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Reliability and Time Course of Postexercise Hypotension during Exercise Training among Adults with Hypertension.

ABSTRACT: Postexercise hypotension (PEH), or the immediate decrease in blood pressure (BP) lasting for 24 h following an exercise bout, is well-established; however, the influence of exercise training on PEH dynamics is unknown. This study investigated the reliability and time course of change of PEH during exercise training among adults with hypertension. PEH responders (n = 10) underwent 12 weeks of aerobic exercise training, 40 min/session at moderate-to-vigorous intensity for 3 d/weeks. Self-measured BP was used to calculate PEH before and for 10 min after each session. The intraclass correlation coefficient (ICC) and Akaike Information Criterion (AIC) determined PEH reliability and goodness-of-fit for each week, respectively. Participants were obese (30.6 ± 4.3 kg∙m^-2), middle-aged (57.2 ± 10.5 years), and mostly men (60%) with stage I hypertension (136.5 ± 12.1/83.4 ± 6.7 mmHg). Exercise training adherence was 90.6 ± 11.8% with 32.6 ± 4.2 sessions completed. PEH occurred in 89.7 ± 8.3% of these sessions with BP reductions of 9.3 ± 13.1/3.2 ± 6.8 mmHg. PEH reliability was moderate (ICC ~0.6). AIC analysis revealed a stabilization of maximal systolic and diastolic BP reductions at 3 weeks and 10 weeks, respectively. PEH persisted throughout exercise training at clinically meaningful levels, suggesting that the antihypertensive effects of exercise training may be largely due to PEH. Further studies in larger samples and under ambulatory conditions are needed to confirm these novel findings.

SUBMITTER: Kiernan PA

PROVIDER: S-EPMC10889392 | biostudies-literature | 2024 Jan

REPOSITORIES: biostudies-literature

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Reliability and Time Course of Postexercise Hypotension during Exercise Training among Adults with Hypertension.

Kiernan Peter A PA Day Christina A CA Berkowsky Rachel S RS Zaleski Amanda L AL Gao Simiao S Taylor Beth A BA Santos Lucas P LP Panza Gregory G Kramarz Melody M McCormick Kyle K Thompson Paul D PD Fernandez Antonio B AB Chen Ming-Hui MH Pescatello Linda S LS

Journal of cardiovascular development and disease 20240129 2

Postexercise hypotension (PEH), or the immediate decrease in blood pressure (BP) lasting for 24 h following an exercise bout, is well-established; however, the influence of exercise training on PEH dynamics is unknown. This study investigated the reliability and time course of change of PEH during exercise training among adults with hypertension. PEH responders (<i>n</i> = 10) underwent 12 weeks of aerobic exercise training, 40 min/session at moderate-to-vigorous intensity for 3 d/weeks. Self-me ...[more]

PMID: 38392256

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Project description: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].

Project description:IntroductionHigh salt intake is a widespread cardiovascular risk factor with systemic effects. These effects include an expansion of plasma volume, which may interfere with postexercise hypotension (PEH). However, the effects of high salt intake on central and peripheral indices of PEH remain unknown. We tested the hypothesis that high salt intake would attenuate central and peripheral PEH.MethodsNineteen healthy adults (7 female/12 male; age, 25 ± 4 yr; body mass index, 23.3 ± 2.2 kg·m; V[Combining Dot Above]O2peak, 41.6 ± 8.7 mL·min·kg; systolic blood pressure (BP), 112 ± 9 mm Hg; diastolic BP, 65 ± 9 mm Hg) participated in this double-blind, randomized, placebo-controlled crossover study. Participants were asked to maintain a 2300 mg·d sodium diet for 10 d on two occasions separated by ≥2 wk. Total salt intake was manipulated via ingestion of capsules containing either table salt (3900 mg·d) or placebo (dextrose) during each diet. On the 10th day, participants completed 50 min of cycling at 60% V[Combining Dot Above]O2peak. A subset of participants (n = 8) completed 60 min of seated rest (sham trial). Beat-to-beat BP was measured in-laboratory for 60 min after exercise via finger photoplethysmography. Brachial and central BPs were measured for 24 h after exercise via ambulatory BP monitor.ResultsTen days of high salt intake increased urinary sodium excretion (134 ± 70 (dextrose) vs 284 ± 74 mmol per 24 h (salt), P < 0.001), expanded plasma volume (7.2% ± 10.8%), and abolished PEH during in-laboratory BP monitoring (main effect of diet, P < 0.001). Ambulatory systolic BPs were higher for 12 h after exercise during the salt and sham trials compared with the dextrose trial (average change, 3.6 ± 2.1 mm Hg (dextrose), 9.9 ± 1.4 mm Hg (salt), 9.8 ± 2.5 mm Hg (sham); P = 0.01). Ambulatory central systolic BP was also higher during the salt trial compared with dextrose trial.ConclusionHigh salt intake attenuates peripheral and central PEH, potentially reducing the beneficial cardiovascular effects of acute aerobic exercise.

Project description:Background: Postexercise hypotension (PEH) is a common physiological phenomenon occurring immediately after endurance training (ET), resistance training (RT), and ET plus RT, also termed concurrent training (CT); however, there is little knowledge about the interindividual and magnitude response of PEH in morbidly obese patients. Aim: The aims of this study were (1) to investigate the effect of CT order (ET + RT vs. RT + ET) on the blood pressure responses; 2) characterize these responses in responders and nonresponders, and 3) identify potential baseline outcomes for predicting blood pressure decreases as responders. Methods: A quasi-experimental study developed in sedentary morbidly obese men and women (age 43.6 ± 11.3 years; body mass index [BMI] ≥40 kg/m2) was assigned to a CT group of ET plus RT (ET + RT; n = 19; BMI 47.8 ± 16.7) or RT plus ET order group (RT + ET; n = 17; BMI 43.0 ± 8.0). Subjects of both groups received eight exercise sessions over four weeks. Primary outcomes include systolic (SBP), diastolic (DBP), mean arterial pressure [MAP], heart rate at rest [HR], and pulse pressure [PP] measurements before and after 10 min post-exercise. Secondary outcomes were other anthropometric, body composition, metabolic, and physical fitness parameters. Using the delta ∆SBP reduction, quartile categorization (Q) in "high" (Rs: quartile 4), "moderate" (MRs: quartile 3), "low" (LRs: quartile 2), and "nonresponders" (NRs: quartile 1) was reported. Results: Significant pre-post changes were observed in ET + RT in session 2 for SBP (131.6 vs. 123.4 mmHg, p = 0.050) and session 4 (131.1 vs. 125.2 mmHg, p = 0.0002), while the RT + ET group showed significant reductions in session 4 (134.2 vs. 125.3 mmHg, p < 0.001). No significant differences were detected in the sum of the eight sessions for SBP (∑∆SBP) between ET + RT vs. RT + ET (-5.7 vs. -4.3 mmHg, p = 0.552). Interindividual analyses revealed significant differences among frequencies comparing Q1 "NRs" (n = 8; 22.2%), Q2 "LRs" (n = 8; 22.2%), Q3 "MRs" (n = 9; 25.0%), and Q4 "HRs" (n = 11; 30.5%), p < 0.0001. Quartile comparisons showed significant differences in SBP changes (p = 0.035). Linear regression analyses revealed significant association between ∑∆SBP with body fat % (β -3.826, R 2 0.211 [21.1%], p = 0.031), skeletal muscle mass [β -2.150, R 2 0.125 (12.5%), p = 0.023], fasting glucose [β 1.273, R 2 0.078 (7.8%), p = 0.003], triglycerides [β 0.210, R 2 0.014 (1.4%), p = 0.008], and the 6-min walking test [β 0.183, R 2 0.038 (3.8%), p = 0.044]. Conclusion: The CT order of ET + RT and RT + ET promote a similar 'magnitude' in the postexercise hypotensive effects during the eight sessions of both CT orders in 4 weeks of training duration, revealing "nonresponders" and 'high' responders that can be predicted from body composition, metabolic, and physical fitness outcomes.

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Reliability and Time Course of Postexercise Hypotension during Exercise Training among Adults with Hypertension.

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Reliability and Time Course of Postexercise Hypotension during Exercise Training among Adults with Hypertension.

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