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Oliveira-Silva L, Fecchio RY, Silva Junior NDD, Pio-Abreu A, Silva GVD, Drager LF, Silva de Sousa JC, Forjaz CLDM. Post-dynamic, isometric and combined resistance exercise responses in medicated hypertensive men. J Hum Hypertens 2024; 38:52-61. [PMID: 37670145 DOI: 10.1038/s41371-023-00859-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/07/2023]
Abstract
This study investigated the effects of dynamic resistance exercise (DRE), isometric handgrip exercise (IHE) and combined resistance exercise (DRE+IHE) on post-exercise hypotension (PEH) and its hemodynamic, autonomic, and vascular mechanisms. For that, 70 medicated hypertensives men (52 ± 8 years) were randomly allocated to perform one of the following interventions: DRE (3 sets, 8 exercises, 50% of 1RM), IHE (4 sets, 2 min, 30% of MVC), CRE (DRE+IHE) and control (CON, seated rest). Before and after the interventions, blood pressure (BP), systemic hemodynamics, cardiovascular autonomic modulation and brachial vascular parameters were evaluated. After the DRE and CRE, systolic and mean BP decreased (SBP = -7 ± 6 and -8 ± 8 mmHg; MBP -4 ± 5 and -5 ± 5 mmHg, respectively, all P < 0.05), vascular conductance increased (+ 0.47 ± 0.61 and +0.40 ± 0.47 ml.min-1.mmHg-1, respectively, both P < 0.05) and baroreflex sensitivity decreased (-0.15 ± 0.38 and -0.29 ± 0.47 ms/mmHg, respectively, both P < 0.05) in comparison to pre-exercise values. No variable presented any significant change after IHE. The responses observed after CRE were similar to DRE and significantly different from CON and IHE. In conclusion, DRE, but not IHE, elicits PEH, which happens concomitantly to skeletal muscle vasodilation and decreased baroreflex sensitivity. Moreover, adding IHE to DRE does not potentiate PEH and neither changes its mechanisms.Clinical Trial Registration: Data from this study derived from an ongoing longitudinal clinical trial approved by the Institution's Ethics Committee of Human Research (process 2.870.688) and registered at the Brazilian Clinical Trials (RBR-4fgknb) at http://www.ensaiosclinicos.gov.br .
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Affiliation(s)
- Laura Oliveira-Silva
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Rafael Yokoyama Fecchio
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Natan Daniel da Silva Junior
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Andrea Pio-Abreu
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Giovânio Vieira da Silva
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Luciano Ferreira Drager
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
- Unidade de Hipertensão, Instituto do Coração (InCor), Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Julio Cesar Silva de Sousa
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
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Takeda R, Hirono T, Yoshiko A, Kunugi S, Okudaira M, Ueda S, Watanabe K. Impact of muscle echo intensity on post-exercise blood pressure response in older normotensive and hypertensive females: Pilot study. PHYSICS REPORTS-REVIEW SECTION OF PHYSICS LETTERS 2022; 10:e15514. [PMID: 36353930 PMCID: PMC9647407 DOI: 10.14814/phy2.15514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022]
Abstract
Exaggerated post-exercise blood pressure (BP) is considered a risk factor for the development of cardiovascular disease in older females. Muscle echo intensity (EI) using ultrasound can be used to evaluate intramuscular fat, one of the risk factors for cardiovascular disease. This study aimed to determine whether intramuscular fat assessed by muscle echo intensity is associated with the post-exercise BP response in older females. Ten older normotensive (SBP <130 mmHg, 71 ± 4 years), eight systolic BP-controlled (78 ± 4 years), and 17 hypertensive (SBP ≥130 mmHg, 74 ± 6 years) females were studied. After obtaining ultrasound images to assess the EI, participants performed ramp-up exercise until 50% maximal voluntary contraction (MVC: ~30-s; 3% MVC/s gradually increased knee extension force from 0% to 50% MVC followed by sustaining the force at 50% MVC for 10-s) and then five MVCs (~50 s; 10-s rest between each contraction). BP was measured before and immediately after exercise. Mean arterial pressure (MAP) pre- and post-exercise were significantly lower in normotensive and SBP-controlled, than in -uncontrolled hypertensive females (PRE: 85 ± 5 and 87 ± 7 vs. 106 ± 9; POST: 92 ± 8 and 94 ± 9 vs. 103 ± 11 mmHg, respectively, p < 0.05). EI was negatively correlated with ∆diastolic BP (∆DBP) but not ∆SBP and ∆MAP in normotensive females only (∆SBP, r = -0.21, p = 0.56; ∆DBP, R = -0.73, p = 0.02; ∆MAP, R = -0.49, p = 0.15). Greater intramuscular fat as indicated by higher EI is associated with less BP elevation immediately after exercise in older normotensive females. Greater intramuscular fat may lead to lower intramuscular pressure, resulting in less post-exercise BP elevation.
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Affiliation(s)
- Ryosuke Takeda
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport ScienceChukyo UniversityToyotaJapan
| | - Tetsuya Hirono
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport ScienceChukyo UniversityToyotaJapan,Research Fellow of Japan Society for the Promotion of ScienceTokyoJapan
| | - Akito Yoshiko
- Faculty of Liberal Arts and SciencesChukyo UniversityNagoyaJapan
| | - Shun Kunugi
- Center for General EducationAichi Institute of TechnologyToyotaJapan
| | - Masamichi Okudaira
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport ScienceChukyo UniversityToyotaJapan
| | - Saeko Ueda
- Department of Human Nutrition, School of Life StudiesSugiyama Jogakuen UniversityNagoyaJapan
| | - Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport ScienceChukyo UniversityToyotaJapan
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Bertoletti OA, Ferrari R, Ferlin EL, Barcellos OM, Fuchs SC. Isometric handgrip exercise impacts only on very short-term blood pressure variability, but not on short-term blood pressure variability in hypertensive individuals: A randomized controlled trial. Front Physiol 2022; 13:962125. [PMID: 36176768 PMCID: PMC9513464 DOI: 10.3389/fphys.2022.962125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background: The effect of a single isometric handgrip exercise (IHG) on blood pressure (BP) variability (BPV) has not been addressed. This randomized controlled trial evaluated the effect of IHG vs. sham on BPV and BP.Methods: Hypertensive patients using up to two BP-lowering medications were randomly assigned to IHG (4 × 2 min; 30% of maximal voluntary contraction, MVC, with 1 min rest between sets, unilateral) or sham (protocol; 0.3% of MVC). Systolic and diastolic BP were assessed beat-to-beat in the laboratory before, during, and post-intervention and also using 24-h ambulatory BP monitoring (ABPM). BPV was expressed as average real variability (ARV) and standard deviation (SD).Results: Laboratory BPV, ARV and SD variability, had marked increase during the intervention, but not in the sham group, decreasing in the post-intervention recovery period. The overall change in ARV from pre- to 15 min post-intervention were 0.27 ± 0.07 (IHG) vs. 0.05 ± 0.15 (sham group), with a statistically significant p-value for interaction. Similarly, mean systolic BP increased during the intervention (IHG 165.4 ± 4.5 vs. sham 152.4 ± 3.5 mmHg; p = 0.02) as did diastolic BP (104.0 ± 2.5 vs. 90.5 ± 1.7 mmHg, respectively; p < 0.001) and decreased afterward. However, neither the short-term BPV nor BP assessed by ABPM reached statistically significant differences between groups.Conclusion: A single session of IHG reduces very short-term variability but does not affect short-term variability. IHG promotes PEH in the laboratory, but does not sustain 24-h systolic and diastolic PEH beyond the recovery period.
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Affiliation(s)
- Otávio A. Bertoletti
- Programa de Pós-Graduação em Epidemiologia, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Rodrigo Ferrari
- Programa de Pós-Graduação em Cardiologia, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Elton L. Ferlin
- Serviço de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Ozi M. Barcellos
- Coordenadoria de Gestão da Tecnologia da Informação e Comunicação, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Sandra C. Fuchs
- Programa de Pós-Graduação em Epidemiologia, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Programa de Pós-Graduação em Cardiologia, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- *Correspondence: Sandra C. Fuchs,
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Wan Yusof WMN, Nasaruddin WNS, Hami R, Che Muhamed AM, Ahmad Yusof H. The effect of a single session of isometric handgrip exercise on blood pressure. ISOKINET EXERC SCI 2022. [DOI: 10.3233/ies-220057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: It is unknown whether a session of isometric handgrip (IHG) exercise can influence the blood pressure of hypertensive and normotensive individuals. OBJECTIVE: To compare post exercise hypotension among groups with different resting blood pressure (BP) levels. METHODS: 56 Malay male volunteers (12 normotensive, 14 pre-hypertensive, 19 hypertensive stage 1, and 11 hypertensive stage 2) completed four sets of 2-minute isometric handgrip exercises at 30% of their maximum handgrip contraction with a one-minute break between the sets. Systolic BP (SBP), diastolic BP (DBP), pulse pressure (PP), mean arterial pressure (MAP), resting heart rate (RHR), and handgrip strength (HGS) were measured before and after an hour of IHG exercise. A paired sample t-test, one-way ANOVA, and two-way repeated measure ANCOVA were used to examine the data. RESULTS: All parameters, except RHR and HGS, were significantly changed following the exercise across the BP groups. The SBP, MAP, and HGS were greatly reduced among hypertensive stage 1 (SBP =-6.3 ± 0.6 mmHg; MAP =-4.8 ± 1.1 mmHg; HGS =-6.8 ±-0.4 mmHg) compared to other groups. Meanwhile, the most DBP was reduced among hypertensive stage 2 (mean =-5.2 ± 0.6 mmHg). CONCLUSIONS: The current study discovered a significant reduction in BP among hypertensive stage 1 and 2 individuals after a session of IHG exercise.
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Swift HT, O'Driscoll JM, Coleman DD, Caux AD, Wiles JD. Acute cardiac autonomic and haemodynamic responses to leg and arm isometric exercise. Eur J Appl Physiol 2022; 122:975-985. [PMID: 35089384 DOI: 10.1007/s00421-022-04894-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/13/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Acute cardiovascular responses following a single session of isometric exercise (IE) have been shown to predict chronic adaptations in blood pressure (BP) regulation. It was hypothesised that exercises which recruit more muscle mass induce greater reductions in BP compared to exercises using smaller muscle mass. To test this hypothesis, the current study aimed to compare the acute haemodynamic and autonomic responses to a single session of isometric wall squat (IWS) and isometric handgrip (IHG) training. METHODS Twenty-six sedentary participants performed a single IWS and IHG session in a randomised cross-over design, with training composed of 4 × 2-min contractions, with 2-min rest, at 95 HRpeak and 30% MVC respectively. Haemodynamic and cardiac autonomic variables were recorded pre, during, immediately post, and 1-h post-exercise, with the change from baseline for each variable used for comparative analysis. RESULTS During IWS exercise, there was a significantly greater increase in systolic BP (P < 0.001), diastolic BP (P < 0.001), mean BP (P < 0.001), heart rate (P < 0.001), and cardiac output (P < 0.001), and a contrasting decrease in baroreflex effectiveness index (BEI) and cardiac baroreceptor sensitivity (cBRS). In the 10-min recovery period following IWS exercise, there was a significantly greater reduction in systolic BP (P = 0.005), diastolic BP (P = 0.006), mean BP (P = 0.003), total peripheral resistance (TPR) (P < 0.001), BEI (P = 0.003), and power spectral density (PSD-RRI) (P < 0.001). There were no differences in any variables between conditions 1-h post exercise. CONCLUSIONS Isometric wall squat exercise involving larger muscle mass is associated with a significantly greater post-exercise hypotensive response during a 10-min recovery window compared to smaller muscle mass IHG exercise. The significantly greater reduction in TPR may be an important mechanism for the differences in BP response.
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Affiliation(s)
- Harry T Swift
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK
| | - Jamie M O'Driscoll
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK
| | - Damian D Coleman
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK
| | - Anthony De Caux
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK
| | - Jonathan D Wiles
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK.
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Yamada Y, Spitz RW, Wong V, Bell ZW, Song JS, Abe T, Loenneke JP. The impact of isometric handgrip exercise and training on health‐related factors: A review. Clin Physiol Funct Imaging 2022; 42:57-87. [DOI: 10.1111/cpf.12741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/10/2021] [Accepted: 12/23/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Yujiro Yamada
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management The University of Mississippi Oxford Mississippi USA
| | - Robert W. Spitz
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management The University of Mississippi Oxford Mississippi USA
| | - Vickie Wong
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management The University of Mississippi Oxford Mississippi USA
| | - Zachary W. Bell
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management The University of Mississippi Oxford Mississippi USA
| | - Jun Seob Song
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management The University of Mississippi Oxford Mississippi USA
| | - Takashi Abe
- Graduate School of Health and Sports Science Juntendo University Inzai Chiba Japan
| | - Jeremy P. Loenneke
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management The University of Mississippi Oxford Mississippi USA
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Wiles J, Rees-Roberts M, O'Driscoll JM, Doulton T, MacInnes D, Short V, Pellatt-Higgins T, Saxby K, Gousia K, West A, Smith M, Santer E, Darby J, Farmer CK. Feasibility study to assess the delivery of a novel isometric exercise intervention for people with stage 1 hypertension in the NHS: protocol for the IsoFIT-BP study including amendments to mitigate the risk of COVID-19. Pilot Feasibility Stud 2021; 7:192. [PMID: 34711266 PMCID: PMC8551940 DOI: 10.1186/s40814-021-00925-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 09/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hypertension (HTN) affects approximately 25% of the UK population and is a leading cause of mortality. Associated annual health care costs run into billions. National treatment guidance includes initial lifestyle advice, followed by anti-hypertensive medication if blood pressure (BP) remains high. However, adoption and adherence to recommended exercise guidelines, dietary advice and anti-hypertensive medication is poor. Four short bouts of isometric exercise (IE) performed 3 days per week (d/wk) at home elicits clinically significant reductions in BP in those with normal to high-normal BP. This study will determine the feasibility of delivering personalised IE to patients with stage 1 hypertension for whom lifestyle changes would be recommended before medication within NHS primary care. METHODS This is a randomised controlled feasibility study. Participants were 18+ years, with stage 1 hypertension, not on anti-hypertensive medication and without significant medical contraindications. Trial arms will be standard lifestyle advice (control) or isometric wall squat exercise and standard lifestyle advice. Primary outcomes include the feasibility of healthcare professionals to deliver isometric exercise prescriptions in a primary care NHS setting and estimation of the variance of change in systolic BP. Secondary outcomes include accuracy of protocol delivery, execution of and adherence to protocol, recruitment rate, attrition, perception of intervention viability, cost, participant experience and accuracy of home BP. The study will last 18 months. Sample size of 100 participants (50 per arm) allows for 20% attrition and 6.5% incomplete data, based upon 74 (37 each arm) participants (two-sided 95% confidence interval, width of 1.33 and standard deviation of 4) completing 4 weeks. Ethical approval IRAS ID is 274676. DISCUSSION Before the efficacy of this novel intervention to treat stage 1 hypertension can be investigated in any large randomised controlled trial, it is necessary to ascertain if it can be delivered and carried out in a NHS primary care setting. Findings could support IE viability as a prophylactic/alternative treatment option. TRIAL REGISTRATION ISRCTN13472393 , registered 18 August 2020.
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Affiliation(s)
- Jonathan Wiles
- Faculty of Science, Engineering and Social Sciences, Canterbury Christ Church University, Canterbury, Kent, UK.
| | | | - Jamie M O'Driscoll
- Faculty of Science, Engineering and Social Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Timothy Doulton
- Renal Department East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent, UK
| | - Douglas MacInnes
- Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Vanessa Short
- Centre for Health Services Studies, University of Kent, Canterbury, Kent, UK
| | | | - Katie Saxby
- Centre for Health Services Studies, University of Kent, Canterbury, Kent, UK
| | - Katerina Gousia
- Centre for Health Services Studies, University of Kent, Canterbury, Kent, UK
| | | | | | - Ellie Santer
- Faculty of Science, Engineering and Social Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | | | - Chris K Farmer
- Centre for Health Services Studies, University of Kent, Canterbury, Kent, UK
- Renal Department East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent, UK
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Characterization of resting and exercise inter-arm differences in SBP to isometric handgrip exercise in males and females. Blood Press Monit 2020; 25:252-258. [PMID: 32675474 DOI: 10.1097/mbp.0000000000000465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A large inter-arm difference (IAD; ≥10 mmHg) in SBP is linked to cardiovascular and peripheral vascular disease, hypertension, and premature mortality. Exercise-induced IAD (eIAD) is related to resting IAD, and acute aerobic activity alters eIAD and reduces IAD in recovery. Isometric handgrip exercise (IHE) affects blood pressure (BP), though the eIAD response to IHE is unknown. Further, the eIAD response may differ between males and females. OBJECTIVES To characterize the eIAD response to IHE in males and females. METHODS On visit 1, participants (16 females and 15 males, aged 18-35 years) completed three maximal voluntary isometric contractions (MVIC) per arm. On visit 2, before IHE, a series of three simultaneous, bilateral BP measures were averaged at rest. During IHE, participants maintained handgrip at 20% of MVIC for 2 minutes (arm randomly assigned), at which time bilateral BP was measured (IHE) during exercise and subsequent recovery (REC1 and REC2). Repeated-measures analysis of variance assessed eIAD and SBP (time × sex). RESULTS IHE increased absolute eIAD (4 mmHg). Differences in relative eIAD were observed at IHE and REC2 based on resting IAD status (P < 0.05). Females only had an exaggerated SBP and pulse pressure response in the working arm. CONCLUSION Acute IHE was shown to augment eIAD. Further eIAD and resting IAD were related. Acute IHE induced different bilateral responses between males and females, though the impact of sex on eIAD warrants further investigation. Future studies should address the effects of repeated bouts of IHE, which may benefit individuals with a large resting IAD.
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OLHER RAFAELREIS, ROSA THIAGOSANTOS, SOUZA LUIZHUMBERTORODRIGUES, OLIVEIRA JOSÉFERNANDO, SOARES BRANDERANTERALVES, RIBEIRO THIAGOBELARMINOALVES, SOUZA IORANNYRAQUELCASTRO, NEVES RODRIGOVANERSONPASSOS, SOUSA CAIOVICTOR, DEUS LYSLEINEALVES, MARCHETTI PAULOHENRIQUE, SIMOES HERBERTGUSTAVO, MORAES MILTONROCHA. Isometric Exercise with Large Muscle Mass Improves Redox Balance and Blood Pressure in Hypertensive Adults. Med Sci Sports Exerc 2019; 52:1187-1195. [DOI: 10.1249/mss.0000000000002223] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Gronwald T, Hoos O. Correlation properties of heart rate variability during endurance exercise: A systematic review. Ann Noninvasive Electrocardiol 2019; 25:e12697. [PMID: 31498541 PMCID: PMC7358842 DOI: 10.1111/anec.12697] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/23/2019] [Accepted: 08/05/2019] [Indexed: 11/27/2022] Open
Abstract
Background Non‐linear measures of heart rate variability (HRV) may provide new opportunities to monitor cardiac autonomic regulation during exercise. In healthy individuals, the HRV signal is mainly composed of quasi‐periodic oscillations, but it also possesses random fluctuations and so‐called fractal structures. One widely applied approach to investigate fractal correlation properties of heart rate (HR) time series is the detrended fluctuation analysis (DFA). DFA is a non‐linear method to quantify the fractal scale and the degree of correlation of a time series. Regarding the HRV analysis, it should be noted that the short‐term scaling exponent alpha1 of DFA has been used not only to assess cardiovascular risk but also to assess prognosis and predict mortality in clinical settings. It has also been proven to be useful for application in exercise settings including higher exercise intensities, non‐stationary data segments, and relatively short recording times. Method Therefore, the purpose of this systematic review was to analyze studies that investigated the effects of acute dynamic endurance exercise on DFA‐alpha1 as a proxy of correlation properties in the HR time series. Results The initial search identified 442 articles (351 in PubMed, 91 in Scopus), of which 11 met all inclusion criteria. Conclusions The included studies show that DFA‐alpha1 of HRV is suitable for distinguishing between different organismic demands during endurance exercise and may prove helpful to monitor responses to different exercise intensities, movement frequencies, and exercise durations. Additionally, non‐linear DFA of HRV is a suitable analytical approach, providing a differentiated and qualitative view of exercise physiology.
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Affiliation(s)
- Thomas Gronwald
- Department of Performance, Neuroscience, Therapy and Health, MSH Medical School Hamburg, Hamburg, Germany
| | - Olaf Hoos
- Center for Sports and Physical Education, Julius Maximilians University of Wuerzburg, Wuerzburg, Germany
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Javidi M, Argani H, Ahmadizad S. Hemodynamic responses to different isometric handgrip protocols in hypertensive men. Sci Sports 2019. [DOI: 10.1016/j.scispo.2018.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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12
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Gordon BD, Thomas EV, Warren-Findlow J, Marino JS, Bennett JM, Reitzel AM, Leamy LJ, Swaine I, Howden R. A comparison of blood pressure reductions following 12-weeks of isometric exercise training either in the laboratory or at home. ACTA ACUST UNITED AC 2018; 12:798-808. [DOI: 10.1016/j.jash.2018.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 09/08/2018] [Indexed: 02/03/2023]
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Characterizing and Comparing Acute Responses of Blood Pressure, Heart Rate, and Forearm Blood Flow to 2 Handgrip Protocols. J Cardiopulm Rehabil Prev 2018; 38:400-405. [PMID: 29952807 DOI: 10.1097/hcr.0000000000000344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Growing evidence supports handgrip exercise training for reducing resting blood pressure (BP), with inconsistent exercise protocols reported throughout the literature. To verify safety of such protocols, real-time cardiovascular responses must be assessed. Consequently, this research sought to evaluate the acute impact of dissimilar handgrip protocols on the cardiovascular responses of BP, heart rate (HR), and forearm blood flow. METHODS Using a randomized intraindividual crossover design, 20 post-menopausal women completed 2 distinct handgrip protocols compared with a nonexercise control: 4 × 2-min sustained grips at 30% moderate intensity with 1-min rest between sets (ZONA), and 32 × 5-sec intermittent grips at maximal intensity with 5-sec rest between sets (MINT). Cardiovascular responses were measured throughout exercise and post-exercise recovery. RESULTS Compared to ZONA, the MINT protocol required less time and less exercise effort, yet caused greater average BP perturbations (systolic, MINT: 16.9 ± 12.9 mm Hg, ZONA: 7.9 ± 11.6 mm Hg; diastolic, MINT: 8.7 ± 7.2 mm Hg, ZONA: 4.5 ± 4.9 mm Hg) (P < .05), with peak BP changes far below published safety guidelines. Average HR responses were similarly elevated between protocols (MINT: 5.4 ± 4.9 beats/min, ZONA: 3.4 ± 3.6 beats/min). Post-exercise recovery of BP and HR occurred swiftly following MINT while remaining elevated following ZONA. CONCLUSIONS Handgrip exercise protocols with distinct design features (ie, grip intensity, grip strategy, and exercise duration) cause dissimilar acute cardiovascular responses. Careful and controlled attention should be directed toward determining how such acute dissimilarities influence corresponding training outcomes. Given the confirmed safety of acute BP perturbations, future researchers can have confidence in prescribing even the high-intensity MINT protocol for at-home, unsupervised activity.
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TEIXEIRA ANDRÉL, RITTI-DIAS RAPHAEL, ANTONINO DIEGO, BOTTARO MARTIM, MILLAR PHILIPJ, VIANNA LAUROC. Sex Differences in Cardiac Baroreflex Sensitivity after Isometric Handgrip Exercise. Med Sci Sports Exerc 2018; 50:770-777. [DOI: 10.1249/mss.0000000000001487] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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O'Driscoll JM, Taylor KA, Wiles JD, Coleman DA, Sharma R. Acute cardiac functional and mechanical responses to isometric exercise in prehypertensive males. Physiol Rep 2017; 5:5/7/e13236. [PMID: 28381447 PMCID: PMC5392522 DOI: 10.14814/phy2.13236] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 03/08/2017] [Accepted: 03/09/2017] [Indexed: 01/10/2023] Open
Abstract
Isometric exercise (IE) training has been shown to reduce resting arterial blood pressure (ABP) in hypertensive, prehypertensive, and normotensive populations. However, the acute hemodynamic response of the heart to such exercise remains unclear. We therefore performed a comprehensive assessment of cardiac structure, function, and mechanics at rest and immediately post a single IE session in 26 male (age 44.8 ± 8.4 years) prehypertensive participants. Conventional echocardiography recorded standard and tissue Doppler measures of left ventricular (LV) structure and function. Speckle tracking echocardiography was used to measure LV global longitudinal, circumferential, and radial strain and strain rate. From this data, apical and basal rotation and rotational velocities, LV twist, systolic twist velocity, untwist velocity, and torsion were determined. IE led to a significant post exercise reduction in systolic (132.6 ± 5.6 vs. 109.4 ± 19.6 mmHg, P < 0.001) and diastolic (77.6 ± 9.4 vs. 58.8 ± 17.2 mmHg, P < 0.001) blood pressure, with no significant change in heart rate (62 ± 9.4 vs. 63 ± 7.5b·min−1, P = 0.63). There were significant reductions in LV end systolic diameter (3.4 ± 0.2 vs. 3.09 ± 0.3 cm, P = 0.002), LV posterior wall thickness (0.99 ± 0.1 vs. 0.9 ± 0.1 cm, P = 0.013), relative wall thickness (0.4 ± 0.06 vs. 0.36 ± 0.05, P = 0.027) estimated filling pressure (E/E' ratio 6.08 ± 1.87 vs. 5.01 ± 0.82, P = 0.006) and proportion of participants with LV concentric remodeling (30.8% vs. 7.8%, P = 0.035), and significant increases in LV ejection fraction (60.8 ± 3 vs. 68.3 ± 4%, P < 0.001), fractional shortening (31.6 ± 4.5 vs. 39.9 ± 5%, P < 0.001), cardiac output (4.3 ± 0.7 vs. 6.1 ± 1L·min−1, P < 0.001), and stroke volume (74.6 ± 11 vs. 96.3 ± 13.5 ml, P < 0.001). In this setting, there were significant increases in global longitudinal strain (−17.8 ± 2.4 vs. −20 ± 1.8%, P = 0.002) and strain rate (−0.88 ± 0.1 vs. −1.03 ± 0.1%, P < 0.001), basal rotation (−5 ± 3.5 vs. −7.22 ± 3.3°, P = 0.047), basal systolic rotational velocity (−51 ± 21.9 vs. −79.3 ± 41.3°·s−1, P = 0.01), basal diastolic rotational velocity (48.7 ± 18.9 vs. 62.3 ± 21.4°·s−1, P = 0.042), LV twist (10.4 ± 5.8 vs. 13.8 ± 5°, P = 0.049), systolic twist velocity (69.6 ± 27.5 vs. 98.8 ± 35.8°·s−1, P = 0.006), and untwist velocity (−64.2 ± 23 vs. −92.8 ± 38°·s−1, P = 0.007). These results suggest that IE improves LV function and mechanics acutely. This may in turn be partly responsible for the observed reductions in ABP following IE training programs and may have important implications for clinical populations.
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Affiliation(s)
- Jamie M O'Driscoll
- School of Human and Life Sciences, Canterbury Christ Church University, Kent, UK .,Department of Cardiology, St George's Healthcare NHS Trust, Tooting, London, UK
| | - Katrina A Taylor
- School of Human and Life Sciences, Canterbury Christ Church University, Kent, UK
| | - Jonathan D Wiles
- School of Human and Life Sciences, Canterbury Christ Church University, Kent, UK
| | - Damian A Coleman
- School of Human and Life Sciences, Canterbury Christ Church University, Kent, UK
| | - Rajan Sharma
- Department of Cardiology, St George's Healthcare NHS Trust, Tooting, London, UK
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TAYLOR KATRINAA, WILES JONATHAND, COLEMAN DAMIAND, SHARMA RAJAN, O'DRISCOLL JAMIEM. Continuous Cardiac Autonomic and Hemodynamic Responses to Isometric Exercise. Med Sci Sports Exerc 2017; 49:1511-1519. [DOI: 10.1249/mss.0000000000001271] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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17
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McGowan CL, Proctor DN, Swaine I, Brook RD, Jackson EA, Levy PD. Isometric Handgrip as an Adjunct for Blood Pressure Control: a Primer for Clinicians. Curr Hypertens Rep 2017; 19:51. [PMID: 28528376 DOI: 10.1007/s11906-017-0748-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Considered a global health crisis by the World Health Organization, hypertension (HTN) is the leading risk factor for death and disability. The majority of treated patients do not attain evidence-based clinical targets, which increases the risk of potentially fatal complications. HTN is the most common chronic condition seen in primary care; thus, implementing therapies that lower and maintain BP to within-target ranges is of tremendous public health importance. Isometric handgrip (IHG) training is a simple intervention endorsed by the American Heart Association as a potential adjuvant BP-lowering treatment. With larger reductions noted in HTN patients, IHG training may be especially beneficial for those who (a) have difficulties continuing or increasing drug-based treatment; (b) are unable to attain BP control despite optimal treatment; (c) have pre-HTN or low-risk stage I mild HTN; and (d) wish to avoid medications or have less pill burden. IHG training is not routinely prescribed in clinical practice. To shift this paradigm, we focus on (1) the challenges of current HTN management strategies; (2) the effect of IHG training; (3) IHG prescription; (4) characterizing the population for whom it works best; (5) clinical relevance; and (6) important next steps to foster broader implementation by clinical practitioners.
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Affiliation(s)
- Cheri L McGowan
- Department of Kinesiology, Faculty of Human Kinetics, University of Windsor, 401 Sunset Avenue, Windsor, ON, N9B 3P4, Canada. .,Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA. .,School of Medicine, Department of Emergency Medicine, Wayne State University, Detroit, MI, USA.
| | - David N Proctor
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | - Ian Swaine
- Department of Life & Sport Sciences, University of Greenwich, Medway Campus, London, UK
| | - Robert D Brook
- Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Elizabeth A Jackson
- Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Phillip D Levy
- School of Medicine, Department of Emergency Medicine, Wayne State University, Detroit, MI, USA
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18
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Goessler K, Buys R, Cornelissen VA. Low-intensity isometric handgrip exercise has no transient effect on blood pressure in patients with coronary artery disease. ACTA ACUST UNITED AC 2016; 10:633-9. [PMID: 27168475 DOI: 10.1016/j.jash.2016.04.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 03/30/2016] [Accepted: 04/12/2016] [Indexed: 01/26/2023]
Abstract
Hypertension is highly prevalent among patients with coronary artery disease (CAD). Exercise-based cardiac rehabilitation reduces blood pressure (BP). However, less is known about the transient effect of a single bout of exercise on BP. Isometric handgrip exercise has been proposed as a new nonpharmacologic tool to lower BP. We aimed to investigate the acute effect of isometric handgrip exercise on BP in CAD patients. Twenty-one male CAD patients were included. All patients completed two experimental sessions in random order: one control and one low-intensity isometric handgrip session. BP was measured by means of a 24-hour ambulatory BP monitor preintervention, for 1 hour in the office and subsequently for 24 hours. Our results suggest that isometric handgrip exercise performed at low intensity is safe in patients with CAD but does not induce a transient reduction in BP.
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Affiliation(s)
- Karla Goessler
- Research Group for Cardiovascular Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Roselien Buys
- Research Group for Cardiovascular Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Véronique A Cornelissen
- Research Group for Cardiovascular Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
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19
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Abstract
Exercise training is the cornerstone in the prevention and management of hypertension and atherosclerotic cardiovascular disease. However, blood pressure (BP) response to exercise is exaggerated in hypertension often to the range that raises the safety concern, which may prohibit patients from regular exercise. This augmented pressor response is shown to be related to excessive sympathetic stimulation caused by overactive muscle reflex. Exaggerated sympathetic-mediated vasoconstriction further contributes to the rise in BP during exercise in hypertension. Exercise training has been shown to reduce both exercise pressor reflex and attenuate the abnormal vasoconstriction. Hypertension also contributes to cognitive impairment, and exercise training has been shown to improve cognitive function through both BP-dependent and BP-independent pathways. Additional studies are still needed to determine if newer modes of exercise training such as high-intensity interval training may offer advantages over traditional continuous moderate training in improving BP and brain health in hypertensive patients.
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20
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Araújo CG, Castro CLBD, Franca JF, Ramos PS. 4-Second Exercise Test: Reference Values for Ages 18-81 Years. Arq Bras Cardiol 2015; 104:366-74. [PMID: 25830712 PMCID: PMC4495451 DOI: 10.5935/abc.20150026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 01/20/2015] [Indexed: 02/04/2023] Open
Abstract
Background Physiological reflexes modulated primarily by the vagus nerve allow the heart to
decelerate and accelerate rapidly after a deep inspiration followed by rapid
movement of the limbs. This is the physiological and pharmacologically validated
basis for the 4-s exercise test (4sET) used to assess the vagal modulation of
cardiac chronotropism. Objective To present reference data for 4sET in healthy adults. Methods After applying strict clinical inclusion/exclusion criteria, 1,605 healthy adults
(61% men) aged between 18 and 81 years subjected to 4sET were evaluated between
1994 and 2014. Using 4sET, the cardiac vagal index (CVI) was obtained by
calculating the ratio between the duration of two RR intervals in the
electrocardiogram: 1) after a 4-s rapid and deep breath and immediately before
pedaling and 2) at the end of a rapid and resistance-free 4-s pedaling
exercise. Results CVI varied inversely with age (r = -0.33, p < 0.01), and the intercepts and
slopes of the linear regressions between CVI and age were similar for men and
women (p > 0.05). Considering the heteroscedasticity and the asymmetry of the
distribution of the CVI values according to age, we chose to express the reference
values in percentiles for eight age groups (years): 18–30, 31–40, 41–45, 46–50,
51–55, 56–60, 61–65, and 66+, obtaining progressively lower median CVI values
ranging from 1.63 to 1.24. Conclusion The availability of CVI percentiles for different age groups should promote the
clinical use of 4sET, which is a simple and safe procedure for the evaluation of
vagal modulation of cardiac chronotropism.
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Affiliation(s)
| | | | | | - Plínio Santos Ramos
- Hospital e Maternidade Therezinha de Jesus, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Juiz de Fora, MG, Brazil
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21
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Teixeira AL, Ramos PS, Vianna LC, Ricardo DR. Effects of ovarian hormones and oral contraceptive pills on cardiac vagal withdrawal at the onset of dynamic exercise. PLoS One 2015; 10:e0119626. [PMID: 25785599 PMCID: PMC4364722 DOI: 10.1371/journal.pone.0119626] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 02/01/2015] [Indexed: 12/24/2022] Open
Abstract
The purpose of this study was to investigate the effects of the ovarian hormones and the use of oral contraceptive pills (OCP) on cardiac vagal withdrawal at the onset of dynamic exercise. Thirty physically active women aged 19-32 years were divided into two groups: OCP users (n = 17) and non-OCP users (n = 13). Participants were studied randomly at three different phases of the menstrual cycle: early follicular (day 3.6 ± 1.2; range 1-5), ovulatory (day 14.3 ± 0.8; range 13-16) and midluteal (day 21.3 ± 0.8; range 20-24), according to endogenous (in non-OCP users) or exogenous (in OCP users) estradiol and progesterone variations. The cardiac vagal withdrawal was represented by the cardiac vagal index (CVI), which was obtained by the 4-s exercise test. Additionally, resting heart rate, systolic (SBP) and diastolic blood pressure (DBP) were obtained. The CVI was not significantly different between the three phases of the menstrual cycle in either the non-OCP users (early follicular: 1.58 ± 0.1; ovulatory: 1.56 ± 0.1; midluteal: 1.58 ± 0.1, P > 0.05) or OCP users (early follicular: 1.47 ± 0.1; ovulatory: 1.49 ± 0.1; midluteal: 1.47 ± 0.1, P > 0.05) (mean ± SEM). Resting cardiovascular responses were not affected by hormonal phase or OCP use, except that the SBP was higher in the OCP users than non-OCP users in all phases of the cycle (P < 0.05). In summary, our results demonstrate that cardiac vagal withdrawal at the onset of dynamic exercise was not impacted by the menstrual cycle or OCP use in physically active women.
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Affiliation(s)
- André L. Teixeira
- Maternity Hospital Therezinha de Jesus, Faculty of Medical and Health Sciences—SUPREMA, Juiz de Fora, MG, Brazil
- Postgraduate Program in Exercise and Sports Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Plinio S. Ramos
- Maternity Hospital Therezinha de Jesus, Faculty of Medical and Health Sciences—SUPREMA, Juiz de Fora, MG, Brazil
- Postgraduate Program in Exercise and Sports Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Lauro C. Vianna
- Faculty of Physical Education, University of Brasília, Brasília, DF, Brazil
| | - Djalma R. Ricardo
- Maternity Hospital Therezinha de Jesus, Faculty of Medical and Health Sciences—SUPREMA, Juiz de Fora, MG, Brazil
- Postgraduate Program in Exercise and Sports Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
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22
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Cardiac acceleration at the onset of exercise: a potential parameter for monitoring progress during physical training in sports and rehabilitation. Sports Med 2014; 44:591-602. [PMID: 24469736 DOI: 10.1007/s40279-013-0141-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
There is a need for easy-to-use methods to assess training progress in sports and rehabilitation research. The present review investigated whether cardiac acceleration at the onset of physical exercise (HRonset) can be used as a monitoring variable. The digital databases of Scopus and PubMed were searched to retrieve studies investigating HRonset. In total 652 studies were retrieved. These articles were then classified as having emphasis on HRonset in a sports or rehabilitation setting, which resulted in 8 of 112 studies with a sports application and 6 of 68 studies with a rehabilitation application that met inclusion criteria. Two co-existing mechanisms underlie HRonset: feedforward (central command) and feedback (mechanoreflex, metaboreflex, baroreflex) control. A number of studies investigated HRonset during the first few seconds of exercise (HRonsetshort), in which central command and the mechanoreflex determine vagal withdrawal, the major mechanism by which heart rate (HR) increases. In subsequent sports and rehabilitation studies, interest focused on HRonset during dynamic exercise over a longer period of time (HRonsetlong). Central command, mechanoreflexes, baroreflexes, and possibly metaboreflexes contribute to HRonset during the first seconds and minutes of exercise, which in turn leads to further vagal withdrawal and an increase in sympathetic activity. HRonset has been described as the increase in HR compared with resting state (delta HR) or by exponential modeling, with measurement intervals ranging from 0-4 s up to 2 min. Delta HR was used to evaluate HRonsetshort over the first 4 s of exercise, as well as for analyzing HRonsetlong. In exponential modeling, the HR response to dynamic exercise is biphasic, consisting of fast (parasympathetic, 0-10 s) and slow (sympathetic, 1-4 min) components. Although available studies differed largely in measurement protocols, cross-sectional and longitudinal training studies showed that studies analyzing HRonset in relation to physical training primarily incorporated HRonsetlong. HRonsetlong slowed in athletes as well as in patients with a coronary disease, who have a relatively fast HRonsetlong. It is advised to include both HRonsetlong and HRonsetshort in further studies. The findings of this review suggest that HRonset is a potential tool for monitoring and titrating training in sports as well as in rehabilitation settings, particularly in patients with ventricular fibrillation. Monitoring HRonset in the early phase of training can help optimize the effectiveness of training and therapy. More research is needed to gain a better understanding of the mechanisms underlying HRonset in relation to their application in sports and rehabilitation settings.
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23
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Zaniqueli D, Morra EA, Dantas EM, Baldo MP, Carletti L, Perez AJ, Rodrigues SL, Mill JG. Heart rate at 4 s after the onset of exercise in endurance-trained men. Can J Physiol Pharmacol 2014; 92:476-80. [PMID: 24886303 DOI: 10.1139/cjpp-2014-0042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
It has been suggested that the increase in heart rate (HR) at the onset of exercise is caused by vagal withdrawal. In fact, endurance runners show a lower HR in maximum aerobic tests. However, it is still unknown whether endurance runners have a lower HR at 4 s after the onset of exercise (4th-sec-HR). We sought to measure the HR at the onset of the 4 s exercise test (4-sET), clarifying its relationship to heart rate variability (HRV), spectral indices, and cardiac vagal index (CVI) in endurance runners (ER) and healthy untrained controls (CON). HR at 4th-sec-HR, CVI, and percent HR increase during exercise were analyzed in the 4-sET. High frequency spectrum (HF-nu), low frequency spectrum (LF-nu), and low frequency/high frequency band ratio (LF/HF) were analyzed from the HRV. ER showed a significantly higher HF, and both a lower LF and LF/HF ratio compared with the CON. ER presented a significantly lower 4th-sec-HR, although neither CVI nor HR increases during exercise were statistically different from the CON. In conclusion, ER presented a lower 4th-sec-HR secondary to increased vagal influence over the sinus node. CVI seems to be too weak to use for discriminating individuals with respect to the magnitude of HR vagal control.
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Affiliation(s)
- Divanei Zaniqueli
- Department of Physiological Sciences, Federal University of Espírito Santo, Avenida Marechal Campos 1468, Maruipe, Vitoria, Espirito Santo 29042-751, Brazil
| | - Elis Aguiar Morra
- Centre of Physical Education and Sports, Federal University of Espírito Santo, Vitória, Espirito Santo, Brazil
| | - Eduardo Miranda Dantas
- Department of Physiological Sciences, Federal University of Espírito Santo, Avenida Marechal Campos 1468, Maruipe, Vitoria, Espirito Santo 29042-751, Brazil
| | - Marcelo Perim Baldo
- Department of Physiological Sciences, Federal University of Espírito Santo, Avenida Marechal Campos 1468, Maruipe, Vitoria, Espirito Santo 29042-751, Brazil
| | - Luciana Carletti
- Centre of Physical Education and Sports, Federal University of Espírito Santo, Vitória, Espirito Santo, Brazil
| | - Anselmo José Perez
- Centre of Physical Education and Sports, Federal University of Espírito Santo, Vitória, Espirito Santo, Brazil
| | - Sérgio Lamêgo Rodrigues
- Department of Physiological Sciences, Federal University of Espírito Santo, Avenida Marechal Campos 1468, Maruipe, Vitoria, Espirito Santo 29042-751, Brazil
| | - José Geraldo Mill
- Department of Physiological Sciences, Federal University of Espírito Santo, Avenida Marechal Campos 1468, Maruipe, Vitoria, Espirito Santo 29042-751, Brazil
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24
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Lawrence MM, Cooley ID, Huet YM, Arthur ST, Howden R. Factors influencing isometric exercise training-induced reductions in resting blood pressure. Scand J Med Sci Sports 2014; 25:131-42. [DOI: 10.1111/sms.12225] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2014] [Indexed: 01/13/2023]
Affiliation(s)
- M. M. Lawrence
- Laboratory of Systems Physiology; Department of Kinesiology; University of North Carolina at Charlotte; Charlotte North Carolina USA
| | - I. D. Cooley
- Laboratory of Systems Physiology; Department of Kinesiology; University of North Carolina at Charlotte; Charlotte North Carolina USA
| | - Y. M. Huet
- Laboratory of Systems Physiology; Department of Kinesiology; University of North Carolina at Charlotte; Charlotte North Carolina USA
| | - S. T. Arthur
- Laboratory of Systems Physiology; Department of Kinesiology; University of North Carolina at Charlotte; Charlotte North Carolina USA
| | - R. Howden
- Laboratory of Systems Physiology; Department of Kinesiology; University of North Carolina at Charlotte; Charlotte North Carolina USA
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25
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Freeman SR, Hanik SAE, Littlejohn ML, Malandruccolo AA, Coughlin J, Warren B, McGowan CL. Sit, breathe, smile: effects of single and weekly seated Qigong on blood pressure and quality of life in long-term care. Complement Ther Clin Pract 2013; 20:48-53. [PMID: 24439645 DOI: 10.1016/j.ctcp.2013.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 10/10/2013] [Accepted: 10/14/2013] [Indexed: 10/26/2022]
Abstract
Long-term care (LTC) facilities house individuals with diverse combinations of cognitive and physical impairments, and the practice of Seated Qigong eliminates common exercise barriers. This study hypothesized: 1) a single session would lower blood pressure (BP) and improve quality of life (QOL) in a generalized LTC population, and 2) these responses would be attenuated with chronic (weekly) Seated Qigong practice. Ten residents (6 female; 86 ± 7 years) participated in 1X/week Seated Qigong sessions for 10-weeks. BP and QOL were assessed pre- and post-session at baseline and following 5- and 10-weeks of Qigong. Systolic BP was significantly reduced immediately post-session after 10-weeks of Qigong (P = 0.03), yet unchanged at baseline and after 5-weeks (all P > 0.05). Diastolic BP and QOL remained unchanged (P > 0.05). A session of Seated Qigong elicits a hypotensive response with exposure, supporting the notion that repeated sessions may provide advantageous health benefits.
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Affiliation(s)
- Shane R Freeman
- Physical Activity and Cardiovascular Research Laboratory, Department of Kinesiology, University of Windsor, 401 Sunset Ave., Windsor, Ontario, Canada N9B 3P4.
| | - Sarah-Anne E Hanik
- Physical Activity and Cardiovascular Research Laboratory, Department of Kinesiology, University of Windsor, 401 Sunset Ave., Windsor, Ontario, Canada N9B 3P4.
| | - Meagan L Littlejohn
- Physical Activity and Cardiovascular Research Laboratory, Department of Kinesiology, University of Windsor, 401 Sunset Ave., Windsor, Ontario, Canada N9B 3P4.
| | - Amanda A Malandruccolo
- Physical Activity and Cardiovascular Research Laboratory, Department of Kinesiology, University of Windsor, 401 Sunset Ave., Windsor, Ontario, Canada N9B 3P4.
| | - Joanna Coughlin
- School of Dramatic Art, Faculty of Arts and Social Sciences, University of Windsor, 401 Sunset Ave., Windsor, Ontario, Canada N9B 3P4.
| | - Bernie Warren
- School of Dramatic Art, Faculty of Arts and Social Sciences, University of Windsor, 401 Sunset Ave., Windsor, Ontario, Canada N9B 3P4; Schlegel-University of Waterloo Research Institute for Aging, 325 Max Becker Dr., Suite 202, Kitchener, Ontario, Canada N2E 4H5.
| | - Cheri L McGowan
- Physical Activity and Cardiovascular Research Laboratory, Department of Kinesiology, University of Windsor, 401 Sunset Ave., Windsor, Ontario, Canada N9B 3P4; Schlegel-University of Waterloo Research Institute for Aging, 325 Max Becker Dr., Suite 202, Kitchener, Ontario, Canada N2E 4H5.
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26
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Goldring N, Wiles JD, Coleman D. The effects of isometric wall squat exercise on heart rate and blood pressure in a normotensive population. J Sports Sci 2013; 32:129-36. [PMID: 23879248 DOI: 10.1080/02640414.2013.809471] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The isometric wall squat could be utilised in home-based training aimed at reducing resting blood pressure, but first its suitability must be established. The aim of this study was to determine a method of adjusting wall squat intensity and explore the cardiovascular responses. Twenty-three participants performed one 2 minute wall squat on 15 separate occasions. During the first ten visits, ten different knee joint angles were randomly completed from 135° to 90° in 5° increments; five random angles were repeated in subsequent visits. Heart rate and blood pressure (systolic, diastolic and mean arterial pressure) were measured. The heart rate and blood pressure parameters produced significant inverse relationships with joint angle (r at least -0.80; P < 0.05), demonstrating that wall squat intensity can be adjusted by manipulating knee joint angle. Furthermore, the wall squat elicited similar cardiovascular responses to other isometric exercise modes that have reduced resting blood pressure (135° heart rate: 76 ± 10 beats ∙ min(-1); systolic: 134 ± 14 mmHg; diastolic: 76 ± 6 mmHg and 90° heart rate: 119 ± 20 beats ∙ min(-1); systolic: 196 ± 18 mmHg; diastolic: 112 ± 13 mmHg). The wall squat may have a useful role to play in isometric training aimed at reducing resting blood pressure.
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Affiliation(s)
- Natalie Goldring
- a Department of Sport Science , Tourism and Leisure, Canterbury Christ Church University , Canterbury , UK
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27
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Olher RDRV, Bocalini DS, Bacurau RF, Rodriguez D, Figueira A, Pontes FL, Navarro F, Simões HG, Araujo RC, Moraes MR. Isometric handgrip does not elicit cardiovascular overload or post-exercise hypotension in hypertensive older women. Clin Interv Aging 2013; 8:649-55. [PMID: 23766641 PMCID: PMC3678710 DOI: 10.2147/cia.s40560] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Arterial hypertension is a serious health problem affecting mainly the elderly population. Recent studies have considered both aerobic and resistance exercises as a non-pharmacological aid for arterial hypertension treatment. However, the cardiovascular responses of the elderly to isometric resistance exercise (eg, isometric handgrip [IHG]) have not yet been documented. OBJECTIVE The purpose of this study was to investigate cardiovascular responses to different intensities of isometric exercise, as well as the occurrence of post-isometric exercise hypotension in hypertensive elderly people under antihypertensive medication treatment. PATIENTS AND METHODS Twelve women volunteered to participate in the study after a maximal voluntary contraction test (MVC) and standardization of the intervention workload consisting of two sessions of IHG exercise performed in four sets of five contractions of a 10-second duration. Sessions were performed both at 30% of the MVC and 50% of the MVC, using a unilateral IHG protocol. Both intensities were compared with a control session without exercise. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) at rest (R), during peak exercise (PE), and after 5, 10, 15, 30, 45, and 60 minutes of post-exercise recovery were evaluated. RESULTS No significant changes were observed after isometric exercise corresponding to 30% MVC for either SBP (R: 121 ± 10; PE: 127 ± 14; 5 min: 125 ± 13; 10 min: 123 ± 12; 15 min: 122 ± 11; 30 min: 124 ± 11; 45 min: 124 ± 10; 60 min: 121 ± 10 mmHg) or DBP (R: 74 ± 9; PE: 76 ± 6; 5 min: 74 ± 5; 10 min: 72 ± 8; 15 min: 72 ± 5; 30 min: 72 ± 8; 45 min: 73 ± 6; 60 min: 75 ± 7 mmHg). Similarly, the 50% MVC did not promote post-isometric exercise hypotension for either SBP (R: 120 ± 7; PE: 125 ± 11; 5 min: 120 ± 9; 10 min: 122 ± 9; 15 min: 121 ± 11; 30 min: 121 ± 9; 45 min: 121 ± 9; 60 min: 120 ± 7 mmHg) or DBP (R: 72 ± 8; PE: 78 ± 7; 5 min: 72 ± 7; 10 min: 72 ± 8; 15 min: 71 ± 7; 30 min: 72 ± 8; 45 min: 75 ± 10; 60 min: 75 ± 7 mmHg). CONCLUSION Our data reveal that cardiovascular overload or post-exercise hypotension did not occur in elderly women with controlled hypertension when they undertook an IHG session. Thus this type of resistance exercise, with mild to moderate intensity, with short time of contraction appears to be safe for this population.
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Affiliation(s)
| | | | - Reury Frank Bacurau
- Universidade de São Paulo – Escola de Artes, Ciências e Humanidades, São Paulo
| | | | | | | | | | | | | | - Milton Rocha Moraes
- Universidade Federal de São Paulo – Escola Paulista de Medicina, São Paulo, Brazil
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Effects of isometric handgrip training dose on resting blood pressure and resistance vessel endothelial function in normotensive women. Eur J Appl Physiol 2013; 113:2091-100. [PMID: 23588257 DOI: 10.1007/s00421-013-2644-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 04/08/2013] [Indexed: 10/27/2022]
Abstract
Isometric handgrip (IHG) training lowers resting blood pressure (BP) in both hypertensives and normotensives, yet the effect of training dose on the magnitude of reduction and the mechanisms associated with the hypotensive response are elusive. We investigated, in normotensive women, the effects of two different doses of IHG training on resting BP, and explored improved resistance vessel endothelial function and heart rate variability (HRV) as potential mechanisms of BP reduction. Resting BP, HRV, and resistance vessel endothelial function (venous strain-gauge plethysmography with reactive hyperemia) were assessed in 32 women before and after 4 and 8 weeks of 3×/week (n = 12) or 5×/week (n = 11) IHG training (four, 2-min unilateral contractions at 30 % maximal voluntary contraction), or 0×/week control (n = 9). IHG training decreased systolic BP in the 3×/week (94 ± 6 to 91 ± 6 to 88 ± 5 mmHg, pre- to mid- to post-training; P < 0.01) and 5×/week (97 ± 11 to 90 ± 9 to 91 ± 9 mmHg, P < 0.01) groups, concomitant with increased forearm reactive hyperemic blood flow (26 ± 7 to 30 ± 8 to 36 ± 9 mL/min/100 mL tissue, P < 0.01; and 26 ± 7 to 29 ± 7 to 38 ± 13 mL/min/100 mL tissue, P < 0.01, respectively), yet both remained unchanged in the control group. No changes were observed in diastolic BP, mean arterial BP, or any indices of HRV in any group (all P > 0.05). In conclusion, IHG training lowers resting systolic BP and improves resistance vessel endothelial function independent of training dose in normotensive women.
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Abstract
Double-leg isometric training has been demonstrated to reduce resting blood pressure in young men when using electromyographic activity (EMG) to regulate exercise intensity. This study assessed this training method in healthy older (45–60 years.) men. Initially, 35 older men performed an incremental isometric exercise test to determine the linearity of the heart rate versus percentage peak EMG (%EMGpeak) and systolic blood pressure versus %EMGpeak relationship. Thereafter, 20 participants were allocated to a training or control group. The training group performed three double-leg isometric sessions per week for 8 weeks, at 85% of peak heart rate. The training resulted in a significant reduction in resting systolic (11 ± 8 mmHg, P < 0.05) and mean arterial (5 ± 7 mmHg, P < 0.05) blood pressure. There was no significant change in resting systolic blood pressure for the control group or diastolic blood pressure in either group (all P > 0.05). These findings show that this training method, used previously in young men, is also effective in reducing resting systolic and mean arterial blood pressure in older men.
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Affiliation(s)
- Anthony W Baross
- Sport and Exercise Science, University of Northampton, Northampton, UK
| | - Jonathan D Wiles
- Sport and Exercise Science, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Ian L Swaine
- Sport and Exercise Science, Canterbury Christ Church University, Canterbury, Kent, UK
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30
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Effects of the intensity of leg isometric training on the vasculature of trained and untrained limbs and resting blood pressure in middle-aged men. Int J Vasc Med 2012; 2012:964697. [PMID: 22991668 PMCID: PMC3443998 DOI: 10.1155/2012/964697] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 07/20/2012] [Accepted: 07/26/2012] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to establish whether changes in resting blood pressure and the vasculature of trained and untrained limbs are dependent on training intensity, following isometric-leg training. Thirty middle-aged males undertook an 8 week training programme (4 × 2 min bilateral-leg isometric contractions 3 times per week). Two groups trained at either high (HI; 14%MVC) or low (LO; 8%MVC) intensity a third group (CON) acted as controls. All parameters were measured at baseline, 4-weeks and post-training. Resting SBP (−10.8 ± 7.9 mmHg), MAP (−4.7 ± 6.8 mmHg) and HR (−4.8 ± 5.9 b·min−1) fell significantly in the HI group post-training with concomitant significant increases in resting femoral mean artery diameter (FMAD; 1.0 ± 0.4 mm), femoral mean blood velocity (FMBV; 0.68 ± 0.83 cm·s−1), resting femoral artery blood flow (FABF; 82.06 ± 31.92 ml·min−1) and resting femoral vascular conductance (FVC, 45%). No significant changes occurred in any brachial artery measure nor in any parameters measured in the LO or CON groups. These findings show that training-induced reductions in resting blood pressure after isometric-leg training in healthy middle-aged men are associated with concomitant adaptations in the local vasculature, that appear to be dependent on training intensity and take place in the later stages of training.
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Millar PJ, McGowan CL. Serial remote ischemic preconditioning and rhythmic isometric exercise training: A hypothesis. Med Hypotheses 2012; 78:822-3. [DOI: 10.1016/j.mehy.2012.03.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 03/22/2012] [Indexed: 11/24/2022]
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Millar PJ, Levy AS, McGowan CL, McCartney N, MacDonald MJ. Isometric handgrip training lowers blood pressure and increases heart rate complexity in medicated hypertensive patients. Scand J Med Sci Sports 2012; 23:620-6. [PMID: 22260503 DOI: 10.1111/j.1600-0838.2011.01435.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2011] [Indexed: 11/27/2022]
Abstract
Hypertension is characterized by elevated blood pressure (BP) and autonomic dysfunction, both thought to be improved with exercise training. Isometric handgrip (IHG) training may represent a beneficial, time-effective exercise therapy. We investigated the effects of IHG training on BP and traditional and nonlinear measures of heart rate variability (HRV). Pre- and post-measurements of BP and HRV were determined in 23 medicated hypertensive participants (mean ± SEM, 66 ± 2 years) following either 8 weeks of IHG training (n = 13) or control (n = 10). IHG exercise consisted of four unilateral 2-min isometric contractions at 30% of maximal voluntary contraction, each separated by 4 min of rest. IHG training was performed 3 days/week for 8 weeks. IHG training decreased systolic BP (125 ± 3 mmHg to 120 ± 2 mmHg, P < 0.05) and mean BP (90 ± 2 mmHg to 87 ± 2 mmHg, P < 0.05), while sample entropy was increased (1.07 ± 0.1 to 1.35 ± 0.1, P < 0.05) and the fractal scaling distance score was decreased (0.34 ± 0.1 to 0.19 ± 0.1, P < 0.05). No significant changes were observed in traditional spectral or time-domain measures of HRV or control participants. IHG training improves nonlinear HRV, but not traditional HRV, while reducing systolic and mean BP. These results may highlight the benefits of IHG training for patients with primary hypertension.
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Affiliation(s)
- P J Millar
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
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Woolf KJ, Bisognano JD. Nondrug interventions for treatment of hypertension. J Clin Hypertens (Greenwich) 2011; 13:829-835. [PMID: 22051428 PMCID: PMC8112377 DOI: 10.1111/j.1751-7176.2011.00524.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Revised: 06/14/2011] [Accepted: 06/15/2011] [Indexed: 01/05/2024]
Abstract
The treatment of hypertension is no longer limited to the simple prescription of pharmaceuticals. For many patients, maximal medical therapy is insufficient to adequately treat refractory hypertension. In addition, some patients may prefer to explore therapies that do not involve drugs as an initial step. Utilizing our broadening understanding of the physiology of hypertension, new technology and interventions have been developed that allow for treatments that do not rely on medications. In addition, dietary supplements and modification, as well as herbal supplements, may be useful under the right circumstances. Lifestyle modification remains a necessary part of treatment for all patients with hypertension. This article will review the evidence behind some available nondrug interventions for the treatment of hypertension.
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Affiliation(s)
- Kevin J. Woolf
- From the Division of Cardiology, University of Rochester Medical Center, Rochester, NY
| | - John D. Bisognano
- From the Division of Cardiology, University of Rochester Medical Center, Rochester, NY
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Mortimer J, McKune AJ. Effect of short-term isometric handgrip training on blood pressure in middle-aged females. Cardiovasc J Afr 2010; 22:257-60. [PMID: 21161116 PMCID: PMC3721942 DOI: 10.5830/cvja-2010-090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2009] [Accepted: 11/26/2010] [Indexed: 11/06/2022] Open
Abstract
Objective To determine the effect of isometric handgrip training on blood pressure (BP) in middle-aged women (47.88 ± 1.8 years). Methods Isometric handgrip training was performed over five consecutive days. In each session, the treatment group (n = 9) performed four isometric contractions of 45 seconds each at 30% of their maximal grip strength. The control group (n = 9) sat for 15 minutes without exercising, for five consecutive days. Resting systolic (SBP) and diastolic blood pressure (DBP) were measured pre- and post-intervention. Data were analysed using a two-factor ANOVA (p ≤ 0.05). Results Blood pressure readings were reduced in both groups (SBP: p = 0.036; DBP: p = 0.0079), however there was no interaction effect for SBP or DBP. Conclusions The findings suggest that 15 minutes of sitting per day for five consecutive days is just as effective as isometric handgrip training for reducing BP levels. Future research is required to investigate the optimal isometric handgrip training stimulus required to reduce resting BP levels.
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Affiliation(s)
- J Mortimer
- Discipline of Sports Science, School of Physiotherapy, Sports Science and Optometry, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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