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Soto-Rodríguez FJ, Moya AP, Bobadilla-Agouborde CJ, Pérez-Mármol JM. Effect of Exercise Prior to Sedentary Behavior on Vascular Health Parameters: A Systematic Review and Meta-Analysis of Crossover Trials. SPORTS MEDICINE - OPEN 2024; 10:69. [PMID: 38853205 PMCID: PMC11162984 DOI: 10.1186/s40798-024-00734-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 05/22/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Sedentary behavior has been shown to negatively affect parameters of endothelial function and central hemodynamics, both of which are closely associated with vascular health. Exercise prior to sedentary behavior has demonstrated potential as a preventive strategy to mitigate these detrimental effects. To evaluate the impact of exercise prior to sedentary behavior on vascular health parameters in the adult population, a systematic review and meta-analysis were conducted, synthesizing the available body of knowledge. METHODS A literature search was carried out in 6 databases. For each outcome, standard error and mean difference or standardized mean difference were calculated, as appropriate. An analysis was performed using a random effects model with a 95% confidence interval, using the inverse variance statistical method. Risk of bias assessment was performed using ROB2 and considerations for crossover trials. The quality of evidence was assessed using the GRADE system. RESULTS Exercise performed prior to prolonged sedentary behavior resulted in increased flow-mediated vasodilation at the first and third hours of sedentary time, compared with the control condition of sedentary behavior without prior exercise [MD: 1.51% (95% CI: 0.57 to 2.45) and MD: 1.36% (95% CI: 0.56 to 2.16), respectively]. Moreover, prior exercise led to increased shear rate at the first and third hours of sedentary time [MD: 7.70 s^-1 (95% CI: 0.79 to 14.61) and MD: 5.21 s^-1 (95% CI: 1.77 to 8.43), respectively]. Furthermore, it increased blood flow at the third hour [SMD: 0.40 (95%CI: 0.07 to 0.72)], compared with the control condition of prolonged sedentary behavior without prior exercise. Regarding hemodynamic parameters, exercise prior to prolonged sedentary behavior decreased mean arterial pressure during the first and third hours of sedentary behavior [MD: -1.94 mmHg (95% CI: -2.77 to -1.11) and MD: -1.90 mmHg (95% CI: -3.27 to -0.53), respectively], and an increase in heart rate during the first hour [MD: 4.38 beats per minute (95%CI: 2.78 to 5.98)] compared with the control condition of prolonged sedentary behavior without prior exercise. CONCLUSIONS The findings of this research suggest that prior exercise may prevent the impairment of vascular health parameters caused by sedentary behavior. However, the quality of the evidence was estimated as moderate. Therefore, further experimental studies and high-quality clinical trials are needed in this field to strengthen the results and conclusions drawn. PROSPERO REGISTRATION NUMBER CRD42023393686.
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Affiliation(s)
- Francisco Javier Soto-Rodríguez
- Departamento de Ciencias de la Rehabilitación, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile.
- Facultad de Ciencias de la Salud, Carrera de Kinesiología, Universidad Autónoma de Chile, Temuco, Chile.
| | - Alicia Peris Moya
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Granada, Granada, Spain
| | | | - José Manuel Pérez-Mármol
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain
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Benjamim CJR, da Silva LSL, Sousa YBA, Rodrigues GDS, Pontes YMDM, Rebelo MA, Gonçalves LDS, Tavares SS, Guimarães CS, da Silva Sobrinho AC, Tanus-Santos JE, Gualano B, Bueno Júnior CR. Acute and short-term beetroot juice nitrate-rich ingestion enhances cardiovascular responses following aerobic exercise in postmenopausal women with arterial hypertension: A triple-blinded randomized controlled trial. Free Radic Biol Med 2024; 211:12-23. [PMID: 38092272 DOI: 10.1016/j.freeradbiomed.2023.11.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/19/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND The increase in blood pressure (BP) levels in the postmenopausal period can be partly explained by the decrease in nitric oxide synthases (NOS). OBJECTIVE To investigate the acute and one-week effects of beetroot juice nitrate-rich (BRJ-NO3-rich) ingestion on cardiovascular and autonomic performance in response to submaximal aerobic exercise in postmenopausal women with systemic arterial hypertension (SAH) who are physically inactive. METHODS Fourteen postmenopausal women with SAH [mean (SD) age: 59(4) y; BMI (kg/m2): 29.2(3.1)] completed submaximal aerobic exercise bouts after an acute and a one-week intervention with BRJ in a placebo-controlled, randomized, triple-blind, crossover design. Participants ingested either BRJ (800 mg of NO3-) or placebo acutely and drank either BRJ (400 mg of NO3-) or placebo every day for the next six days. After two and ½ hours, they performed a session of aerobic submaximal aerobic exercise, and their systolic BP (SBP) and diastolic BP (DBP), flow-mediated dilation (FMD), heart rate (HR) recovery, and HR variability were measured. RESULTS In the post-exercise recovery period, SBP dropped significantly in the BRJ-NO3-rich group (-9.28 mmHg [95%CI: -1.68 to -16.88] ES: -0.65, p = 0.019) compared to placebo after acute ingestion. The FMD values increased after acute BRJ-NO3-rich on post-exercise (3.18 % [0.36 to 5.99] ES: 0.87, p = 0.031). After the one-week intervention, FMD values were higher in the BRJ-NO3-rich group before (4.5 % [1.62 to 7.37] ES: 1.21, p = 0.005) and post-exercise measurements (4.2 % [1.52 to 6.87] ES: 1.22, p = 0.004) vs. placebo. HRV indices with remarkable parasympathetic modulation to heart recovered faster on the BRJ-NO3-rich group than placebo group. No between-group differences were identified in values of HR post-exercise recovery in the 30s, 60s, 120s, 180s, and 300s. CONCLUSIONS Acute and short-term BRJ-NO3-rich ingestion may enhance cardiovascular and autonomic behavior in response to aerobic exercise in postmenopausal women diagnosed with SAH. CLINICAL TRIAL REGISTRY NUMBER https://clinicaltrials.gov/ct2/show/NCT05384340.
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Affiliation(s)
- Cicero Jonas R Benjamim
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP/USP), Ribeirão Preto, São Paulo, Brazil.
| | - Leonardo Santos L da Silva
- School of Physical Education of Ribeirão Preto, University of São Paulo (EEFERP/USP) Ribeirão Preto, Brazil
| | - Yaritza B Alves Sousa
- Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo, USP, Ribeirao Preto, Sao Paulo, Brazil
| | - Guilherme da Silva Rodrigues
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP/USP), Ribeirão Preto, São Paulo, Brazil
| | | | - Macario Arosti Rebelo
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil
| | | | - Simone Sakagute Tavares
- School of Physical Education of Ribeirão Preto, University of São Paulo (EEFERP/USP) Ribeirão Preto, Brazil
| | - Carolina S Guimarães
- Ribeirao Preto Nursing School, University of São Paulo (EERP/USP), Ribeirão Preto, SP, Brazil
| | - Andressa C da Silva Sobrinho
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP/USP), Ribeirão Preto, São Paulo, Brazil
| | - Jose E Tanus-Santos
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo (FMRP/USP), Ribeirão Preto, SP, Brazil
| | - Bruno Gualano
- Center of Lifestyle Medicine, Applied Physiology & Nutrition Research Group, University of São Paulo, Medical School (FMUSP), São Paulo, SP, Brazil
| | - Carlos R Bueno Júnior
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP/USP), Ribeirão Preto, São Paulo, Brazil; School of Physical Education of Ribeirão Preto, University of São Paulo (EEFERP/USP) Ribeirão Preto, Brazil; Ribeirao Preto Nursing School, University of São Paulo (EERP/USP), Ribeirão Preto, SP, Brazil
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Kiernan PA, Day CA, Berkowsky RS, Zaleski AL, Gao S, Taylor BA, Santos LP, Panza G, Kramarz M, McCormick K, Thompson PD, Fernandez AB, Chen MH, Pescatello LS. Reliability and Time Course of Postexercise Hypotension during Exercise Training among Adults with Hypertension. J Cardiovasc Dev Dis 2024; 11:42. [PMID: 38392256 PMCID: PMC10889392 DOI: 10.3390/jcdd11020042] [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: 12/28/2023] [Revised: 01/25/2024] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
Postexercise hypotension (PEH), or the immediate decrease in blood pressure (BP) lasting for 24 h following an exercise bout, is well-established; however, the influence of exercise training on PEH dynamics is unknown. This study investigated the reliability and time course of change of PEH during exercise training among adults with hypertension. PEH responders (n = 10) underwent 12 weeks of aerobic exercise training, 40 min/session at moderate-to-vigorous intensity for 3 d/weeks. Self-measured BP was used to calculate PEH before and for 10 min after each session. The intraclass correlation coefficient (ICC) and Akaike Information Criterion (AIC) determined PEH reliability and goodness-of-fit for each week, respectively. Participants were obese (30.6 ± 4.3 kg∙m-2), middle-aged (57.2 ± 10.5 years), and mostly men (60%) with stage I hypertension (136.5 ± 12.1/83.4 ± 6.7 mmHg). Exercise training adherence was 90.6 ± 11.8% with 32.6 ± 4.2 sessions completed. PEH occurred in 89.7 ± 8.3% of these sessions with BP reductions of 9.3 ± 13.1/3.2 ± 6.8 mmHg. PEH reliability was moderate (ICC ~0.6). AIC analysis revealed a stabilization of maximal systolic and diastolic BP reductions at 3 weeks and 10 weeks, respectively. PEH persisted throughout exercise training at clinically meaningful levels, suggesting that the antihypertensive effects of exercise training may be largely due to PEH. Further studies in larger samples and under ambulatory conditions are needed to confirm these novel findings.
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Affiliation(s)
- Peter A Kiernan
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Christina A Day
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Rachel S Berkowsky
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | | | - Simiao Gao
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | | | - Lucas P Santos
- Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
| | | | - Melody Kramarz
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Kyle McCormick
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | | | | | - Ming-Hui Chen
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
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