV (Control: -32.9 ± 5.6%, CS: -24.3 ± 11.6%; P = .01) and CBV (Control: -25.1 ± 5.8%, CS: -17.6 ± 7.8%; P = .02) during the post-exercise HUT test. These results indicate that CS attenuated HUT-induced reductions in SV and CBV following moderate-intensity cycling exercise and suggest that CS may be an effective countermeasure to reduce the incidence of post-exercise syncope in vulnerable populations.

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Section: Discussionsupporting

confidence: 87%

Section: Post-exercise Hutmentioning

confidence: 99%

Knee‐high compression socks minimize head‐up tilt‐induced cerebral and cardiovascular responses following dynamic exercise

Dorey

O’Brien

Robinson

et al. 2018

Scandinavian Med Sci Sports

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“…In a clinical trial of experienced male runners, systolic blood pressure decreases after exercise secondary to a reduction in peripheral vascular resistance leading to a decreased filling volume 34. Women, however, may respond differently to exercise than do men.…”

Section: Baroreflex Modulationmentioning

confidence: 99%

Exercise-associated collapse: an evidence-based review and primer for clinicians

2011

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Exercise-associated collapse (EAC) commonly occurs after the completion of endurance running events. EAC is a collapse in conscious athletes who are unable to stand or walk unaided as a result of light headedness, faintness and dizziness or syncope causing a collapse that occurs after completion of an exertional event. Although EAC is perhaps the most common aetiology confronted by the medical provider attending to collapsed athletes in a fi nish-line tent, providers must fi rst maintain vigilance for other potential life-threatening aetiologies that cause collapse, such as cardiac arrest, exertional heat stroke or exercise-associated hyponatraemia. Previously, it has been believed that dehydration and hyperthermia were primary causes of EAC. On review of the evidence, EAC is now believed to be principally the result of transient postural hypotension caused by lower extremity pooling of blood once the athlete stops running and the resultant impairment of cardiac barorefl exes. Once life-threatening aetiologies are ruled out, treatment of EAC is symptomatic and involves oral hydration and a Trendelenburg positiontotal body cooling, intravenous hydration or advanced therapies is generally not needed.

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“…Previous studies revealed that healthy individuals showed pre-syncopal symptoms during orthostatic stress in the range of 10-80 % accompanied by orthostatic hypotension after longterm aerobic exercise such as marathon (28,29), ultramarathon (30) or equivalent exercise (31,32) under the various environmental conditions. Although one previous study denied the direct relationship between orthostatic tolerance and orthostatic hypotension after long-term aerobic exercise (31), it is likely that orthostatic hypotension after the exercise triggers neutrally mediated syncope and that improvement of the orthostatic hypotension leads to prevention of post-exercise syncope (18,33).…”

Section: Clinical Implicationmentioning

confidence: 99%

Acute effects of bolus water intake on post-exercise orthostatic hypotension and cardiovascular hemodynamics

Tajima,

Komiyama,

Mimura

et al. 2024

Preprint

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Introduction Water intake is known to be effective to prevent orthostatic hypotension (OH). However, it is unknown whether water intake would be effective in acutely preventing exercise-induced OH. Methods Fourteen adults (men/women:7/7, age: 20±8 years old) were recruited. Each subject underwent two protocols with and without 500ml water intake using a randomized crossover design (Water vs. Control). They underwent 30 minutes of cycle ergometry at the 60-70% predicted VO2 max. The OH and hemodynamics were assessed before and after exercise, and immediately (Water 1) and 20 minutes (Water 2) after the water intake. The OH was evaluated with a one-minute standing test as the criteria of SBP<90mmHg. The cross-spectral analysis for RR and SBP variabilities was used to evaluate the cardiac autonomic activity and baroreflex sensitivity. Results In both protocols, the incidence of OH increased after the exercise. The incidence of OH was lower in Water than in Control at Water 1 (OR: 0.093, 95% CI: 0.015-0.591). HR was lower and SBP was higher in Water than in Control at Water 1 and 2 (P<0.05). High-frequency power of RR variability and transfer function gains in Water were normalized and higher than in Control at Water 1 and 2 (P<0.05). The ratio of low to high-frequency power of RR variability in Water was normalized and lower in Water than in Control at Water 1 (P<0.05). Conclusion Our findings indicate that water intake may acutely prevent exerciseinduced OH, accompanied by normalized cardiac autonomic activity and baroreflex sensitivity.

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The effect of prolonged endurance exercise upon blood pressure regulation during a postexercise orthostatic challenge

Abstract: Following prolonged exercise, a fall in systolic blood pressure during orthostasis results from an inadequately compensated decrease in SV and resultant CO during standing.

Cited by 7 publications

References 19 publications

Knee‐high compression socks minimize head‐up tilt‐induced cerebral and cardiovascular responses following dynamic exercise

Knee‐high compression socks minimize head‐up tilt‐induced cerebral and cardiovascular responses following dynamic exercise

Exercise-associated collapse: an evidence-based review and primer for clinicians

Acute effects of bolus water intake on post-exercise orthostatic hypotension and cardiovascular hemodynamics

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