Effect of type 2 diabetes on plasma kallikrein activity after physical exercise and its relationship to post-exercise hypotension

Exaggerated post exercise hypotension following concentric but not eccentric resistance exercise: Implications for metabolism

Post exercise hypotension (PEH) is primarily attributed to post-exercise vasodilation via central and peripheral mechanisms. However, the specific contribution of metabolic cost during exercise, independent of force production, is less clear. This study aimed to use isolated concentric and eccentric exercise to examine the role of metabolic activity in eliciting PEH, independent of total work. Twelve participants (6 male) completed upper and lower body concentric (CONC), eccentric (ECC), and traditional (TRAD) exercise sessions matched for work (3 × 10 in TRAD and 3 × 20 in CONC and ECC; all at 65% 1RM). Blood pressure was collected at baseline and every 15 min after exercise for 120 min. Brachial blood flow and vascular conductance were also assessed at baseline, immediately after exercise, and every 30 min after exercise. ⩒O₂ was lower during ECC compared to CONC and TRAD (-2.7 mL/Kg/min ± 0.4 and -2.2 mL/Kg/min ± 0.4, respectively p < 0.001). CONC augmented the PEH response (Peak ΔMAP -3.3 mmHg ± 0.9 [mean ± SE], p = 0.006) through 75 min of recovery and ECC elicited a post-exercise hypertensive response through 120 min of recovery (Peak ΔMAP +4.5 mmHg ± 0.8, p < 0.001). CONC and TRAD elicited greater increases in brachial blood flow post exercise than ECC (Peak Δ brachial flow +190.4 mL/min ± 32.3, +202.3 mL/min ± 39.2, and 69.6 mL/min ± 19.8, respectively, p ≤ 0.005), while conductance increased immediately post exercise in all conditions and then decreased throughout recovery following ECC (-32.9 mL/min/mmHg ± 9.3, p = 0.005). These data suggest that more metabolically demanding concentric exercise augments PEH compared to work-matched eccentric exercise.

Fractionated Concurrent Exercise throughout the Day Does Not Promote Acute Blood Pressure Benefits in Hypertensive Middle-aged Women

Hypertension is a chronic disease that affects about 30% of the world’s population, and the physical exercise plays an important role on its non-pharmacological treatment. Anywise, the dose–response of physical exercise fractionation throughout the day demands more investigation, allowing new exercise prescription possibilities. Therefore, this study aimed to analyze the acute blood pressure (BP) kinetics after 1 h of exercises and the BP reactivity after different concurrent exercise (CE) sessions and its fractioning of hypertensive middle-aged women. In this way, 11 hypertensive women voluntarily underwent three experimental sessions and one control day [control session (CS)]. In the morning session (MS) and night session (NS), the exercise was fully realized in the morning and evening, respectively. For the fractionized session (FS), 50% of the volume was applied in the morning and the remaining 50% during the evening. The MS provided the greatest moments (p ≤ 0.05) of post-exercise hypotension (PEH) for systolic BP (SBP) and highest reduction of BP reactivity for SBP (~44%) and diastolic BP (DBP) (~59%) compared to CS (p ≤ 0.05). The findings of the present study have shown that MS is effective for PEH to SBP, as well as it promotes high quality of attenuation for BP reactivity, greater than the other sessions.

Contact Karate Promotes Post-Exercise Hypotension in Young Adult Males

Background

Worldwide, systemic arterial hypertension is a leading cause of death and non-communicable cardiovascular disease. A major factor contributing to this disease is a sedentary lifestyle. However, physical exercise, such as martial arts, may be an option for blood pressure (BP) control. The magnitude of post-exercise hypotension is associated with a prolonged decrease in BP in normotensive and hypertensive individuals.

Objectives

The present study aimed to verify the effects of a Contact Karate (CK) session on BP responses during a post-exercise recovery period in young adults.

Patients and Methods

Thirty-two male CK athletes volunteered (28.2 ± 6.7 years; 77.0 ± 5.7 kg; and 176.0 ± 4.7 cm) and underwent one CK session (50 minutes) and a control session in which no exercise was performed and the individuals remain seated during the whole time. BP was measured during rest (before sessions), as well as on the 15th, 30th, 45th, and 60th minutes of the post-exercise recovery.

Results

The systolic (SBP), diastolic (DBP), and mean arterial pressure (MAP) were significantly lower at the post-exercise period compared to pre-exercise rest (P < 0.05), with the largest reductions being observed at the 60th minutes of recovery [SBP (rest: 125.9 ± 4.7 vs. 60th minutes of recovery: 111.7 ± 5.4 mmHg); DBP (rest: 78.8 ± .7 vs. 60th minutes of recovery: 69.8 ± 2.7 mmHg)] and at the same periods of post-exercise recovery of the control session.

Conclusions

A single CK session can promote a decrease in BP for at least 60 minutes after performing this type of exercise in young adults.

Double product break point estimates ventilatory threshold in individuals with type 2 diabetes

[Purpose] To verify the identification of the anaerobic threshold through the double product breakpoint (DPBP) method for individuals with type 2 diabetes. [Subjects and Methods] Nine individuals with T2D (7 females; age=63.2 ± 8.9 y) and 10 non-diabetic (ND) (7 females; age=58.3 ± 7.8 y) performed an incremental exercise test on a cycle ergometer. Heart rate (HR), blood pressure (BP) and expired gas were measured at the end of each stage. The ventilatory threshold (VT) and DPBP were considered as the exercise intensities above which an over proportional increases in VE and DP were observed in relation to increasing workload. [Results] No differences were observed between the workloads, HR and VO2 corresponding to the AT identified respectively by VT and DPBP. For the T2D, strong correlations between VT and DBPB workloads (r=0.853), HR (r=0.714), and VO2 (r=0.863) were found. These relationships were similar to those found for the control group (r=0.923; r=0.881; and r=0.863, respectively). [Conclusion] These results demonstrate that the DPBP enables for the prediction of AT and correlated well the VT in both the T2D and ND participants.

The period of the day affects the twenty-four hour blood pressure response to an acute combined exercise session in Brazilian jiu jitsu athletes

AbstractThe purpose of this study was to compare the effect of a combined exercise session performed at different periods of the day on the 24h blood pressure (BP) response. Anaerobic threshold (AT) and 12 repetition maximum (12RM) tests were evaluated in nine Brazilian jiu-jitsu athletes (male) (22±3.7 y; 176±5.0 cm; 73.4±9.7 kg; 6.8±2.1 % body fat). Four experimental sessions were performed: resistance exercise followed by aerobic exercise [Morning (MornS) and Afternoon (AfternS)] and Control (C) [Morning and Afternoon]. The morning sessions were conducted at 09:00 a.m. and the afternoon sessions were conducted at 3:00 p.m. The resistance exercise consisted of three sets at 90% of a 12RM for six resistance exercises. The aerobic exercise consisted of 15min at 90% of the AT. Blood pressure (BP) was measured before, during and 1h (Microlife(r) BP3A1C) after the performance of exercises in laboratory, and then during daily activities for the succeeding 23h by ambulatory BP monitoring (Dyna-MAPA(r)). Analysis of the area under the curve (AUC) indicated significant reductions in blood pressure parameters at various time points during the 24h monitoring period. For systolic BP (SBP), significantly lower values were shown following the morning session versus the control (MornS: 1756.2±100.8 vs. C: 1818.2±84.3 mmHg*15h; p < .05) and total-24h (MornS: 2695.8±143.3 vs. C: 2784.1±143.2 mmHg*24h; p < .05). The total-24h mean BP (MAP) was also significantly lower following the morning session versus the control (MornS: 2015.7±121.2 vs. C: 2087.3±153.8 mmHg*24h; p < .05). There were significant differences in the sleeping AUC of SBP (AfternS: 883.6±27.0 vs. C: 965.2±67.9 mmHg*9h; p< .05), diastolic BP (DBP) (AfternS: 481.4±30.9 vs. MornS: 552.9±34.2 and C: 562.1±52.3 mmHg*9h; p < .01) and MBP (AfternS: 651.9±22.4 vs. MornS: 708.7±43.1 and C: 726.9±64.7 mmHg*9h; p < .01). The combined exercise performed at different periods of the day contributed distinctly to the reduction of BP. The morning session was important in reducing SBP and MBP in the total-24h monitoring, while the afternoon session reduced SBP, DBP and MBP during sleeping in jiu-Jitsu athletes.

Post-exercise hypotension of normotensive young men through track running sessions

INTRODUCTION: After a single session of physical exercise the blood pressure is reduced (post-exercise hypotension, PHE) and it has been considered as a non-pharmacological mechanism to control the blood pressure. When the exercise is performed since youth it can prevent or avoid hypertension. However, it is important to consider studies with clear practical applications to optimize its reproducibility on a daily basis. OBJECTIVE: Analyze the PEH of normotensive and physically active young men after two track running sessions (maximum and submaximal). METHODS: Participated in this study 62 physically active young men (23.3 ± 4.2 years old; 75.5 ± 9.8 kg; 177.7 ± 5.5 cm; 12.0 ± 4.6% body fatF; 52.4 ± 4.0 mL.kg-1.min-1oxygen uptake), which performed a maximum laboratory exercise test for determination of maximal oxygen uptake (VO2max - aerobic power) and subsequently three randomly running sessions (maximum - T1600; submaximal - T20; control - CON), with 48h interval between themselves. Blood pressure (BP) was measured each 15min during a 60 min period after sessions. RESULTS: Both the maximum and the submaximal exercise lead to PEH. The post-exercise values of systolic blood pressure and diastolic blood pressure differed from resting value in session T20 (p<0.05). The same pattern occurred after T1600 (p<0.05), evidenced from 30th minute post-exercise. The CON did not result in PEH. The magnitude of decay for the mean BP at the 45th after maximum exercise was higher than the other sessions (p<0.05). CONCLUSION: We concluded that both maximum and submaximal exercises, performed on a track running condition, caused PEH in young normotensive and physically active men.

Effects of aerobic exercise intensity on 24-h ambulatory blood pressure in individuals with type 2 diabetes and prehypertension

[Purpose] To verify the effects of different intensities of aerobic exercise on 24-hour ambulatory blood pressure (BP) responses in individuals with type 2 diabetes mellitus (T2D) and prehypertension. [Subjects and Methods] Ten individuals with T2D and prehypertension (55.8 ± 7.7 years old; blood glucose 133.0 ± 36.7 mg·dL⁻¹ and awake BP 130.6 ± 1.6/ 80.5 ± 1.8 mmHg) completed three randomly assigned experiments: non-exercise control (CON) and exercise at moderate (MOD) and maximal (MAX) intensities. Heart rate (HR), BP, blood lactate concentrations ([Lac]), oxygen uptake (VO₂), and rate of perceived exertion (RPE) were measured at rest, during the experimental sessions, and during the 60 min recovery period. After this period, ambulatory blood pressure was monitored for 24 h. [Results] The results indicate that [Lac] (MAX: 6.7±2.0 vs. MOD: 3.8±1.2 mM), RPE (MAX: 19±1.3 vs. MOD: 11±2.3) and VO₂peak (MAX: 20.2±4.1 vs. MOD: 14.0±3.0 mL·kg⁻¹·min⁻¹) were highest following the MAX session. Compared with CON, only MAX elicited post-exercise BP reduction that lasted for 8 h after exercise and during sleep. [Conclusion] A single session of aerobic exercise resulted in 24 h BP reductions in individuals with T2D, especially while sleeping, and this reduction seems to be dependent on the intensity of the exercise performed.

Increased lactate threshold after five weeks of treadmill aerobic training in rats

The aim of the present study was to analyse the lactate threshold (LT) changes in rats submitted to an aerobic treadmill-training programme. Twenty-five Wistar rats were divided into two groups: a sedentary control group (CG), and a trained group (TG) submitted to an aerobic training during 5 weeks. All the animals were submitted to an incremental treadmill exercise test in order to determine LT. There was an increase in the maximum running speed in the TG (from 32.25 ± 1.27 to 47.75 ± 3.13 m.min-1 - p = 0.001), and running speed at LT (from 26.21 ± 1.15 to 35.30 ± 2.24 m.min-1 - p = 0.004), a part from the reduction in blood lactate at LT. LT can be determined in rats, and aerobic training induced positive oxidative physiological adaptations in the animals.

Acute effects of physical exercise in type 2 diabetes: A review

The literature has shown the efficiency of exercise in the control of type 2 diabetes (T2D), being suggested as one of the best kinds of non-pharmacological treatments for its population. Thus, the scientific production related to this phenomenon has growing exponentially. However, despite its advances, still there is a lack of studies that have carried out a review on the acute effects of physical exercise on metabolic and hemodynamic markers and possible control mechanisms of these indicators in individuals with T2D, not to mention that in a related way, these themes have been very little studied today. Therefore, the aim of this study was to organize and analyze the current scientific production about the acute effects of physical exercise on metabolic and hemodynamic markers and possible control mechanisms of these indicators in T2D individuals. For such, a research with the following keywords was performed: -exercise; diabetes and post-exercise hypotension; diabetes and excess post-exercise oxygen consumption; diabetes and acute effects in PUBMED, SCIELO and HIGHWIRE databases. From the analyzed studies, it is possible to conclude that, a single exercise session can promote an increase in the bioavailability of nitric oxide and elicit decreases in postexercise blood pressure. Furthermore, the metabolic stress from physical exercise can increase the oxidation of carbohydrate during the exercise and keep it, in high levels, the post exercise consumption of O_², this phenomenon increases the rate of fat oxidation during recovery periods after exercise, improves glucose tolerance and insulin sensitivity and reduces glycemia between 2-72 h, which seems to be dependent on the exercise intensity and duration of the effort.

Combined exercise circuit session acutely attenuates stress-induced blood pressure reactivity in healthy adults

Objective

To investigate the blood pressure (BP) responses to cardiovascular stress test after a combined exercise circuit session at moderate intensity.

Method

Twenty individuals (10 male/10 fem; 33.4± 6.9 years; 70.2± 15.8 kg; 170.4± 11.5 cm; 22.3± 6.8% body fat) were randomized in a different days to control session with no exercise or exercise session consisting of 3 laps of the following circuit: knee extension, bench press, knee flexion, rowing in the prone position, squats, shoulder press, and 5 min of aerobic exercise at 75-85% of age-predicted maximum heart rate and/or 13 on the Borg Rating of Perceived Exertion [scale of 6 to 20]. The sets of resistance exercise consisted of 15 repetitions at ~50% of the estimated 1 repetition maximum test. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured at rest and during 1h of recovery in both experimental sessions. After that, blood pressure reactivity (BP_R) was evaluated using the Cold Pressor Test.

Results

During 1h of exercise recovery, there was a reduction in SBP (3-6 mmHg) and DBP (2-5 mmHg) in relation to pre-session rest (p<0.01), while this reduction was not observed in the control session. A decline in BP_R (4-7 mmHg; p<0.01) was observed 1h post-exercise session, but not in the control session. Post-exercise reductions in SBP and DBP were significantly correlated with BP_R reductions (r=0.50-0.45; p<0.05).

Conclusion

A combined exercise circuit session at moderate intensity promoted subsequent post-exercise hypotension and acutely attenuated BP_R in response to a cardiovascular stress test. In addition, the post-exercise BP reduction was correlated with BP_R attenuation in healthy adults of both genders.

Type 2 diabetes elicits lower nitric oxide, bradykinin concentration and kallikrein activity together with higher DesArg(9)-BK and reduced post-exercise hypotension compared to non-diabetic condition

This study compared the plasma kallikrein activity (PKA), bradykinin concentration (BK), DesArg(9)-BK production, nitric oxide release (NO) and blood pressure (BP) response after moderate-intensity aerobic exercise performed by individuals with and without type 2 diabetes. Ten subjects with type 2 diabetes (T2D) and 10 without type 2 diabetes (ND) underwent three sessions: 1) maximal incremental test on cycle ergometer to determine lactate threshold (LT); 2) 20-min of constant-load exercise on cycle ergometer, at 90% LT and; 3) control session. BP and oxygen uptake were measured at rest and at 15, 30 and 45 min post-exercise. Venous blood samples were collected at 15 and 45 minutes of the recovery period for further analysis of PKA, BK and DesArg(9)-BK. Nitrite plus nitrate (NOx) was analyzed at 15 minutes post exercise. The ND group presented post-exercise hypotension (PEH) of systolic blood pressure and mean arterial pressure on the 90% LT session but T2D group did not. Plasma NOx increased ~24.4% for ND and ~13.8% for T2D group 15 min after the exercise session. Additionally, only ND individuals showed increases in PKA and BK in response to exercise and only T2D group showed increased DesArg(9)-BK production. It was concluded that T2D individuals presented lower PKA, BK and NOx release as well as higher DesArg(9)-BK production and reduced PEH in relation to ND participants after a single exercise session.

Cycling above rather than below lactate threshold is more effective for nitric oxide release and post-exercise blood pressure reduction in individuals with type-2 diabetes

The purposes of this study were to analyze and compare the effects of exercise performed in different intensities, above and below lactate threshold (LT) on post-exercise blood pressure (BP) and nitric oxide (NO) responses in individuals with type 2 diabetes (T2D). For this, 11 T2D underwent the following sessions: 1) control session; 2) 20-min of moderate cycling (80% LT); and 3) 20-min of high intensity cycling (120%LT) on a cycle ergometer. Plasma NO and BP measurements were carried out at rest and at 15 and 45 min of post-sessions. When compared to rest, only the exercise session performed at 120%LT elicited an increase of NO (from 7.2 to 9.5 µM, p<0.05), as well as a decrease in systolic BP (from 126.6±7.9 to 118.7±3.9 mmHg, p<0.05) during the post-exercise period. In conclusion, the results suggest that NO release and post-exercise BP decrease are intensity-dependent for individuals with T2D.

Noninvasive method to estimate anaerobic threshold in individuals with type 2 diabetes

BACKGROUND

While several studies have identified the anaerobic threshold (AT) through the responses of blood lactate, ventilation and blood glucose others have suggested the response of the heart rate variability (HRV) as a method to identify the AT in young healthy individuals. However, the validity of HRV in estimating the lactate threshold (LT) and ventilatory threshold (VT) for individuals with type 2 diabetes (T2D) has not been investigated yet.

AIM

To analyze the possibility of identifying the heart rate variability threshold (HRVT) by considering the responses of parasympathetic indicators during incremental exercise test in type 2 diabetics subjects (T2D) and non diabetics individuals (ND).

METHODS

Nine T2D (55.6 ± 5.7 years, 83.4 ± 26.6 kg, 30.9 ± 5.2 kg.m2(-1)) and ten ND (50.8 ± 5.1 years, 76.2 ± 14.3 kg, 26.5 ± 3.8 kg.m2(-1)) underwent to an incremental exercise test (IT) on a cycle ergometer. Heart rate (HR), rate of perceived exertion (RPE), blood lactate and expired gas concentrations were measured at the end of each stage. HRVT was identified through the responses of root mean square successive difference between adjacent R-R intervals (RMSSD) and standard deviation of instantaneous beat-to-beat R-R interval variability (SD1) by considering the last 60 s of each incremental stage, and were known as HRVT by RMSSD and SD1 (HRVT-RMSSD and HRVT-SD1), respectively.

RESULTS

No differences were observed within groups for the exercise intensities corresponding to LT, VT, HRVT-RMSSD and HHVT-SD1. Furthermore, a strong relationship were verified among the studied parameters both for T2D (r = 0.68 to 0.87) and ND (r = 0.91 to 0.98) and the Bland & Altman technique confirmed the agreement among them.

CONCLUSION

The HRVT identification by the proposed autonomic indicators (SD1 and RMSSD) were demonstrated to be valid to estimate the LT and VT for both T2D and ND.

Lactate threshold prediction by blood glucose and rating of perceived exertion in people with type 2 diabetes

The validity of rating of perceived exertion (RPE) in predicting lactate threshold during an incremental test was analyzed in 15 men with type 2 diabetes (M age = 53.4 yr., SD = 12.9). Blood glucose, lactate, and minute ventilation (VE)/VO2 responses identified the lactate, ventilatory, and glucose thresholds. Workloads (W) corresponding to RPEs 12, 13, 14, and 15 were determined. Second-order polynomials fit to VE/W and [lac]/W ratios corresponding to RPEs of 9-10, 12-13, and 16-17 also identified workloads above which there was an overproportional increase in VE and [lac]. These workload breakpoints did not differ, although at RPE 12 underestimated and at RPE 15 overestimated lactate threshold. RPE 13 and 14 and the responses of VE/W and [lac]/W to submaximal exercise accurately predicted lactate threshold.

Acute resistance exercise is more effective than aerobic exercise for 24h blood pressure control in type 2 diabetics

AIM

The study aimed to analyze blood pressure (BP) responses in individuals with type 2 diabetes (T2D) over a 24h period following resistance (RES) and aerobic (AER) exercise.

METHODS

Ten adults with T2D (age: 55.8 ± 7.7 years; weight: 79.4 ± 14.0 kg; fasting glucose: 133.0 ± 36.7 mg.dL⁻¹) underwent: (1) AER: 20 min of cycling at 90% lactate threshold (90% LT); (2) RES: three laps of a circuit of six exercises with eight repetitions at 70% 1-RM and 40s of recovery; and (3) a control session of no exercise. Heart rate (HR), and systolic (SBP), diastolic (DBP), mean arterial (MAP) and pulse (PP) BP, as well as lactataemia (Lac), VO(2), respiratory exchange ratio (RER) and rate of perceived exertion (RPE) were measured at rest, during exercise and control (CON) periods, and 60min after interventions. After each session, BP was also monitored over a 24h period.

RESULTS

Peak Lac (RES: 6.4 ± 1.4mM; AER: 3.8 ± 1.2mM), RER (RES: 1.1 ± 0.1; AER: 0.9 ± 0.1) and RPE (RES: 14.0 ± 1.3; AER: 11.0 ± 2.3) were higher following the RES session (P < 0.05). Similar VO₂ (~70% VO(₂peak)) was reached during AER and RES sessions (14.0 ± 3.0 vs 14.3 ± 1.6 mL.kg.min⁻¹; P > 0.05). Compared with CON, only RES elicited post-exercise BP reduction that lasted 8h after exercise. Also, in comparison to pre-exercise rest, the BP dip during sleep was greater following RES (P < 0.05).

CONCLUSION

A single exercise bout decreases BP in T2D patients over a 24h period, with RES being more effective than AER exercise for BP control.