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de Oliveira Carpes L, Domingues LB, Fuchs SC, Ferrari R. Rate of Responders for Post-Exercise Hypotension after Beach Tennis, Aerobic, Resistance and Combined Exercise Sessions in Adults with Hypertension. Sports (Basel) 2023; 11:sports11030058. [PMID: 36976944 PMCID: PMC10058339 DOI: 10.3390/sports11030058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/24/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
Post-exercise hypotension (PEH) is typically reported as mean values, but a great inter-individual variation in blood pressure (BP) response after a single exercise session is expected, especially when comparing different modalities of exercise. The purpose was to evaluate the inter-individual BP responses after beach tennis, aerobic, resistance and combined exercise sessions in adults with hypertension. We conducted a post hoc analysis of pooled crossover randomized clinical trials from six previously published studies of our research group, and analyzed data from 154 participants with hypertension (≥35 years). BP was assessed using office BP, and the mean changes throughout the 60 min after recreational beach tennis (BT, n = 23), aerobic (AE, n = 18), combined (COMB, n = 18), and resistance (RES, n = 95) exercise sessions were compared to a non-exercising control session (C). To categorize the participants as responders and non-responders for PEH, the typical error (TE) was calculated as follows: TE = SDdifference/√2, where SDdifference is the standard deviation of the differences in BP measured before the interventions in the exercise and control sessions. Participants who presented PEH greater than TE were classified as responders. The TE was 7 and 6 mmHg for baseline systolic and diastolic BP, respectively. The rate of responders for systolic BP was as follows: BT: 87%; AE: 61%; COMB: 56%; and RES: 43%. For diastolic BP, the rate of responders was as follows: BT: 61%; AE: 28%; COMB: 44%; and RES: 40%. Results evidenced that there was a high inter-individual variation of BP after a single bout of different physical activity modalities in adults with hypertension, suggesting that exercise protocols with aerobic characteristics (i.e., BT, AE, and COMB sessions) presented PEH in most of its practitioners.
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Affiliation(s)
- Leandro de Oliveira Carpes
- Graduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-903, Brazil
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
| | - Lucas Betti Domingues
- Graduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-903, Brazil
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
| | - Sandra Costa Fuchs
- Graduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-903, Brazil
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
| | - Rodrigo Ferrari
- Graduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-903, Brazil
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
- Postgraduate Program in Human Movement Sciences, School of Physical Education, Universidade Federal do Rio Grande do Sul, Porto Alegre 90690-200, Brazil
- Correspondence:
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Carpes LO, Domingues LB, Bertoletti O, Fuchs SC, Ferrari R. Inter-individual responses of post-exercise hypotension in older adults with hypertension: An exploratory analysis of different exercise modalities. Front Physiol 2022; 13:1050609. [PMID: 36505064 PMCID: PMC9727289 DOI: 10.3389/fphys.2022.1050609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/09/2022] [Indexed: 11/24/2022] Open
Abstract
Background: Various physical exercise modalities can acutely reduce blood pressure (BP). However, not all individuals respond similarly after an exercise session. Purpose: To measure inter-individual variations in 24-h BP after a single bout of various exercise modalities in older adults with hypertension. Methods: This retrospective study analyzed data from participants with hypertension (≥60 years) previously included in three randomized controlled trials on this topic. BP was assessed using ambulatory BP monitoring. We compared the mean changes in total 24-h, daytime, and nighttime BP after aerobic (AE, n = 19), combined (COMB, n = 19), resistance (RES, n = 23), and isometric handgrip (ISO, n = 18) exercise sessions to a non-exercising control session (C). The minimum detectable changes to classify the participant as a "Responder" for the corresponding exercise protocol were 4 and 2 mmHg for systolic and diastolic BP, respectively. Results: The prevalence of Responders for systolic BP was as follows: AE 24-h: 37%, daytime: 47% and nighttime: 37%; COMB 24-h: 26%, daytime: 21% and nighttime: 32%; RES 24-h: 26%, daytime: 26% and nighttime: 35%; and ISO 24-h: 22%, daytime: 22% and nighttime: 39%. For diastolic BP, the prevalence of Responders was as follows: AE 24-h: 53%, daytime: 53% and nighttime: 31%; COMB 24-h: 26%, daytime: 26% and nighttime: 31%; RES 24-h: 35%, daytime: 22% and nighttime: 52%; and ISO 24-h: 44%, daytime: 33% and nighttime: 33%. Conclusion: There was a high inter-individual variation of BP after a single bout of various exercises in older adults. Responders had higher BP values on the control day without exercise. Various exercise modalities might acutely reduce 24-h BP in older adults with hypertension.
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Affiliation(s)
- Leandro O. Carpes
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil,Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Lucas B. Domingues
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil,Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Otávio Bertoletti
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sandra C. Fuchs
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil,Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil,Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Rodrigo Ferrari
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil,Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil,*Correspondence: Rodrigo Ferrari,
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Acute and chronic effects of traditional and high-speed resistance training on blood pressure in older adults: A crossover study and systematic review and meta-analysis. Exp Gerontol 2022; 163:111775. [DOI: 10.1016/j.exger.2022.111775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 03/03/2022] [Accepted: 03/21/2022] [Indexed: 11/22/2022]
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Acute Blood Pressure Response to High- and Moderate-Speed Resistance Exercise in Older Adults With Hypertension. J Aging Phys Act 2021; 30:689-696. [PMID: 34856535 DOI: 10.1123/japa.2021-0214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/20/2021] [Accepted: 10/02/2021] [Indexed: 11/18/2022]
Abstract
An increase in blood pressure (BP) occurs during resistance exercise; attention to this response may be necessary in older individuals with hypertension. We compared the BP responses following high- (HSRE) and moderate-speed resistance exercise (MSRE) (4 × 8 repetitions at 60% one-repetition maximum) and control protocol in 15 older adults with hypertension. HSRE and MSRE increased systolic BP (SBP) by the end of each set compared with preexercise and control protocol. Immediately after the fourth set, a higher SBP was observed in MSRE than HSRE (147 ± 14 vs. 141 ± 12 mmHg; p = .01). Taking an exploratory analysis of the individual response, we observed that MSRE resulted in greater mean changes and number of SBP exposures to values ≥150 mmHg (22-fold) than HSRE (10-fold). Diastolic BP increased (p < .05) with exercise, but only MSRE increased compared with the control condition (p < .05). HSRE may be an alternative for individuals in which SBP peak should be avoided.
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de Oliveira Carpes L, Domingues LB, Schimitt R, Fuchs SC, Alhalimi T, Tanaka H, Ferrari R. Sex Differences in Post-exercise Hypotension, Ambulatory Blood Pressure Variability, and Endothelial Function After a Power Training Session in Older Adults. Front Physiol 2021; 12:657373. [PMID: 34335289 PMCID: PMC8322608 DOI: 10.3389/fphys.2021.657373] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/11/2021] [Indexed: 01/04/2023] Open
Abstract
Background: The efficacy of power training (PT) to acutely reduce blood pressure (BP) in participants with hypertension is controversial, and no studies have assessed the influence of sex on post-exercise hypotension and its mechanisms in older adults. Purpose: The aims of this secondary, exploratory analysis were to compare the effects of a single bout of PT on post-exercise hypotension, BP variability, and endothelial function between older men and women with hypertension. Methods: Twenty-four participants with hypertension (12 men and 12 women aged to >60 years old) took part in this crossover study and randomly performed two experimental sessions: power exercise training (PT) and non-exercising control session (Con). The PT protocol was composed of 3 sets of 8–10 repetitions of five exercises performed in the following order: leg press, bench press, knee extension, upright row, and knee flexion, using an intensity corresponding to 50% of one repetition maximal test (1RM) and 2-min intervals between sets and exercises. The concentric phase of exercises during each repetition was performed “as fast as possible,” while the eccentric phase lasted 1 to 2 s. During Con, the participants remained at seated rest on the same exercise machines, but without any exercise. Each protocol lasted 40 min. Office BP, flow-mediated dilatation (FMD), 24-h ambulatory BP, and the average real variability (ARV) of systolic and diastolic BP were assessed before and after experimental sessions. Results: Comparing PT with Con, a reduced office BP after exercise was found in men (systolic BP—average post 1 h: −14 mmHg, p < 0.001; diastolic BP—average post 1 h: −8 mmHg, p < 0.001) and only a reduced systolic BP in women (average post 1 h: −7 mmHg, p = 0.04). Comparing men and women, a reduced systolic BP (post 60': −15 mmHg, p = 0.048; average post 1 h: −7 mmHg, p = 0.046) and diastolic BP (post 60': −9 mmHg, p = 0.049) after the first hour were found in men. In relation to 24-h ambulatory BP, ARV, and FMD, no statistically significant differences were found between men and women. Conclusion: In older adults with hypertension, the office BP response after the experimental sessions was different in men and women, showing that the PT protocol is more effective to acutely reduce BP in men. Additionally, the mechanisms behind this reduction remain unclear. This finding suggests that sex cannot be combined to analyze post-exercise hypotension. Clinical Trial Registration: ClinicalTrials.gov, Identifier: NCT03615625.
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Affiliation(s)
- Leandro de Oliveira Carpes
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Lucas Betti Domingues
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Renato Schimitt
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Sandra C Fuchs
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Taha Alhalimi
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, United States
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, United States
| | - Rodrigo Ferrari
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Carpes L, Jacobsen A, Domingues L, Jung N, Ferrari R. Recreational beach tennis reduces 24-h blood pressure in adults with hypertension: a randomized crossover trial. Eur J Appl Physiol 2021; 121:1327-1336. [PMID: 33590342 DOI: 10.1007/s00421-021-04617-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 02/05/2021] [Indexed: 01/23/2023]
Abstract
PURPOSE To evaluate the effect of a beach tennis session on 24-h ambulatory blood pressure in adults with hypertension. METHODS In this randomized crossover trial, 24 participants (12 men and 12 women) randomly performed two experimental sessions: a beach tennis session and a non-exercise control session. The beach tennis session started with a standardized 5-min warm-up consisting of basic techniques, followed by three 12-min beach tennis matches with 2-min intervals between them. Heart rate was continuously recorded and rating of perceived exertion was assessed in the middle and at the end of each set during the beach tennis session. Enjoyment was also assessed after the beach tennis session. The control session was performed in seated rest. Both experimental sessions lasted 45 min. Ambulatory blood pressure was measured continuously for 24 h after sessions. RESULTS Systolic blood pressure (24-h: 6 mmHg, P = 0.008; daytime: 6 mmHg, P = 0.031; nighttime: 6 mmHg, P = 0.042) and diastolic blood pressure (24-h: 3 mmHg, P = 0.021; daytime: 3 mmHg, P = 0.036; nighttime: 4 mmHg, P = 0.076) decreased after beach tennis when compared with control. The participants presented a reserve heart rate of 59-68%, and a rating of perceived exertion score of 3.4-4.7 using Borg's CR10 Scale. The enjoyment scores after beach tennis session were higher than 90%. CONCLUSION A single session of recreational beach tennis reduces 24-h ambulatory blood pressure in adults with hypertension. Additionally, the participants can achieve a high physiological stress but perceive less effort during the practice. TRIAL REGISTRATION Date: April 10, 2019; identifier number NCT03909308 (Clinicaltrials.gov).
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Affiliation(s)
- Leandro Carpes
- Graduate Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, RS, 90035-903, Brazil
| | - Alexandre Jacobsen
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, RS, 90035-903, Brazil
| | - Lucas Domingues
- Graduate Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, RS, 90035-903, Brazil
| | - Nathalia Jung
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, RS, 90035-903, Brazil
| | - Rodrigo Ferrari
- Graduate Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, RS, 90035-903, Brazil.
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