Effect of 12 weeks of resistance exercise on post-exercise hypotension in stage 1 hypertensive individuals

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

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

Can postexercise hypotension also be observed in African and Asian populations: a systematic review and meta-analysis of randomized controlled trials

Worldwide, raised blood pressure (BP) or hypertension is the global leading risk factor for the development of cardiovascular diseases and all-cause mortality, with the highest prevalence found in Asian and African origin populations. Post-exercise hypotension (PEH), defined as a sustained reduction in BP after a single bout of exercise is an important physiological phenomenon in BP management. However, little is known about the hypotensive effect of a single bout of exercise in non-Caucasian populations. We systematically summarized the acute effects of a single bout of aerobic exercise on BP in a population of African or Asian origin. We searched the MEDLINE database identifying randomized controlled trials investigating the effect of a single bout of aerobic exercise on BP in African or Asian populations with optimal BP, high normal BP or hypertension published in a peer reviewed journal up to August 2021. A subsequent meta-analysis was performed using random-effect models fitted to estimate effect sizes. We identified 10 aerobic exercise trials performed in individuals of Asian origin (n = 136; mean age: 29.51 (21.2-69) years: 78% male; baseline systolic BP/diastolic BP: 118.9 ± 9.64/68.9 ± 2.69 mmHg) and 11 aerobic exercise trials involving individuals of African origin (n = 157; mean age: 41.05 (29.9-49) years; 59% male; baseline systolic BP/diastolic BP: 134.5 ± 8.65 mmHg/82.2 ± 3.24 mmHg). Non-significant reductions in office systolic BP and diastolic BP at 30 min post exercise (-2.25 [-6.38, 1.88] mmHg, p = 0.28/-1.02 [-2.51, 0.47] mmHg, p = 0.18) and 60 min post exercise (-2.80 [-7.90, 2.28], p = 0.27/-1.95, [-5.66, 1.75], p = 0.3) were observed compared to the control intervention. No statistically significant differences were found between both ethnic groups (p > 0.05). Ambulatory BP was reported only in a few African groups. No effect was found on 24h-systolic BP post exercise, but 24h-diastolic BP was statistically significantly reduced (-1.89 [-3.47, -0.31] mmHg, p < 0.01) after a bout of aerobic exercise compared to the control intervention. The available evidence is insufficient to recommend a single session of aerobic exercise as an efficient tool to lower BP in African and Asian populations. Though, the paucity of data in non-Caucasian populations underscores the need for additional efforts to establish the efficacy of single bouts of exercise, including isometric and dynamic resistance exercise, as a potential non-pharmacological adjunct to help lowering BP in the daily life of descendants of Asian or African origin.

Cardiovascular Autonomic Responses to Aerobic, Resistance and Combined Exercises in Resistance Hypertensive Patients

Here, we report the acute effects of aerobic (AER), resistance (RES), and combined (COM) exercises on blood pressure, central blood pressure and augmentation index, hemodynamic parameters, and autonomic modulation of resistant (RH) and nonresistant hypertensive (NON-RH) subjects. Twenty participants (10 RH and 10 NON-RH) performed three exercise sessions (i.e., AER, RES, and COM) and a control session. Hemodynamic (Finometer®, Beatscope), office blood pressure (BP), and autonomic variables (accessed through spectral analysis of the pulse-to-pulse BP signal, in the time and frequency domain-Fast Fourrier Transform) were assessed before (T0), one-hour (T1), and twenty-four (T2) hours after each experimental session. There were no changes in office BP, pulse wave behavior, and hemodynamic parameters after (T0 and T1) exercise sessions. However, AER and COM exercises significantly reduced sympathetic modulation in RH patients. It is worth mentioning that more significant changes in sympathetic modulation were observed after AER as compared to COM exercise. These findings suggest that office blood pressure, arterial stiffness, and hemodynamic parameters returned to baseline levels in the first hour and remained stable in the 24 hours after the all-exercise sessions. Notably, our findings bring new light to the effects of exercise on RH, indicating that RH patients show different autonomic responses to exercise compared to NON-RH patients. This trial is registered with trial registration number NCT02987452.

Resistance training improves cognitive function in older adults with different cognitive status: a systematic review and Meta-analysis

The present study investigated the impact of resistance training (RT) on cognitive function in older adults with different cognitive status by conducting a systematic review and meta-analysis of intervention studies. We performed a literature search with no restriction on publication year in MEDLINE, Embase, CINAHL, SPORTDiscus, and AgeLine from inception up to August 2020. Experimental studies investigating the impact of RT on the cognitive function of cognitively healthy (CH) and cognitively impaired (CI) older adults (≥60 years) were included for analysis. Eighteen studies were included in the final analysis, of which ten studies investigated CH community-dwelling older adult, seven studies investigated CI older adults, and one study investigated both. RT significantly improved overall cognitive function in both CH (SMD = 0.54; 95% CI = 0.00 to 1.08, P = 0.047) and CI (SMD = 0.60; 95% CI = 0.21 to 1.16, P = 0.005) older adults. However, short-term memory was only improved in CH older adults (MD = -0.20; 95% CI = -0.25 to -0.15, P < 0.00001). In conclusion, RT improved overall cognitive function in CH and CI older adults, whereas short-term memory, assessed by the digit span of the WAIS III, was only significantly improved in CH older adults.

Effects of resistance training in elderly women with cognitive decline

Abstract Introduction: With aging, it is common for some changes to occur in different areas of cognition, such as memory, executive function, language and psychomotor speed. However, regular physical activity has been described as an excellent way to alleviate the degeneration caused by aging within the various physical, psychological and social domains. Objective: To evaluate the effects of resistance training in elderly women with mild cognitive impairment. Methods: Experimental study with 31 sedentary elderly women divided into control (CG; n=15) and resistance training (RTG; n=16) groups who underwent assessment of anthropometric measures, body composition, maximum strength, heart rate and blood pressure and questionnaire application (Mini-Mental State Examination). Results: Cognitive ability increased in RTG (post 26.00 ± 2.13 vs. CG 22.24 ± 3.82 vs. pre 24.06 ± 2.38 RTG). In RTG, there was a reduction in systolic blood pressure (post 107.50 ± 11.97 vs. CG 126.00 ± 9.72 vs. pre 124.13 ± 12.55 mmHg RTG), diastolic blood pressure (post 68.50 ± 8.15 vs. CG 81.73 ± 4.59 vs. pre 74.69 ± 6.87 mmHg RTG) and double product (post 7746 ± 1244 vs. CG 9336 ± 1595 vs. pre 9286 ± 1309 mmHg x bpm RTG), but not in heart rate (post 72.00 ± 7.40 vs. CG 74.00 ± 10.50 vs. pre 74.94 ± 8.42 bpm RTG). Regarding muscle strength, an increase was evident in all exercises. Conclusion: The present study showed that resistance training in elderly women increased muscle strength and reduced hemodynamic variables. But the most important finding was that there was an increase in cognitive capacity.

Efeitos do treinamento resistido em idosas com declínio cognitivo

Resumo Introdução: Com o envelhecimento, é comum ocorrerem alterações em diferentes áreas da cognição, como a memória, função executiva, linguagem, desenvolvimento psicomotor e função visoespacial. A atividade física regular, contudo, tem sido descrita como um excelente meio de atenuar as degenerações provocadas pelo envelhecimento dentro dos domínios físico, psicológico e social. Objetivo: Avaliar os efeitos do treinamento resistido em idosas com comprometimento cognitivo leve. Métodos: Estudo experimental com 31 idosas sedentárias, divididas em grupo controle (GC; n = 15) e grupo treinamento resistido (GTR; n = 16), submetidas a avaliações antropométricas, composição corporal, força máxima, frequência cardíaca (FC), pressão arterial (PA) e aplicação de questionário (Mini Exame do Estado Mental). Resultados: Observou-se aumento da capacidade cognitiva no GTR (pós 26,00 ± 2,13 vs. GC 22,24 ± 3,82 vs. pré 24,06 ± 2,38 GTR) e redução na PA sistólica (pós 107,50 ± 11,97 vs. GC 126,00 ± 9,72 vs. pré 124,13 ± 12,55 mmHg GTR), PA diastólica (pós 68,50 ± 8,15 vs. GC 81,73 ± 4,59 vs. pré 74,69 ± 6,87 mmHg GTR) e duplo produto no GTR (pós 7746 ± 1244 vs. GC 9336 ± 1595 vs. pré 9286 ± 1309 mmHg x bpm GTR). Não houve redução na FC no GTR (pós 72,00 ± 7,40 vs. GC 74,00 ± 10,50 vs. pré 74,94 ± 8,42 bpm GTR). Em relação à força muscular, observou-se aumento em todos os exercícios. Conclusão: O presente estudo mostrou que o treinamento resistido aumentou a força muscular e que houve redução de variáveis hemodinâmicas; entretanto, o achado mais importante desse estudo foi o aumento na capacidade cognitiva das idosas.

Saffron (Crocus sativus L.) in combination with resistance training reduced blood pressure in the elderly hypertensive men: A randomized controlled trial

AIMS

We aimed to determine the independent and combined effects of saffron and resistance training on blood pressure (BP) and some chemical biomarkers in the elderly with hypertension.

METHODS

The present study was a randomized clinical trial on hypertensive men aged 60-70 years who were assigned to a control group (CO) and 3 experimental groups; resistance training (RT); saffron (S); and resistance training + saffron (RTS) for 12 weeks. Dynamic resistance training was applied with moderate intensity. Patients in S and RTS received 1 tablet containing 200 mg of saffron daily. BP variables, chemical biomarkers and anthropometric indicators were measured at weeks 0, 6, 12 and 18. Data were analysed by repeated measurements ANOVA with 95% confidence interval (CI).

RESULTS

In comparison to the CO (153.3 ± 1.18, CI = 10.9-20.2, P < .001) and S (143.3 ± 1.18, CI = 0.97-10.2, P = .01), RTS (137.7 ± 1.18) reduced systolic BP with the effect size partial η² of 0.68. Nitric oxide increased in the RTS compared to the CO group (CI = 0.13-0.62, P = .001). There was a significant increase and decrease in adiponectin and endothelin-1 in the S (CI = 0.03-1.20, P = .012; CI = 4.30-17.3, P < .001) and RT (CI = 0.36-1.60, P < .001; CI = 2.26-15.3, P = .003) compared to the CO, respectively. The partial η² for nitric oxide, adiponectin and ET-1 were 0.35, 0.35 and 0.38, respectively. There was no significant difference between the groups for atrial natriuretic peptide.

CONCLUSIONS

Resistance training and consumption of saffron can improve BP in the elderly with hypertension by affecting the factors involved in altering vascular endothelial resistance. The present study was approved by the Ethics Committee of Iran's sports science research institution (IR.SSRC.REC.1398.020) and registered at the Iranian Registry of Clinical Trials (IRCT20190731044398N1).

Acute Effects of Resistance Exercise With Blood Flow Restriction in Elderly Women: A Pilot Study

AIM

To compare the acute effects of two resistance exercise sessions with different partial blood flow restrictions (BFR) on hemodynamic parameters and cardiac autonomic modulation in older women with metabolic syndrome.

METHODS

Thirty-nine older women (64.4 ± 4.5 years) were allocated into three groups: BFR0 = resistance exercise (20%, 1 maximum repetition [MR]) + 0% BFR; BFR60 = 20% 1 MR resistance exercise + 60% BFR; and BFR80 = 20% 1MR resistance exercise + 80% BFR.

RESULTS

A reduction of 14 mmHg (BFR60 group) and 13 mmHg (BRF80 group) was observed 48 hr after the first exercise session, while vagal modulation was increased in the BRF60 group after 24 and 48 hr.

CONCLUSION

A low-intensity resistance exercise session with 60% and 80% of BFR resulted in blood pressure (systolic, diastolic, and mean) reduction and positive changes on heart rate variability after 24 h of a RE session.

Combined Aerobic and Resistance Exercises Evokes Longer Reductions on Ambulatory Blood Pressure in Resistant Hypertension: A Randomized Crossover Trial

Aim

The present study compared the acute effects of aerobic (AER), resistance (RES), and combined (COM) exercises on blood pressure (BP) levels in people with resistant hypertension (RH) and nonresistant hypertension (NON-RH).

Methods

Twenty patients (10 RH and 10 NON-RH) were recruited and randomly performed three exercise sessions and a control session. Ambulatory BP was monitored over 24 hours after each experimental session.

Results

Significant reductions on ambulatory BP were found in people with RH after AER, RES, and COM sessions. Notably, ambulatory BP was reduced during awake-time and night-time periods after COM. On the other hand, the effects of AER were more prominent during awake periods, while RES caused greater reductions during the night-time period. In NON-RH, only RES acutely reduced systolic BP, while diastolic BP was reduced after all exercise sessions. However, the longest postexercise ambulatory hypotension was observed after AER (~11 h) in comparison to RES (~8 h) and COM (~4 h) exercises.

Conclusion

Findings of the present study indicate that AER, RES, and COM exercises elicit systolic and diastolic postexercise ambulatory hypotension in RH patients. Notably, longer hypotension periods were observed after COM exercise. In addition, NON-RH and RH people showed different changes on BP after exercise sessions, suggesting that postexercise hypotension is influenced by the pathophysiological bases of hypertension.

Systematic review of intra-abdominal and intrathoracic pressures initiated by the Valsalva manoeuvre during high-intensity resistance exercises

The Valsalva manoeuvre, intra-abdominal pressure (IAP) and intrathoracic pressure (ITP) play important roles in resistance training and common daily activities. The purpose of this review is to summarize the ITP and IAP responses to resistance exercises and to determine which exercises elicit the highest or lowest body pressure values under high-intensity resistance exercise. The PubMed, Scopus and Web of Science databases were searched until November 1, 2018. A combination of the following search terms was used: Valsalva manoeuvre, hold breath, controlled breathing, controlled breath, abdominal pressure, intrathoracic pressure AND weight training, resistance exercise, power lifting. The search process yielded 1125 studies, of which 16 were accepted according to the selection criteria and methodological quality. The highest IAP was recorded during squats (over 200 mmHg) followed by deadlift, slide row and leg press (161–176 mmHg), and the lowest IAP was found during bench press (79±44 mmHg). The highest ITP was elicited by the leg press, deadlift and box lift (105–130 mmHg), which were higher than during the bench press (95±37 mmHg) and slide row (88±32 mmHg). We recommend the bench press and slide row as exercises useful for beginners and individuals with hypertension. Untrained individuals should not use heavy squats, deadlift, box lift and clean exercises until they have undergone progressive adaptation for lifting high loads resulting in high IAP and ITP. The values of IAP and ITP during high-intensity exercise seem to be determined mutually by the position of the human body and the external load.

Role of Nutrition and Exercise Programs in Reducing Blood Pressure: A Systematic Review

The combined effect of diet and strength training (ST) on blood pressure (BP) seems to be very important for the treatment of prehypertension and hypertension (HT). Therefore, the aim of this study was to determine whether ST alone or combined with nutrition or supplementation has an impact on the arterial pressure reduction in normotensive and hypertensive populations. A systematic computerized literature search was performed according to the PRISMA guidelines using PubMed, Scopus and Google Scholar; only English language studies published from 1999 until 2018 were included. This systematic search identified the results of 303 individuals from nine studies. The ST program alone had a similar effectiveness as the nutrition program (NP) alone; however, their combination did not result in increased effectiveness in terms of a high BP reduction. The consumption of L-citrulline had a similar effect as ST on lowering BP; on the other hand, caffeine led to an increase in BP during the ST session. Our data suggest that a combination of ST 2-3 times a week at moderate intensity and a NP seems to be equally effective in terms of lowering BP (systolic and diastolic) as ST and NP alone.

Acute citrulline oral supplementation induces greater post-exercise hypotension response in hypertensive than normotensive individuals

ABSTRACT Objective To investigate whether acute citrulline supplementation might influence post-exercise hypotension in normotensive and hypertensive individuals. Methods Following a randomized double-blind design, twenty normotensive (28±7 years, 74±17kg, 1.7±0.09m) and 20 hypertensive individuals (55±12 years, 76±15kg, 1.59±0.09m) were randomly assigned to one of the four experimental groups (Normotensive-Placebo; Normotensive-Citrulline; Hypertensive-Placebo; Hypertensive-Citrulline). The placebo groups ingested 6g of corn starch and the citrulline groups ingested 6g of citrulline dissolved in water. The participants performed 40 minutes of walking/running on a treadmill at 60-70% heart rate reserve. Blood pressure was measured immediately after a 60-min exercise session using an oscillometric device and 24-h ambulatory monitoring. Results The post-exercise hypotension was more pronounced in hypertensives and the Hypertensive-Citrulline group showed a consistent systolic blood pressure reduction during the laboratorial phase, which can be seen by looking at the mean of 60 minutes (-15.01mmHg vs -3.14mmHg [P=0.005]; -4.16mmHg [P=0.009]; -6.30mmHg [P=0.033] in comparison with the Normotensive-Placebo, Normotensive-Citrulline, and Hypertensive-Placebo groups, respectively). During ambulatory blood pressure monitoring, the Hypertensive-Citrulline group showed a significant reduction in systolic blood pressure (-21.05mmHg) in the awake period compared with the Normotensive-Citrulline group (-3.17mmHg [P=0.010]). Conclusion Acute citrulline oral supplementation can induce greater post-exercise hypotension response in hypertensive than normotensive individuals.

Moderate Aerobic Training Decreases Blood Pressure but No Other Cardiovascular Risk Factors in Hypertensive Overweight/Obese Elderly Patients

Hypertension and obesity are prevalent diseases in elderly people, and their combination can cause deleterious effects on physiological system. Moderate intensity aerobic training (MIAT) seems to be a beneficial approach to control and treat these diseases separately. However, few studies have investigated the impact of MIAT on cardiovascular risk factors associated with these conditions (i.e., elevated blood pressure values, blood markers, and body composition). Therefore, the present study was designed to investigate the effects of MIAT on blood pressure, blood markers, and body composition in hypertensive overweight/obese elderly patients. Twenty-four hypertensive overweight/obese elderly patients were randomized into control group (CG) and training group (TG), submitted to 12 weeks of MIAT of 50 min, 3 days per week, at 60% of maximal HR (heart rate). There was a decrease in diastolic blood pressure (-10.1 ± 3.3; p = .01; effect size = 1.29) and mean arterial pressure (MAP; -8.2 ± 3.7; p = .04; effect size = 0.94) following 12 weeks of training in the TG as compared with baseline. There was an increase in triacylglycerol levels in the TG (+0.1 ± 0.0; p = .02). There were no significant changes in body composition for both groups. The present study revealed that 12 weeks of MIAT can decrease blood pressure in hypertensive obese elderly patients, with no significant modifications in blood markers and body composition.

Resistance training downregulates macrophages infiltration in the kidney of 5/6 nephrectomized rats

INTRODUCTION

Chronic kidney disease (CKD) is considered a significant world health problem with elevated mortality rates. Patients with CKD are restricted to mild physical activity, present chronic inflammatory state and loss of muscle strength. Currently, the influence of resistance exercise (RE) on the progression of renal disease has not being fully elucidated.

PURPOSE

To evaluate the effects of RE on the progression of CKD in a remnant kidney model (5/6Nx) in rats.

METHODS

Eight-week-old Wistar rats were submitted to 5/6 nephrectomy and were divided into four groups: Sham sedentary (Sham SD); Sham RE (Sham RE); 5/6Nx SD and 5/6Nx RE. The animals were trained for 8 weeks in a vertical climbing ladder for 3 days per week, on non-consecutive days.

RESULTS

As expected, 5/6Nx SD group presented a markedly loss of renal function, increased plasma inflammatory cytokines and increased oxidative stress with a reduced activity of nitric oxide. The higher macrophage infiltration and fibrosis confirmed these conditions. RE attenuated systolic blood pressure and renal function decrease and also improved serum lipid parameters in 5/6 Nx animals. It was evident the increase of muscle strength and mass in the trained groups while the sedentary group showed reduced muscle weight and strength compared to Sham SD.

CONCLUSIONS

RE implemented following 5/6Nx retard the progression of chronic kidney injury while simultaneously allowed the maintenance of skeletal muscle strength.

Acute blood pressure responses after different isometric handgrip protocols in hypertensive patients

OBJECTIVE

The present study analyzed blood pressure responses after a single session of isometric handgrip exercise performed with different volumes and intensities by patients with hypertension.

METHODS

This randomized crossover trial submitted 12 hypertensive patients (58±5 years old) to four isometric handgrip exercise sessions in a random order: 4 x 2 min at 30% of the maximal voluntary contraction (S30%); 4 x 2 min at 50% of the maximal voluntary contraction (S50%2min); 4 x 3 min at 30% of the maximal voluntary contraction (S30%3min); and a control session. The systolic and diastolic blood pressure, heart rate, and rate-pressure product were measured pre- and post-exercise (30th min).

RESULTS

No significant changes were observed in cardiovascular variables after any session (p>0.05 for all comparisons). Similarly, individual analyses revealed heterogeneity in the responses, including increases in blood pressure observed in some sessions. Patients with reduced blood pressure after an isometric handgrip exercise session exhibited a higher body mass index, diastolic blood pressure and heart rate (p<0.05). They also tended to be younger (p=0.07).

CONCLUSION

Isometric handgrip exercise performed with different intensities and volumes did not reduce the blood pressure of hypertensive patients.

Exercise as a tool for hypertension and resistant hypertension management: current insights

Although there has been an observed progress in the treatment of hypertension, its prevalence remains elevated and constitutes a leading cause of cardiovascular disease development. Resistant hypertension is a challenge for clinicians, as the available treatment options have reduced success. Physical activity and exercise training play an important role in the management of blood pressure. The importance of physical activity and exercise training as part of a comprehensive lifestyle intervention is acknowledged by several professional organizations in their recommendations/guidelines for the management of arterial hypertension. Aerobic exercise, dynamic resistance exercise, and concurrent training - the combination of dynamic resistance and aerobic exercise training in the same exercise session or on separate days - has been demonstrated to reduce blood pressure and help in the management of hypertension. The present review draws attention to the importance of exercise training in the management of blood pressure in both hypertension and resistant hypertension individuals.

Pathophysiology of Noncardiac Syncope in Athletes

The most frequent cause of syncope in young athletes is noncardiac etiology. The mechanism of noncardiac syncope (NCS) in young athletes is neurally-mediated (reflex). NCS in athletes usually occurs either as orthostasis-induced, due to a gravity-mediated reduced venous return to the heart, or in the context of exercise. Exercise-related NCS typically occurs after the cessation of an exercise bout, while syncope occurring during exercise is highly indicative of the existence of a cardiac disorder. Postexercise NCS appears to result from hypotension due to impaired postexercise vasoconstriction, as well as from hypocapnia. The mechanisms of postexercise hypotension can be divided into obligatory (which are always present and include sympathoinhibition, histaminergic vasodilation, and downregulation of cardiovagal baroreflex) and situational (which include dehydration, hyperthermia and gravitational stress). Regarding postexercise hypocapnia, both hyperventilation during recovery from exercise and orthostasis-induced hypocapnia when recovery occurs in an upright posture can produce postexercise cerebral vasoconstriction. Athletes have been shown to exhibit differential orthostatic responses compared with nonathletes, involving augmented stroke volume and increased peripheral vasodilation in the former, with possibly lower propensity to orthostatic intolerance.

Postexercise Hypotension After Aquatic Exercise in Older Women With Hypertension: A Randomized Crossover Clinical Trial

BACKGROUND

Hypertension can be prevented and modified with lifestyle interventions that include regular exercise. Aquatic exercise is widely recommended for older adults for a variety of health benefits, but few studies have assessed the immediate ambulatory blood pressure (BP) response to aquatic exercise, a response termed postexercise hypotension (PEH). Thus, we assessed PEH after a session of aquatic exercise in physically active, older women with hypertension.

METHODS

Twenty-four women 70.0 ± 3.9 years with a resting systolic (SBP)/diastolic (DBP) BP of 124.0/72.3 mm Hg and body mass index of 29.8 ± 4.1 kg/m2 were randomly assigned to participate in a 45-minute session of moderate intensity, water-based exercise (WATER) and a 45-minute land control session (CONTROL). All experimental sessions started at 9 am sharply with 7 days between them. Subjects left the experiments wearing an ambulatory BP monitor for the next 21 hours.

RESULTS

SBP was lower by 5.1 ± 1.0 mm Hg after WATER than CONTROL over 21 hours (P < 0.001), over awake hours by 5.7 ± 1.1 mm Hg (P < 0.001), and sleep hours by 4.5 ± 0.4 mm Hg (P = 0.004). DBP was lower following WATER compared to CONTROL: 1.2 ± 0.3 mm Hg over 21 hours (P = 0.043); 0.9 ± 0.6 mm Hg over awake hours (P = 0.101); and 1.4 ± 0.9 mm Hg over sleep hours (P = 0.039).

CONCLUSIONS

Aquatic exercise elicited PEH (~5 mm Hg) over 21 hours, BP reductions that are comparable in magnitude to land aerobic exercise. The immediate antihypertensive benefits of acute aquatic exercise should continue to be explored in future studies.

Heat and Dehydration Additively Enhance Cardiovascular Outcomes following Orthostatically-Stressful Calisthenics Exercise

Exercise and exogenous heat each stimulate multiple adaptations, but their roles are not well delineated, and that of the related stressor, dehydration, is largely unknown. While severe and prolonged hypohydration potentially “silences” the long-term heat acclimated phenotype, mild and transient dehydration may enhance cardiovascular and fluid-regulatory adaptations. We tested the hypothesis that exogenous heat stress and dehydration additively potentiate acute (24 h) cardiovascular and hematological outcomes following exercise. In a randomized crossover study, 10 physically-active volunteers (mean ± SD: 173 ± 11 cm; 72.1 ± 11.5 kg; 24 ± 3 year; 6 females) completed three trials of 90-min orthostatically-stressful calisthenics, in: (i) temperate conditions (22°C, 50% rh, no airflow; CON); (ii) heat (40°C, 60% rh) whilst euhydrated (HEAT), and (iii) heat with dehydration (no fluid ~16 h before and during exercise; HEAT+DEHY). Using linear mixed effects model analyses, core temperature (T_CORE) rose 0.7°C more in HEAT than CON (95% CL: [0.5, 0.9]; p < 0.001), and another 0.4°C in HEAT+DEHY ([0.2, 0.5]; p < 0.001, vs. HEAT). Skin temperature also rose 1.2°C more in HEAT than CON ([0.6, 1.8]; p < 0.001), and similarly to HEAT+DEHY (p = 0.922 vs. HEAT). Peak heart rate was 40 b·min⁻¹ higher in HEAT than in CON ([28, 51]; p < 0.001), and another 15 b·min⁻¹ higher in HEAT+DEHY ([3, 27]; p = 0.011, vs. HEAT). Mean arterial pressure at 24-h recovery was not consistently below baseline after CON or HEAT (p ≥ 0.452), but was reduced 4 ± 1 mm Hg after HEAT+DEHY ([0, 8]; p = 0.020 vs. baseline). Plasma volume at 24 h after exercise increased in all trials; the 7% increase in HEAT was not reliably more than in CON (5%; p = 0.335), but was an additional 4% larger after HEAT+DEHY ([1, 8]; p = 0.005 vs. HEAT). Pooled-trial correlational analysis showed the rise in T_CORE predicted the hypotension (r = −0.4) and plasma volume expansion (r = 0.6) at 24 h, with more hypotension reflecting more plasma expansion (r = −0.5). In conclusion, transient dehydration with heat potentiates short-term (24-h) hematological (hypervolemic) and cardiovascular (hypotensive) outcomes following calisthenics.

Low blood pressure is sustained during subsequent activities of daily living performed after power training in older women

The present study aimed to examine the effects of a prior session of power training on blood pressure values during tasks that mimic the activities of daily living in hypertensive and normotensive older women. A randomized crossover experimental design was used for this study. Eleven older women (age, 66.1±1.2 years; body mass index, 26.7±4.8 kg/m²; systolic blood pressure, 133.9±23.4 mmHg) were recruited to participate. Volunteers were randomly underwent to a single session of physical exercise equalized by training volume, characterized by 3 sets of 8–10 repetitions in 8 different exercises. However, Power training session was performed at a higher intensity (moderate) than Sham session (rest/very, very easy ). Immediately after the end of the exercise session, subjects were assigned to perform five tasks that mimic the activities of daily living. Hemodynamic parameters were recorded before and immediately after the session of physical exercise, as well as in the end of each of the tasks. Results demonstrated significant elevations in systolic blood pressure and pulse pressure values during the performance of the tasks after the Sham session. However, values were not altered in the power training session. Data of the present study indicate that an acute session of power training can maintain blood pressure values lower during the subsequent performance of tasks that mimic activities of daily living in older women.

Acute effects of power and resistance exercises on hemodynamic measurements of older women

Purpose

The purpose of this study was to compare the acute effects of resistance training (RT) and power training (PT) on the hemodynamic parameters and nitric oxide (NO) bioavailability of older women.

Materials and methods

A randomized experimental design was used in this study. Twenty-one older women (age: 67.1±4.6 years; body mass index: 28.03±4.9 kg/m²; systolic blood pressure: 135.1±21.1 mmHg) were recruited to participate in this study. Volunteers were randomly allocated into PT, RT, and control session (CS) groups. The PT and RT groups underwent a single session of physical exercise equalized by training volume, characterized by 3 sets of 8–10 repetitions in 8 different exercises. However, RT group performed exercise at a higher intensity (difficult) than PT (moderate) group. On the other hand, concentric contractions were faster in PT group than in RT group. Hemodynamic parameters and saliva samples (for NO quantification) were collected before and during an hour after exercise completion.

Results

Results demonstrated post-exercise hypotension during 35 minutes in the PT when compared to rest period (P=0.001). In turn, RT showed decreased heart rate and double product (P<0.001) during the whole evaluation period after exercise completion compared with the rest period. NO levels increased in the PT and RT during the whole evaluation period in relation to rest period. However, there were no differences between PT, RT, and CS regarding hemodynamic and NO evaluations.

Conclusion

Data indicate that an acute session of power and resistance exercise can be effective to cause beneficial changes on hemodynamic parameters and NO levels in older women.

Blood pressure reactivity to mental stress is attenuated following resistance exercise in older hypertensive women

PURPOSE

This study aimed to investigate the effects of resistance exercise (RE) on autonomic control and blood pressure (BP) reactivity during mental stress (MS) in treated older hypertensive women.

METHODS

Ten older hypertensive women (age =71.1±5.5 years; body mass index =24.2±3.9; mean BP [MBP] =85.4±3.5) underwent a protocol consisting of BP and heart rate variability (HRV) output assessments at baseline and during MS, and these measurements were taken before and 60 minutes after two bouts of RE (traditional and circuit). MS was induced through a computerized 3-minute Stroop color-word test before and 1 hour after each exercise session; BP was measured every minute during MS, and HRV was monitored as a measure of cardiac autonomic control.

RESULTS

A significant effect of time on systolic BP (Δpre =17.4±12.8 versus Δpost =12.5±9.6; P=0.01), diastolic BP (Δpre =13.7±7.1 versus Δpost =8.8±4.5; P=0.01), and MBP (Δpre =14.0±7.7 versus Δpost =9.3±5.4; P<0.01) after RE was observed, with no differences between the two sessions. In addition, a significant effect of time on log-normalized low-frequency component of HRV (ms2; 5.3±0.8 pre-exercise MS versus 4.8±1.0 baseline value; P=0.023) was also observed, showing a significant change from baseline to MS before RE, but not after RE sessions. These results may be related to a lessened RE-mediated cardiac sympathetic activity during MS.

CONCLUSION

RE is an effective tool to reduce BP reactivity to MS, which could therefore be associated with an acute reduction in cardiovascular risk. This result presents relevant clinical implications, combining previous evidence that recommends this exercise modality as an important component of an exercise program designed for the older and hypertensive subjects.

Blood Pressure Responses after a Session of Functional Training in Young Adults and the Elderly: A Pilot Study

Purpose. The potential of functional training (FT) to improve health is evident. However, regarding post-exercise hypotension (PEH) in older adults, there are few data. The study aimed to determine the cardiometabolic demand imposed by an FT session and evaluate PEH, comparing it with exercise sessions with aerobic and resistance exercises in physically active practitioners.

Methods. Fourteen young (23.3 ± 2 years) and 15 older (68 ± 4 years) adults underwent a control session and FT session randomly determined. Blood pressure, heart rate, and double product were recorded at rest, during exercise, and in every 10 minutes over 60 minutes of recovery. Additionally, we measured the rate of perceived exertion (RPE).

Results. The FT protocol promoted systolic PEH in both groups in the last half of recovery, reaching a reduction of 10.4 ± 4.9 mm Hg in young and 13.4 ± 3.8 mm Hg in older adults (p < 0.05). No differences were observed between the groups (p > 0.05). There were no differences between the groups with reference to RPE at any time (p > 0.05).

Conclusions. A single FT session is able to promote PEH in normotensive young and borderline hypertensive older adults but without changing the RPE in comparison over the time, owing to a great similarity of FT practices in the groups.

Blood pressure and autonomic responses following isolated and combined aerobic and resistance exercise in hypertensive older women

PURPOSE

This study aimed to compare blood pressure (BP) after isolated and combined sessions of aerobic and resistance exercises in hypertensive older women. Heart rate (HR) and heart rate variability (HRV) were included as additional variables.

METHODS

Twenty-one older women (63±1.9 years; 69.9±2.7 kg; 158.8±2.1 cm) with controlled hypertension (resting BP = 132.2 ± 3.1/74.1 ± 4.0 mmHg) performed four random sessions on different days: 1) aerobic exercise (AE: treadmill walking/running; 40 min; 50-60% HR_reserve); 2) resistance exercise (RE: 8 exercises; 3 sets; 15 reps; 40% 1RM)); 3) aerobic exercise followed by resistance exercise (A+R); 4); control (CON). BP, HR and HRV were measured at rest and during 180 min after the sessions.

RESULTS

The AE and A+R sessions demonstrated significant decreases in SBP and DBP (30, 60, 120, and 180 min; P < 0.05) and increases in HR (30 and 60 min; P < 0.05) compared to the CON. The RE session demonstrated significant reductions compared to the CON only for DBP (120 and 180 min; P < 0.05). No significant differences were observed in HRV between resting and all sessions.

CONCLUSION

All sessions that involved aerobic exercise (AE and A+R) caused postexercise hypotension in comparison to the CON, with no differences in HRV.

Session Perceived Exertion Following Traditional and Circuit Resistance Exercise Methods in Older Hypertensive Women

This study compared session ratings of perceived exertion (SRPE) between traditional multiple-set (TR) and circuit (CI) resistance exercise methods in treated hypertensive women. Fourteen volunteers (69.9 ± 5.6 years) performed two training sessions (TR and CI) in a random order, with the same number of sets, exercises, and loads. SRPE was obtained 30 minutes following each session using Foster's scale. OMNI-resistance exercise scale (OMNI-RES) measures were subsequently taken. Foster's SRPE was not significantly different between sessions (3.8 ± 0.9 TR vs. 3.4 ± 1.0 CI; p = .125), but OMNI-RES values were significantly higher following TR than following CI (5.2 ± 1.3 vs. 4.6 ± 1.5; p = .033). Total session duration was longer for TR (29.3 ± 1.2 vs. 20.0 ± 0.9 minutes; p < .001). Using moderate loads, the CI method did not elicit higher SRPE when compared with TR. Conversely, significantly lower OMNI-RES values follow CI. These results will be useful for prescribing exercise regimens for older hypertensive women.

Postaerobic Exercise Blood Pressure Reduction in Very Old Persons With Hypertension

BACKGROUND AND PURPOSE

A single bout of aerobic exercise acutely decreases blood pressure, even in older adults with hypertension. Nonetheless, blood pressure responses to aerobic exercise in very old adults with hypertension have not yet been documented. Therefore, this study aimed to assess the effect of a single session of aerobic exercise on postexercise blood pressure in very old adults with hypertension.

METHODS

Eighteen older adults with essential hypertension were randomized into exercise (N = 9, age: 83.4 ± 3.2 years old) or control (N = 9, age: 82.7 ± 2.5 years old) groups. The exercise group performed a session of aerobic exercise constituting 2 periods of 10 minutes of walking at an intensity of 40% to 60% of the heart rate reserve. The control group rested for the same period of time. Anthropometric variables and medication status were evaluated at baseline. Heart rate and systolic and diastolic blood pressures were measured at baseline, after exercise, and at 20 and 40 minutes postexercise.

RESULTS

Systolic blood pressure showed a significant interaction for group × time (F3,24 = 6.698; P = .002; ηp(2) = 0.153). In the exercise group, the systolic blood pressure at 20 (127.3 ± 20.9 mm Hg) and 40 minutes (123.7 ± 21.0 mm Hg) postexercise was significantly lower in comparison with baseline (135.6 ± 20.6 mm Hg). Diastolic blood pressure did not change. Heart rate was significantly higher after the exercise session. In the control group, no significant differences were observed.

CONCLUSIONS

A single session of aerobic exercise acutely reduces blood pressure in very old adults with hypertension and may be considered an important nonpharmacological strategy to control hypertension in this age group.

The blood pressure-lowering effect of a single bout of resistance exercise: A systematic review and meta-analysis of randomised controlled trials

BACKGROUND

Current exercise guidelines recommend aerobic types of exercises on most days of the week, supplemented with dynamic resistance exercise twice weekly. Whereas the blood pressure (BP)-lowering effects of a single session of aerobic exercise have been well studied, less is known about the hypotensive effect of a single bout of resistance exercise.

OBJECTIVES

To evaluate the transient effect of resistance exercise on BP by means of meta-analytic techniques.

METHODS

A systematic electronic search in Medline, Scientific Electronic Library Online (SciELO), Latin American and Caribbean Health Sciences Literature (LILACS), Elton B Stephens Company (EBSCO), EMBASE and SPORTDiscus was completed in March 2015 identifying randomised controlled trials investigating the effect of a single bout of resistance exercise on resting or ambulatory BP in healthy adults. A subsequent meta-analysis was performed.

RESULTS

The meta-analysis involved 30 studies, 81 interventions and 646 participants (normotensive (n = 505) or hypertensive (n = 141)). A single bout of resistance exercise elicited small-to-moderate reductions in office systolic BP at 60 minutes postexercise [-3.3 (-4.0 to -2.6)/-2.7 (-3.2 to -2.1) mmHg (CI 95%)], 90 minutes postexercise [-5.3 (-8.5 to -2.1)/-4.7 (-6.9 to -2.4) mmHg (CI 95%)] and in 24-hour ambulatory BP [-1.7 (-2.8 to -0.67)/-1.2 (-2.4 to -0.022) mmHg (CI 95%)] compared to a control session. The reduction in office BP was more pronounced in hypertensive compared to normotensive individuals (p < 0.01), when using larger muscle groups (p < 0.05) and when participants were recovering in the supine position (p < 0.01).

CONCLUSION

A single bout of resistance exercise can have a BP-lowering effect that last for up to 24 hours. Supine recovery and the use of larger muscle groups resulted in greater BP reductions after resistance exercise.

Resistance Training in Spontaneously Hypertensive Rats with Severe Hypertension

BACKGROUND

Resistance training (RT) has been recommended as a non-pharmacological treatment for moderate hypertension. In spite of the important role of exercise intensity on training prescription, there is still no data regarding the effects of RT intensity on severe hypertension (SH).

OBJECTIVE

This study examined the effects of two RT protocols (vertical ladder climbing), performed at different overloads of maximal weight carried (MWC), on blood pressure (BP) and muscle strength of spontaneously hypertensive rats (SHR) with SH.

METHODS

Fifteen male SHR ENT#091;206 ± 10 mmHg of systolic BP (SBP)ENT#093; and five Wistar Kyoto rats (WKY; 119 ± 10 mmHg of SBP) were divided into 4 groups: sedentary (SED-WKY) and SHR (SED-SHR); RT1-SHR training relative to body weight (~40% of MWC); and RT2-SHR training relative to MWC test (~70% of MWC). Systolic BP and heart rate (HR) were measured weekly using the tail-cuff method. The progression of muscle strength was determined once every fifteen days. The RT consisted of 3 weekly sessions on non-consecutive days for 12-weeks.

RESULTS

Both RT protocols prevented the increase in SBP (delta - 5 and -7 mmHg, respectively; p > 0.05), whereas SBP of the SED-SHR group increased by 19 mmHg (p < 0.05). There was a decrease in HR only for the RT1 group (p < 0.05). There was a higher increase in strength in the RT2 (140%; p < 0.05) group as compared with RT1 (11%; p > 0.05).

CONCLUSIONS

Our data indicated that both RT protocols were effective in preventing chronic elevation of SBP in SH. Additionally, a higher RT overload induced a greater increase in muscle strength.

Exercise, the Brain, and Hypertension

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.

Association between handgrip strength and physical activity in hypertensive elderly individuals

Introduction : Handgrip is an excellent indicator of functionality, nutritional status and mortality among the elderly. Objective: To compare the handgrip strength of hypertensive elderly individuals classified by different levels and types of physical activity. Method: A cross-sectional study was carried out with a sample of 80 individuals divided into three physical activity groups, according to the leisure-time and transportation sections of the long version of the IPAQ: active (≥150 min/week), insufficiently active (<150 min/week) and sedentary (10 min/week). The active individuals were also separated by type of physical activity: gymnastics, hydro gymnastics and weight training. Strength was measured by a Jamar dynamometer and consisted of a continuous handgrip movement lasting for 30 seconds. Information about demographic, socio-economic and behavioral variables was collected by questionnaire. ANOVA and paired t-test were used to compare the means of strength. The significance level was 5%. Results: Dominant and non-dominant handgrip average was 24.2 kgf (+8.3) and 22.0 kgf (+7.3), respectively. There was no significant difference in the mean handgrip strength between the active and sedentary groups; however, when the type of physical activity was evaluated, the weightlifting group had a significantly higher mean than the gym and aerobics groups. Conclusion: Handgrip strength seems to be associated with the type of activity performed, rather than the amount of time the activity is performed per week.

Effects of exercise intensity on postexercise hypotension after resistance training session in overweight hypertensive patients

Among all nonpharmacological treatments, aerobic or resistance training (RT) has been indicated as a significantly important strategy to control hypertension. However, postexercise hypotension responses after intensity alterations in RT are not yet fully understood. The purpose of this study was to compare the outcomes of differing intensities of RT on hypertensive older women. Twenty hypertensive older women participated voluntarily in this study. After a maximum voluntary contraction test (one repetition maximum) and determination of 40% and 80% experimental loads, the protocol (3 sets/90″ interset rest) was performed in a single session with the following exercises: leg press, leg extension, leg curl, chest press, elbow flexion, elbow extension, upper back row, and abdominal flexion. Systolic and diastolic blood pressures were evaluated at rest, during exercise peak, and after 5, 10, 15, 30, 45, and 60 minutes of exercise and compared to the control. Both experimental loads were effective (P<0.01) in promoting postexercise systolic hypotension (mmHg) compared to controls, after 30, 45, and 60 minutes, respectively, at 40% (113±2, 112±4, and 110±3 mmHg) and 80% (111±3, 111±4, and 110±4 mmHg). Both procedures promoted hypotension with similar systolic blood pressures (40%: -11%±1.0% and 80%: -13%±0.5%), mean arterial blood pressures (40%: -12%±5.5% and 80%: -12%±3.4%), and rate-pressure products (40%: -15%±2.1% and 80%: -17%±2.4%) compared to control measures (systolic blood pressure: 1%±1%, mean arterial blood pressure:\ 0.6%±1.5%, rate-pressure product: 0.33%±1.1%). No differences were found in diastolic blood pressure and heart rate measures. In conclusion, hypertensive older women exhibit postexercise hypotension independently of exercise intensity without expressed cardiovascular overload during the session.

Chronic resistance training does not affect post-exercise blood pressure in normotensive older women: a randomized controlled trial

Resistance training has been recommended for maintenance or improvement of the functional health of older adults, but its effect on acute cardiovascular responses remains unclear. Thus, the purpose of this study was to analyze the effect of 12 weeks of resistance training on post-exercise blood pressure (BP) in normotensive older women. Twenty-eight normotensive and physically inactive women (≥ 60 years) were randomly assigned to a training group (TG) or a control group (CG). The TG underwent a resistance training program (12 weeks, 8 exercises, 2 sets, 10-15 repetitions, 3 days/week), while the CG performed stretching exercises (12 weeks, 2 sets, 20 s each, 2 days/week). At baseline and after the intervention, participants were randomly submitted to two experimental sessions: a resistance exercise session (7 exercises, 2 sets, 10-15 repetitions) and a control session. BP was obtained pre- and post-sessions (90 min), through auscultation. Post-exercise hypotension was observed for systolic, diastolic, and mean BP in the TG (-6.1, -3.4, and -4.3 mmHg, respectively; P < 0.05) and in the CG (-4.1, -0.7, and -1.8 mmHg, respectively; P < 0.05). After the intervention period, the magnitude and pattern of this phenomenon for systolic, diastolic, and mean BP were similar between groups (TG -8.8, -4.1, and -5.7 mmHg, respectively; P < 0.05 vs CG -11.1, -5.8, and -7.6 mmHg, respectively; P < 0.05). These results indicate that a single session of resistance exercise promotes reduction in post-exercise BP and 12 weeks of resistance training program do not change the occurrence or magnitude of this hypotension. (ClinicalTrial.gov: NCT02346981).

Acute blood pressure changes are related to chronic effects of resistance exercise in medicated hypertensives elderly women

BACKGROUND

A previous study observed that the chronic effects of aerobic training on blood pressure (BP) are related to acute BP responses after a single bout of aerobic exercise. However, whether similar responses are observed with resistance exercise (RE) remains obscure. Thus, this study analysed the relationship between the acute BP responses to a single bout of RE and chronic changes in resting BP after a RE training in medicated hypertensive elderly women.

METHODS AND RESULTS

Twenty medicated hypertensive women participated in the study. They underwent an acute RE bout where BP and heart rate (HR) were obtained at rest and for 60 min after the RE. Subsequently, the participants underwent a progressive RE training for 12 weeks at 60-80% of maximal strength test. Resting BP and HR were also obtained after the RE training. The chronic decreases in systolic and diastolic BP were significantly greater in the participants who experienced acutely decreased systolic and diastolic BP, respectively (P<0·05). The changes in systolic BP after acute RE were correlated with the chronic changes in resting systolic BP after RE training (r = 0·47; P = 0·03). Similar correlations between acute and chronic responses were also observed for diastolic BP (r = 0·70; P = 0·01), mean BP (r = 0·58; P = 0·01), HR (r = 0·73; P<0·01) and RPP (r = 0·52; P = 0·01).

CONCLUSION

Similar to previously work involving aerobic exercise, BP responses to a single bout of RE are strongly related to chronic effects of RE training on BP in medicated hypertensive elderly women.

Resistance exercise with different volumes: blood pressure response and forearm blood flow in the hypertensive elderly

Background

The purpose of this study was to evaluate the effect of two sessions of resistance exercise with different volumes on post-exercise hypotension, forearm blood flow, and forearm vascular resistance in hypertensive elderly subjects.

Methods

The study was conducted with ten hypertensive elderly (65±3 years, 28.7±3 kg/m²) subjected to three experimental sessions, ie, a control session, exercise with a set (S1), and exercise with three sets (S3). For each session, the subjects were evaluated before and after intervention. In the pre-intervention period, blood pressure, forearm blood flow, and forearm vascular resistance were measured after 10 minutes of rest in the supine position. Thereafter, the subjects were taken to the gym to perform their exercise sessions or remained at rest during the same time period. Both S1 and S3 comprised a set of ten repetitions of ten exercises, with an interval of 90 seconds between exercises. Subsequently, the measurements were again performed at 10, 30, 50, 70, and 90 minutes of recovery (post-intervention) in the supine position.

Results

Post-exercise hypotension was greater in S3 than in S1 (systolic blood pressure, −26.5±4.2 mmHg versus −17.9±4.7 mmHg; diastolic blood pressure, −13.8±4.9 mmHg versus −7.7±5 mmHg, P<0.05). Similarly, forearm blood flow and forearm vascular resistance changed significantly in both sessions with an increase and decrease, respectively, that was more evident in S3 than in S1 (P<0.05).

Conclusion

Resistance exercises with higher volume were more effective in causing post-exercise hypotension, being accompanied by an increase in forearm blood flow and a reduction of forearm vascular resistance.

Blood pressure changes following aerobic exercise in Caucasian and Chinese descendants

Acute aerobic exercise produces post-exercise hypotension (PEH). Chinese populations have lower prevalence of cardiovascular disease compared to Caucasians. PEH may be associated cardiovascular disease through its influence on hypertension. The purpose of this study was to compare PEH between Caucasian and Chinese subjects following acute aerobic exercise. 62 (30 Caucasian and 32 Chinese, 50% male) subjects underwent measurement of peripheral and central hemodynamics as well as arterial and cardiac evaluations, 30 min and 60 min after 45 min of treadmill exercise. Caucasians exhibited significantly higher baseline BP than the Chinese. While the reduction in brachial artery systolic BP was greater in Caucasian than in the Chinese, there was no difference in changes in carotid systolic BP between the groups. The increase in cardiac output and heart rate was greater in the Chinese than Caucasians, but total peripheral resistance and leg pulse wave velocity decreased by a similar magnitude in the Chinese and Caucasian subjects. We conclude that acute aerobic exercise produces a greater magnitude of PEH in peripheral systolic BP in Caucasian compared to Chinese subjects. The different magnitude in PEH was caused by the greater increase in cardiac output mediated by heart rate, with no change in stroke volume. It is possible that initial BP differences between races influenced the findings.

Influence of resistance training on blood pressure in patients with metabolic syndrome and menopause

This study investigated the chronic and acute influence of resistance exercise on blood pressure in women with metabolic syndrome before and after climacteric. Twenty sedentary women, nine non-menopausal (RNM) and 11 menopausal (RM), performed training for 12 weeks. Meanwhile, 23 controls, 11 not menopausal (CNM) and 12 menopausal (CM), remained sedentary. Blood pressure was measured before and after the training period in conditions of rest and after a session of exercise. Training promoted variations in blood pressure at rest from 116±13 to 118±10 mmHg (p=0.73) and from 128±12 mmHg to 120±11mmHg (p=0.12) in RNM and RM, respectively. CNM and CM varied from 115±11 to 116±12 mmHg (p=0.9) and from 115±14 mmHg to 116±13 mmHg (p=0.74). Blood pressure values in one acute session did not differ between groups (p>0.05). Resistance training did not improve blood pressure in women with metabolic syndrome, regardless of climacteric.

Sit, breathe, smile: effects of single and weekly seated Qigong on blood pressure and quality of life in long-term care

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.