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Lei T, Wang I, Chen Y, Liu X, Fujii N, Koga S, Perry B, Mundel T, Wang F, Cao Y, Dobashi K, Kondo N, Li H, Goulding RP. Critical power is a key threshold determining the magnitude of post-exercise hypotension in non-hypertensive young males. Exp Physiol 2023; 108:1409-1421. [PMID: 37712355 PMCID: PMC10988428 DOI: 10.1113/ep091429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 08/24/2023] [Indexed: 09/16/2023]
Abstract
The effect of different exercise intensities on the magnitude of post-exercise hypotension has not been rigorously clarified with respect to the metabolic thresholds that partition discrete exercise intensity domains (i.e., critical power and the gas exchange threshold (GET)). We hypothesized that the magnitude of post-exercise hypotension would be greater following isocaloric exercise performed above versus below critical power. Twelve non-hypertensive men completed a ramp incremental exercise test to determine maximal oxygen uptake and the GET, followed by five exhaustive constant load trials to determine critical power and W' (work available above critical power). Subsequently, criterion trials were performed at four discrete intensities matched for total work performed (i.e., isocaloric) to determine the impact of exercise intensity on post-exercise hypotension: 10% above critical power (10% > CP), 10% below critical power (10% < CP), 10% above GET (10% > GET) and 10% below GET (10% < GET). The post-exercise decrease (i.e., the minimum post-exercise values) in mean arterial (10% > CP: -12.7 ± 8.3 vs. 10% < CP: v3.5 ± 2.9 mmHg), diastolic (10% > CP: -9.6 ± 9.8 vs. 10% < CP: -1.4 ± 5.0 mmHg) and systolic (10% > CP: -23.8 ± 7.0 vs. 10% < CP: -9.9 ± 4.3 mmHg) blood pressures were greater following exercise performed 10% > CP compared to all other trials (all P < 0.01). No effects of exercise intensity on the magnitude of post-exercise hypotension were observed during exercise performed below critical power (all P > 0.05). Critical power represents a threshold above which the magnitude of post-exercise hypotension is greatly augmented. NEW FINDINGS: What is the central questions of this study? What is the influence of exercise intensity on the magnitude of post-exercise hypotension with respect to metabolic thresholds? What is the main finding and its importance? The magnitude of post-exercise hypotension is greatly increased following exercise performed above critical power. However, below critical power, there was no clear effect of exercise intensity on the magnitude of post-exercise hypotension.
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Affiliation(s)
- Tze‐Huan Lei
- College of Physical EducationHubei Normal UniversityHuangshiChina
| | - I‐Lin Wang
- College of Physical EducationHubei Normal UniversityHuangshiChina
| | - Yi‐Ming Chen
- Department of Food ScienceFu Jen Catholic UniversityNew Taipei CityTaiwan
| | - Xin‐Hao Liu
- College of Physical EducationHubei Normal UniversityHuangshiChina
| | - Naoto Fujii
- Faculty of Health and Sport SciencesUniversity of TsukubaTsukubaJapan
| | - Shunsaku Koga
- Applied Physiology LaboratoryKobe Design UniversityKobeJapan
| | - Blake Perry
- School of Health SciencesMassey UniversityWellingtonNew Zealand
| | - Toby Mundel
- Department of KinesiologyBrock UniversitySt CatharinesCanada
| | - Faming Wang
- Division Animal and Human Health Engineering, Department of Biosystems (BIOSYST)KU LeuvenLeuvenBelgium
| | - Yinhang Cao
- School of Athletic PerformanceShanghai Sport UniversityShanghaiChina
| | - Kohei Dobashi
- Faculty of EducationHokkaido University of EducationAsahikawaJapan
| | - Narihiko Kondo
- Laboratory for Applied Human Physiology, Graduate School of Human Development and EnvironmentKobe UniversityKobeJapan
| | - Hao‐Yu Li
- College of Physical EducationHubei Normal UniversityHuangshiChina
| | - Richie P. Goulding
- Laboratory for Myology, Department of Human Movement Sciences, Faculty of Behavioral and Human Movement Sciences, Vrije Universiteit AmsterdamAmsterdam Movement SciencesAmsterdamthe Netherlands
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2
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Aly K, Yeung PK. Post-Exercise Hypotension: An Alternative Management Strategy for Hypertension and Cardiovascular Disease? J Clin Med 2023; 12:4456. [PMID: 37445491 DOI: 10.3390/jcm12134456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 07/15/2023] Open
Abstract
Cardiovascular disease (CVD), including hypertension, is a leading cause of death worldwide and imposes an enormous burden on our societies [...].
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Affiliation(s)
- Khaled Aly
- College of Pharmacy and Department of Medicine, Faculty of Health and Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Pollen K Yeung
- College of Pharmacy and Department of Medicine, Faculty of Health and Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
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Álvarez C, Guede-Rojas F, Ramírez-Campillo R, Andrade DC, Vásquez-Gómez J, Rodríguez-Rodríguez F, Ciolac EG, Caamaño-Navarrete F, Delgado-Floody P. Characterizing the interindividual postexercise hypotension response for two order groups of concurrent training in patients with morbid obesity. Front Physiol 2022; 13:913645. [PMID: 36299263 PMCID: PMC9589449 DOI: 10.3389/fphys.2022.913645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 09/07/2022] [Indexed: 12/05/2022] Open
Abstract
Background: Postexercise hypotension (PEH) is a common physiological phenomenon occurring immediately after endurance training (ET), resistance training (RT), and ET plus RT, also termed concurrent training (CT); however, there is little knowledge about the interindividual and magnitude response of PEH in morbidly obese patients. Aim: The aims of this study were (1) to investigate the effect of CT order (ET + RT vs. RT + ET) on the blood pressure responses; 2) characterize these responses in responders and nonresponders, and 3) identify potential baseline outcomes for predicting blood pressure decreases as responders. Methods: A quasi-experimental study developed in sedentary morbidly obese men and women (age 43.6 ± 11.3 years; body mass index [BMI] ≥40 kg/m2) was assigned to a CT group of ET plus RT (ET + RT; n = 19; BMI 47.8 ± 16.7) or RT plus ET order group (RT + ET; n = 17; BMI 43.0 ± 8.0). Subjects of both groups received eight exercise sessions over four weeks. Primary outcomes include systolic (SBP), diastolic (DBP), mean arterial pressure [MAP], heart rate at rest [HR], and pulse pressure [PP] measurements before and after 10 min post-exercise. Secondary outcomes were other anthropometric, body composition, metabolic, and physical fitness parameters. Using the delta ∆SBP reduction, quartile categorization (Q) in “high” (Rs: quartile 4), “moderate” (MRs: quartile 3), “low” (LRs: quartile 2), and “nonresponders” (NRs: quartile 1) was reported. Results: Significant pre–post changes were observed in ET + RT in session 2 for SBP (131.6 vs. 123.4 mmHg, p = 0.050) and session 4 (131.1 vs. 125.2 mmHg, p = 0.0002), while the RT + ET group showed significant reductions in session 4 (134.2 vs. 125.3 mmHg, p < 0.001). No significant differences were detected in the sum of the eight sessions for SBP (∑∆SBP) between ET + RT vs. RT + ET (−5.7 vs. −4.3 mmHg, p = 0.552). Interindividual analyses revealed significant differences among frequencies comparing Q1 “NRs” (n = 8; 22.2%), Q2 “LRs” (n = 8; 22.2%), Q3 “MRs” (n = 9; 25.0%), and Q4 “HRs” (n = 11; 30.5%), p < 0.0001. Quartile comparisons showed significant differences in SBP changes (p = 0.035). Linear regression analyses revealed significant association between ∑∆SBP with body fat % (β –3.826, R2 0.211 [21.1%], p = 0.031), skeletal muscle mass [β –2.150, R2 0.125 (12.5%), p = 0.023], fasting glucose [β 1.273, R2 0.078 (7.8%), p = 0.003], triglycerides [β 0.210, R2 0.014 (1.4%), p = 0.008], and the 6-min walking test [β 0.183, R2 0.038 (3.8%), p = 0.044]. Conclusion: The CT order of ET + RT and RT + ET promote a similar ‘magnitude’ in the postexercise hypotensive effects during the eight sessions of both CT orders in 4 weeks of training duration, revealing “nonresponders” and ‘high’ responders that can be predicted from body composition, metabolic, and physical fitness outcomes.
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Affiliation(s)
- Cristian Álvarez
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Francisco Guede-Rojas
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Rodrigo Ramírez-Campillo
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - David C. Andrade
- Exercise Applied Physiology Laboratory, Centro de Investigación en Fisiología y Medicina de Altura, Departamento Biomedico, Facultad de Ciencias de la Salud, Universidad de Antofagasta, Antofagasta, Chile
| | - Jaime Vásquez-Gómez
- Centro de Investigación de Estudios Avanzados del Maule (CIEAM), Laboratorio de Rendimiento Humano, Universidad Católica del Maule, Talca, Chile
| | | | - Emmanuel Gomes Ciolac
- Exercise and Chronic Disease Research Laboratory, Department of Physical Education, School of Sciences, Sáo Paulo State University (UNESP), Bauru, Buazil
| | | | - Pedro Delgado-Floody
- Department of Physical Education, Sport and Recreation, Universidad de La Frontera, Temuco, Chile
- Department Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Strength & Conditioning Laboratory, CTS-642 Research Group, Department Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
- *Correspondence: Pedro Delgado-Floody,
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Day C, Wu Y, Pescatello LS. Evaluating the Methodological Quality of Postexercise Hypotension Aerobic Exercise Interventions. Front Physiol 2022; 13:851950. [PMID: 35360233 PMCID: PMC8960741 DOI: 10.3389/fphys.2022.851950] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPostexercise hypotension (PEH) is the immediate reduction in blood pressure (BP) of 5–8 mmHg that occurs after a single bout of aerobic exercise among adults with hypertension. Across PEH studies, there are variations in the level of rigor of the study designs and methods that limit the conclusions that can be made about PEH.ObjectiveTo develop and then apply a methodological study quality evaluation checklist to aerobic exercise PEH studies to provide methodological guidance.MethodsWe developed a PEH checklist (PEH√list) based upon contemporary methodological study quality standards. The PEH√list contains 38 items divided into three categories: sample (n = 10 items), study (n = 23 items), and intervention characteristics (n = 5 items). We then systematically searched six databases to January 2019 to identify and then evaluate studies that: (1) enrolled adults ≥18 years with hypertension and without other chronic diseases or conditions; (2) included a bout of aerobic exercise and a non-exercise control session; and (3) were published in English.ResultsOf 17,149 potential studies, 64 qualified. Participants (N = 1,489) were middle-aged (38.6 ± 15.6 year), overweight (26.1 ± 2.5 kg/m2) mostly men (64.4%) with elevated BP (systolic BP 129.5 ± 15.2/diastolic BP 81.0 ± 10.1 mmHg). Overall, the qualifying studies satisfactorily reported 53.9 ± 13.3% (24.2–82.8%) of the relevant items on the PEH√list. Of note, only 20.3% of the studies disclosed BP was measured following professional guidelines, 18.8% reported BP was taken by the same assessor pre- and post-intervention, and 35.5% stated participants abstained from caffeine, alcohol, and physical activity prior to testing. Half (51.5%) indicated they statistically controlled for pre-exercise/baseline BP. Meanwhile, 100% of the studies reported the setting in which the BP measurements were taken, time from the end of the exercise to the start of the BP measurements, and if relevant, the length of the ambulatory BP monitoring period.ConclusionOverall, the PEH√list items were not well satisfied; especially items with potential confounding effects on PEH. We contend the PEH√list provides guidance to investigators on the important methodological study considerations in PEH aerobic exercise studies that should be attended to in the future.Systematic Review Registration[https://www.crd.york.ac.uk/PROSPERO/], identifier [#CRD42020221996].
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Affiliation(s)
- Christina Day
- Department of Kinesiology, University of Connecticut, Storrs, CT, United States
- *Correspondence: Christina Day,
| | - Yin Wu
- Department of Kinesiology, University of Connecticut, Storrs, CT, United States
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, United States
| | - Linda S. Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT, United States
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, United States
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Almeida RL, Ogihara CA, de Souza JS, Oliveira KC, Cafarchio EM, Tescaro L, Maciel RMB, Giannocco G, Sato MA. Regularly swimming exercise modifies opioidergic neuromodulation in rostral ventrolateral medulla in hypertensive rats. Brain Res 2022; 1774:147726. [PMID: 34785257 DOI: 10.1016/j.brainres.2021.147726] [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: 07/04/2021] [Revised: 10/14/2021] [Accepted: 11/09/2021] [Indexed: 11/02/2022]
Abstract
Moderate exercise reduces arterial pressure (AP) and heart rate (HR) in spontaneously hypertensive rats (SHR) and changes neurotransmission in medullary areas involved in cardiovascular regulation. We investigated if regularly swimming exercise (SW) affects the cardiovascular adjustments mediated by opioidergic neuromodulation in the RVLM in SHR and Wistar-Kyoto (WKY) rats. Rats were submitted to 6 wks of SW. The day after the last exercise bout, α-chloralose-anesthetized rats underwent a cannulation of the femoral artery for AP and HR recordings, and Doppler flow probes were placed around the lower abdominal aorta and superior mesenteric artery. Bilateral injection of endomorphin-2 (EM-2, 0.4 mmol/L, 60 nL) into the RVLM increased MAP in SW-SHR (20 ± 4 mmHg, N = 6), which was lower than in sedentary (SED)-SHR (35 ± 4 mmHg, N = 6). The increase in MAP in SW-SHR induced by EM-2 into the RVLM was similar in SED- and SW-WKY. Naloxone (0.5 mmol/L, 60 nL) injected into the RVLM evoked an enhanced hypotension in SW-SHR (-66 ± 8 mmHg, N = 6) compared to SED-SHR (-25 ± 3 mmHg, N = 6), which was similar in SED- and SW-WKY. No significant changes were observed in HR after EM-2 or naloxone injections into the RVLM. Changes in hindquarter and mesenteric conductances evoked by EM-2 or naloxone injections into the RVLM in SW- or SED-SHR were not different. Mu Opioid Receptor expression by Western blotting was reduced in SW-SHR than in SED-SHR and SW-WKY. Therefore, regularly SW alters the opioidergic neuromodulation in the RVLM in SHR and modifies the mu opioid receptor expression in this medullary area.
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Affiliation(s)
- Roberto L Almeida
- Dept. Morphology and Physiology, Faculdade de Medicina do ABC, Centro Universitário FMABC, Santo Andre, SP, Brazil
| | - Cristiana A Ogihara
- Dept. Morphology and Physiology, Faculdade de Medicina do ABC, Centro Universitário FMABC, Santo Andre, SP, Brazil
| | | | - Kelen C Oliveira
- Dept. Medicine, Federal University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Eduardo M Cafarchio
- Dept. Morphology and Physiology, Faculdade de Medicina do ABC, Centro Universitário FMABC, Santo Andre, SP, Brazil.
| | - Larissa Tescaro
- Dept. Morphology and Physiology, Faculdade de Medicina do ABC, Centro Universitário FMABC, Santo Andre, SP, Brazil
| | - Rui M B Maciel
- Dept. Medicine, Federal University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Gisele Giannocco
- Dept. Medicine, Federal University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Monica A Sato
- Dept. Morphology and Physiology, Faculdade de Medicina do ABC, Centro Universitário FMABC, Santo Andre, SP, Brazil
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Fernandes DR, Sisconeto TM, Freitas SS, Souza TCF, Delevatti RS, Ferrari R, Puga GM, Kanitz AC. Effect of the execution order from concurrent exercise session on blood pressure responses in hypertensive older men. MOTRIZ: REVISTA DE EDUCACAO FISICA 2022. [DOI: 10.1590/s1980-657420220005122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | | | - Rodrigo Ferrari
- Universidade Federal do Rio Grande do Sul, Brazil; Universidade Federal do Rio Grande do Sul, Brazil
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GjØvaag T, Berge H, Olsrud M, Welde B. Acute Post-Exercise Blood Pressure Responses in Middle-Aged Persons with Elevated Blood Pressure/Stage 1 Hypertension following Moderate and High-Intensity Isoenergetic Endurance Exercise. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2020; 13:1532-1548. [PMID: 33414869 PMCID: PMC7745916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study investigated the acute post-exercise hypotension (PEH) response in persons with elevated blood pressure or stage 1 hypertension following moderate and high-intensity isoenergetic endurance exercise. Twelve middle-aged persons (six females), with resting systolic and diastolic BP of 130±6 and 84±7 mmHg, participated in three bicycle ergometer bouts: 1) Testing of peak aerobic capacity (VO2peak), 2) Moderate intensity exercise (MOD) at 66% of VO2peak, 3) High-intensity exercise (INT) at 80% of VO2peak. All variables were recorded pre-exercise, during exercise and 0, 5, 10, and 30 minutes post-exercise. The total duration of exercise was 26% longer during MOD than INT (p <0.001), while total energy expenditure (TEE) was similar between exercise conditions (359 ± 69 kcal). Oxygen consumption, heart rate, power output and ratings of perceived exertion was 21, 13, 21 and 26% higher during INT than MOD exercise, respectively (0.05 ≤ p ≤ 0.001). Compared to pre-exercise, systolic BP was significantly lower at 30 min post-exercise following both INT (p < 0.05) and MOD (p < 0.01) exercise, and there was no difference between INT and MOD conditions. Other variables were similar to pre-exercise values at 30 min post-exercise. Linear regression shows that the largest post-exercise reductions in systolic BP was found for the persons with the highest pre-exercise systolic BP (r = 0.58 r2 = 0.33, p < 0.003). In conclusion, this study shows that endurance exercise with different intensities and durations, but similar TEE is equally effective in eliciting reductions in the post-exercise systolic BP. Furthermore, the magnitude of PEH response is partly dependent on the individuals' resting blood pressure.
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Affiliation(s)
- Terje GjØvaag
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, NORWAY
| | - Hanna Berge
- Department of Sport Science and Physical Education, Nord University, Levanger, NORWAY
| | - Marianne Olsrud
- Department of Sport Science and Physical Education, Nord University, Levanger, NORWAY
| | - Boye Welde
- School of Sports Sciences, UiT-The Arctic University of Norway, Tromsø, NORWAY
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Abstract
Hypertension is a fatal yet preventable risk factor for cardiovascular disease and is responsible for majority of cardiovascular mortality. Hypertension is closely associated with inactive lifestyle. Physical activity and/or exercise are shown to delay development of hypertension. Both aerobic and resistance exercise have been proven to reduce blood pressure (BP) effectively. Since brisk walking is an easy, inexpensive, simple, and effective way of exercise, this type of an aerobic workout can be recommended to society. All professional organizations and government bodies recommend moderate-intensity aerobic exercise for at least 30 min on at least 3 days of the week or resistance exercise on 2-3 days of the week. Exercise sessions can either be continuous for 30 min or be composed of at least 10 min of short exercise duration to a daily total of 30 min. After an exercise session, BP decreases, and this decline continues for up to 24 h; which is called post-exercise hypotension. Overall 5 mmHg decrease in BP with regular exercise may be ensured. With a decrease of 5 mmHg in systolic BP, mortality due to coronary heart disease decreases by 9%, mortality due to stroke decreases by 14% and all-cause mortality decreases by 7%. Regular exercise should therefore be recommended for all individuals including normotensives, prehypertensives, and hypertensives.
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Affiliation(s)
- Şeref Alpsoy
- Faculty of Medicine, Department of Cardiology, Namık Kemal University, Tekirdag, Turkey.
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Baumgartner L, Schulz T, Oberhoffer R, Weberruß H. Influence of Vigorous Physical Activity on Structure and Function of the Cardiovascular System in Young Athletes-The MuCAYA-Study. Front Cardiovasc Med 2019; 6:148. [PMID: 31649936 PMCID: PMC6794339 DOI: 10.3389/fcvm.2019.00148] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 09/24/2019] [Indexed: 12/21/2022] Open
Abstract
Objective: Moderate physical activity (PA) is associated with a reduced risk to develop cardiovascular disease. However, junior athletes exercise between 10 and 20 h a week with intensities exceeding moderate levels by far. In this regard, the cardiovascular system has to increase its work five to six times compared to moderate intensities. This may result in potentially pathological adaptations of the cardiovascular system. The underlying process of vascular adaptations to exercise is yet not fully understood and hardly investigated in junior athletes. An increased blood pressure and pulse wave velocity, ventricular hypertrophy, arrhythmia, and even sudden cardiac death (SCD) has been reported in adult athletes. Studies, examining the cardiovascular system in children, its association to intensity and type of exercise, are rare. Therefore, we present the study protocol of a prospective cross-sectional study that investigates the influence of PA on the cardiovascular system in young athletes. Methods and Design: Children and adolescents, 7–18 years, presenting for their annual pre-participation screening at the Institute of Preventive Pediatrics, Faculty of Sports and Health Sciences, Technical University of Munich (TUM), are examined in this prospective cross-sectional study. Vascular parameters measured by ultrasound are carotid intima-media thickness (cIMT), vascular stiffness (AC, Ep, β, PWV β), and the vascular diameter (D) to calculate the IMT:Diameter-Ratio (IDR). Cardiac function is evaluated by a 12-lead ECG, and echocardiographic parameters (end-diastolic left ventricular diameter, left ventricular diastolic posterior wall thickness, diastolic septal thickness, left ventricular mass and relative wall thickness, ejection fraction, and shortening fraction). A cardiopulmonary exercise test is performed on a bicycle ergometer, muscular strength is assessed with the handgrip test, and physical activity with the MoMo questionnaire. Discussion: It is essential to follow young athletes over the course of their career in order to detect pathophysiological changes in the myocardium as soon as possible. If these changes are preceded or followed by changes in vascular structure and function is not known yet. Therefore, we present the study protocol of the Munich Cardiovascular adaptations in young athletes study (MuCAYA-Study) which investigates the association between vascular and cardiac adaptation to intensive exercise in junior athletes.
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Affiliation(s)
- Lisa Baumgartner
- Institute of Preventive Pediatrics, TUM Department of Sport and Health Science, Technical University of Munich, Munich, Germany
| | - Thorsten Schulz
- Institute of Preventive Pediatrics, TUM Department of Sport and Health Science, Technical University of Munich, Munich, Germany
| | - Renate Oberhoffer
- Institute of Preventive Pediatrics, TUM Department of Sport and Health Science, Technical University of Munich, Munich, Germany
| | - Heidi Weberruß
- Institute of Preventive Pediatrics, TUM Department of Sport and Health Science, Technical University of Munich, Munich, Germany
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10
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Böhm B, Oberhoffer R. Vascular health determinants in children. Cardiovasc Diagn Ther 2019; 9:S269-S280. [PMID: 31737535 PMCID: PMC6837937 DOI: 10.21037/cdt.2018.09.16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 09/19/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND The epidemic of cardiovascular disease (CVD) in the twentieth century generated numerous population-based surveys. These results clearly demonstrate that many factors are causally related to the development of atherosclerosis. Eighty percent of the CVD can be explained by smoking, high blood pressure, deterioration of lipid and glucose metabolism and physical inactivity. CVD is a disease that becomes clinically apparent in adults. However, it is undisputed that this disease develops over a long period of time due to progressive, subclinical changes in the cardiovascular system. The early manifestation of arteriosclerosis correlates with traditional risk factors. METHODS This brief report focusses on determinates of vascular health. It describes non-invasive diagnostic methods such as oscillometric analysis of pulse wave velocity (PWV), ultrasound measurement of carotid structure and function as well as brachial endothelial function. Special attention is paid to possible correlations with physical activity, fitness and exercise. RESULTS Non-invasive diagnostic methods to determine vascular health are applicable in children. The influence of physical activity and the relationship between aerobic fitness and arterial compliance (AC) remain controversial. First results in young athletes demonstrated an increased carotid intima-media thickness (cIMT), by revealing arterial elasticity. The mechanism and determinants explaining these adaptations have not been fully explained in young healthy athletes. CONCLUSIONS Traditional cardiovascular risk factors act early in life and have a major impact on the development of atherosclerosis. The results underline that the prevention strategies and risk factor control should begin in childhood. The emphasis in the present report lied on the determination of vascular health, analyzing arterial structure and function, using non-invasive diagnostic methods. Vascular health and its relation to obesity, hypertension, physical activity and exercise were emphasized. The harmonization of knowledge and methods would greatly increase the comparability of existing results. To further elucidate the clinical relevance, the mechanisms linking arterial structure and compliance function with physical activity, fitness and exercise need further clinical investigation to enhance early preventive intervention strategies.
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Affiliation(s)
- Birgit Böhm
- Department of Preventive Pediatrics, Technical University of Munich, Munich, Germany
| | - Renate Oberhoffer
- Department of Preventive Pediatrics, Technical University of Munich, Munich, Germany
- Department of Pediatric Cardiology and Congenital Heart Defects, German Heart Center, Technical University of Munich, Munich, Germany
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Cilhoroz BT, Schifano ED, Panza GA, Ash GI, Corso L, Chen M, Deshpande V, Zaleski A, Farinatti P, Santos LP, Taylor BA, O'Neill RJ, Thompson PD, Pescatello LS. FURIN variant associations with postexercise hypotension are intensity and race dependent. Physiol Rep 2019; 7:e13952. [PMID: 30706700 PMCID: PMC6356167 DOI: 10.14814/phy2.13952] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 09/05/2018] [Accepted: 09/17/2018] [Indexed: 12/16/2022] Open
Abstract
FURIN is a proprotein convertase subtilisin/kexin enzyme important in pro-renin receptor processing, and FURIN (furin, paired basic amino acid cleaving enzyme) variants are involved in multiple aspects of blood pressure (BP) regulation. Therefore, we examined associations among FURIN variants and the immediate blood pressure (BP) response to bouts of aerobic exercise, termed postexercise hypotension (PEH). Obese (30.9 ± 3.6 kg m-2 ) Black- (n = 14) and White- (n = 9) adults 42.0 ± 9.8 year with hypertension (139.8 ± 10.4/84.6 ± 6.2 mmHg) performed three random experiments: bouts of vigorous (VIGOROUS) and moderate (MODERATE) intensity cycling and control. Subjects were then attached to an ambulatory BP monitor for 19 h. We performed deep-targeted exon sequencing with the Illumina TruSeq Custom Amplicon kit. FURIN genotypes were coded as the number of minor alleles (#MA) and selected for additional statistical analysis based upon Bonferonni or Benjamini-Yekutieli multiple testing corrected P-values under time-adjusted linear models for 19 hourly BP measurements. After VIGOROUS over 19 h, as FURIN #MA increased in rs12917264 (P = 2.4E-04) and rs75493298 (P = 6.4E-04), systolic BP (SBP) decreased 30.4-33.7 mmHg; and in rs12917264 (P = 1.6E-03) and rs75493298 (P = 9.7E-05), diastolic BP (DBP) decreased 17.6-20.3 mmHg among Blacks only. In addition, after MODERATE over 19 h in FURIN rs74037507 (P = 8.0E-04), as #MA increased, SBP increased 20.8 mmHg among Blacks only. Whereas, after MODERATE over the awake hours in FURIN rs1573644 (P = 6.2E-04), as #MA increased, DBP decreased 12.5 mmHg among Whites only. FURIN appears to exhibit intensity and race-dependent associations with PEH that merit further exploration among a larger, ethnically diverse sample of adults with hypertension.
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Affiliation(s)
| | | | - Gregory A. Panza
- Department of KinesiologyUniversity of ConnecticutStorrsConnecticut
- Department of Preventive CardiologyHartford HospitalHartfordConnecticut
| | | | - Lauren Corso
- Department of KinesiologyUniversity of ConnecticutStorrsConnecticut
| | - Ming‐Hui Chen
- Department of StatisticsUniversity of ConnecticutStorrsConnecticut
| | - Ved Deshpande
- Department of StatisticsUniversity of ConnecticutStorrsConnecticut
| | - Amanda Zaleski
- Department of KinesiologyUniversity of ConnecticutStorrsConnecticut
- Department of Preventive CardiologyHartford HospitalHartfordConnecticut
| | - Paulo Farinatti
- Department of Physical Activity SciencesRio de Janeiro State UniversityRio de JaneiroBrazil
| | - Lucas P. Santos
- Department of Medical SciencesFederal University of Rio Grande do SulPorto AlegreBrazil
| | - Beth A. Taylor
- Department of KinesiologyUniversity of ConnecticutStorrsConnecticut
- Department of Preventive CardiologyHartford HospitalHartfordConnecticut
| | - Rachel J. O'Neill
- Institute for Systems GenomicsUniversity of ConnecticutStorrsConnecticut
- Department of Molecular and Cell BiologyUniversity of ConnecticutStorrsConnecticut
| | - Paul D. Thompson
- Department of Preventive CardiologyHartford HospitalHartfordConnecticut
| | - Linda S. Pescatello
- Department of KinesiologyUniversity of ConnecticutStorrsConnecticut
- Institute for Systems GenomicsUniversity of ConnecticutStorrsConnecticut
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12
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da Silva TF, Cirilo-Souza MDS, de Souza MF, Veloso Neto G, dos Santos MAP, Silva AS. Energy demand in an active videogame session and the potential to promote hypotension after exercise in hypertensive women. PLoS One 2018; 13:e0207505. [PMID: 30543638 PMCID: PMC6292658 DOI: 10.1371/journal.pone.0207505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 10/18/2018] [Indexed: 12/04/2022] Open
Abstract
The aim of this study was to determine the energy demand of one session of active video game (AVG) and its potential to reduce blood pressure (BP). Fourteen hypertensive (56.4±7.5 years) individuals performed sessions of AVG, a traditional sedentary video game sessions (SVG) and walking (WAL), as negative and positive controls, in a randomly determined order. Oxygen consumption and energy expenditure (EE) were measured during sessions. BP and cardiac autonomic modulation (CAM) were measured at rest and every 15 minutes of a 60-minute period of recovery from activities. A rating of enjoyment scale was also applied. AVG and WAL resulted in higher oxygen consumption (10.0±0.5 ml/kg/min and 16.6±3.1 ml/kg/min, respectively) and EE (3.5±0.2 kcal/min and 4.2±0.5 kcal/min) compared to 4.1±0.8 ml/kg/min and 1.4±0.1 kcal/min in SVG. A reduction in systolic and diastolic BP was evident following AVG sessions (-11.6±2.5 mmHg and -8.7±2.5 mmHg) and WAL (-10.8±2.8 mmHg and -8.6±2.3 mmHg) compared to pre-experiment value, and the same did not occur in SVG. All sessions promoted a feeling of enjoyment, with no difference between them. The parasympathetic activity was significantly lower at 30 and 45 minutes in post-WAL recovery (34.6±15.0 ms2 and 34.4±16.0 ms2) in the frequency domain (HF) in relation to both AVG (195.5±67.0 ms2 and 164.5±55.0 ms2) and the SVG (158.9±45.0 and 281.3±98.0 ms2). It is concluded that an AVG session promotes increased metabolic activity and is able to promote acute reduction of BP in hypertensive individuals similar to traditional walking exercise.
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Affiliation(s)
| | | | | | - Geraldo Veloso Neto
- Physical Education Department, Federal University of Paraíba, Paiaíba, Brazil
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13
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Brito LC, Fecchio RY, Peçanha T, Andrade-Lima A, Halliwill JR, Forjaz CL. Postexercise hypotension as a clinical tool: a “single brick” in the wall. ACTA ACUST UNITED AC 2018; 12:e59-e64. [DOI: 10.1016/j.jash.2018.10.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 10/05/2018] [Accepted: 10/16/2018] [Indexed: 11/25/2022]
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14
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Ramirez-Jimenez M, Morales-Palomo F, Ortega JF, Mora-Rodriguez R. Effects of intense aerobic exercise and/or antihypertensive medication in individuals with metabolic syndrome. Scand J Med Sci Sports 2018; 28:2042-2051. [PMID: 29771450 DOI: 10.1111/sms.13218] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2018] [Indexed: 11/29/2022]
Abstract
We studied the blood pressure lowering effects of a bout of exercise and/or antihypertensive medicine with the goal of studying if exercise could substitute or enhance pharmacologic hypertension treatment. Twenty-three hypertensive metabolic syndrome patients chronically medicated with angiotensin II receptor 1 blockade antihypertensive medicine underwent 24-hr monitoring in four separated days in a randomized order; (a) after taking their habitual dose of antihypertensive medicine (AHM trial), (b) substituting their medicine by placebo medicine (PLAC trial), (c) placebo medicine with a morning bout of intense aerobic exercise (PLAC+EXER trial) and (d) combining the exercise and antihypertensive medicine (AHM+EXER trial). We found that in trials with AHM subjects had lower plasma aldosterone/renin activity ratio evidencing treatment compliance. Before exercise, the trials with AHM displayed lower systolic (130 ± 16 vs 133 ± 15 mm Hg; P = .018) and mean blood pressures (94 ± 11 vs 96 ± 10 mm Hg; P = .036) than trials with placebo medication. Acutely (ie, 30 min after treatments) combining AHM+EXER lowered systolic blood pressure (SBP) below the effects of PLAC+EXER (-8.1 ± 1.6 vs -4.9 ± 1.5 mm Hg; P = .015). Twenty-four hour monitoring revealed no differences among trials in body motion. However, PLAC+EXER and AHM lowered SBP below PLAC during the first 10 hours, time at which PLAC+EXER effects faded out (ie, at 19 PM). Adding exercise to medication (ie, AHM+EXER) resulted in longer reductions in SBP than with exercise alone (PLAC+EXER). In summary, one bout of intense aerobic exercise in the morning cannot substitute the long-lasting effects of antihypertensive medicine in lowering blood pressure, but their combination is superior to exercise alone.
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Affiliation(s)
- M Ramirez-Jimenez
- Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain
| | - F Morales-Palomo
- Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain
| | - J F Ortega
- Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain
| | - R Mora-Rodriguez
- Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain
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15
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Pescatello LS, Schifano ED, Ash GI, Panza GA, Corso LML, Chen MH, Deshpande V, Zaleski A, Cilhoroz B, Farinatti P, Taylor BA, O'Neill RJ, Thompson PD. Deep-targeted sequencing of endothelial nitric oxide synthase gene exons uncovers exercise intensity and ethnicity-dependent associations with post-exercise hypotension. Physiol Rep 2017; 5:e13510. [PMID: 29180482 PMCID: PMC5704084 DOI: 10.14814/phy2.13510] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 10/28/2017] [Accepted: 10/30/2017] [Indexed: 12/17/2022] Open
Abstract
In previous studies, we found an endothelial nitric oxide synthase gene (NOS3) variant rs2070744 associated with the ambulatory blood pressure (BP) response following bouts of moderate and vigorous intensity acute exercise, termed post-exercise hypotension (PEH). In a validation cohort, we sequenced NOS3 exons for associations with PEH Obese (30.9 ± 3.6 kg.m-2) African American (n = 14) [AF] and Caucasian (n = 9) adults 42.0 ± 9.8 years with hypertension (139.8 ± 10.4/84.6 ± 6.2 mmHg) performed three random experiments: bouts of vigorous and moderate intensity cycling and control. Subjects were attached to an ambulatory BP monitor for 19 h. We performed deep-targeted exon sequencing with the Illumina TruSeq Custom Amplicon kit. Variant genotypes were coded as number of minor alleles (#MA) and selected for additional statistical analysis based upon Bonferonni or Benjamini-Yekutieli multiple testing-corrected P-values under time-adjusted linear models for 19 hourly BP measurements for each subject. After vigorous intensity over 19 h, among NOS3 variants passing multiple testing thresholds, as the #MA increased in rs891512 (P = 6.4E-04), rs867225 (P = 6.5E-04), rs743507 (P = 2.6E-06), and rs41483644 (P = 2.4E-04), systolic (SBP) decreased from 17.5 to 33.7 mmHg; and in rs891512 (P = 9.7E-05), rs867225 (P = 2.6E-05), rs41483644 (P = 1.6E-03), rs3730009 (P = 2.6E-04), and rs77325852 (P = 5.6E-04), diastolic BP decreased from 11.1 mmHg to 20.3 mmHg among AF only. In contrast, after moderate intensity over 19 h in NOS3 rs3918164, as the #MA increased, SBP increased by 16.6 mmHg (P = 2.4E-04) among AF only. NOS3 variants exhibited associations with PEH after vigorous, but not moderate intensity exercise among AF only. NOS3 should be studied further for its effects on PEH in a large, ethnically diverse sample of adults with hypertension to confirm our findings.
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Affiliation(s)
- Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
- Institute for Systems Genomics, University of Connecticut, Storrs, Connecticut
| | | | - Garrett I Ash
- School of Nursing, Yale University, New Haven, Connecticut
| | - Gregory A Panza
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
- Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut
| | - Lauren M L Corso
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
| | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, Storrs, Connecticut
| | - Ved Deshpande
- Department of Statistics, University of Connecticut, Storrs, Connecticut
| | - Amanda Zaleski
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
- Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut
| | - Burak Cilhoroz
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
| | - Paulo Farinatti
- Department of Physical Activity Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Beth A Taylor
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
- Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut
| | - Rachel J O'Neill
- Institute for Systems Genomics, University of Connecticut, Storrs, Connecticut
- Department of Molecular and Cell Biology, University of Connecticut, Storrs, Connecticut
| | - Paul D Thompson
- Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut
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16
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Pescatello LS, Schifano ED, Ash GI, Panza GA, Lamberti L, Chen MH, Deshpande V, Zaleski A, Farinatti P, Taylor BA, Thompson PD. Deep-targeted exon sequencing reveals renal polymorphisms associate with postexercise hypotension among African Americans. Physiol Rep 2016; 4:e12992. [PMID: 27940662 PMCID: PMC5064144 DOI: 10.14814/phy2.12992] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 09/14/2016] [Accepted: 09/15/2016] [Indexed: 12/23/2022] Open
Abstract
We found variants from the Angiotensinogen-Converting Enzyme (ACE), Angiotensin Type 1 Receptor (AGTR1), Aldosterone Synthase (CYP11B2), and Adducin (ADD1) genes exhibited intensity-dependent associations with the ambulatory blood pressure (BP) response following acute exercise, or postexercise hypotension (PEH). In a validation cohort, we sequenced exons from these genes for their associations with PEH Obese (30.9 ± 3.6 kg m-2) adults (n = 23; 61% African Americans [AF], 39% Caucasian) 42.0 ± 9.8 years with hypertension (139.8 ± 10.4/84.6 ± 6.2 mmHg) completed three random experiments: bouts of vigorous and moderate intensity cycling and control. Subjects wore an ambulatory BP monitor for 19 h. We performed deep-targeted exon sequencing using the Illumina TruSeq Custom Amplicon kit. Variant genotypes were coded as number of minor alleles (#MA) and selected for further statistical analysis based upon Bonferonni or Benjamini-Yekutieli multiple testing corrected p-values under time adjusted linear models for 19 hourly BP measurements per subject. After vigorous intensity over 19 h among ACE, AGTR1, CYP11B2, and ADD1 variants passing multiple testing thresholds, as the #MA increased, systolic (SBP) and/or diastolic BP decreased 12 mmHg (P = 4.5E-05) to 30 mmHg (P = 6.4E-04) among AF only. In contrast, after moderate intensity over 19 h among ACE and CYP11B2 variants passing multiple testing thresholds, as the #MA increased, SBP increased 21 mmHg (P = 8.0E-04) to 22 mmHg (P = 8.2E-04) among AF only. In this replication study, ACE, AGTR1, CYP11B2, and ADD1 variants exhibited associations with PEH after vigorous, but not moderate intensity exercise among AF only. Renal variants should be explored further with a multi-level "omics" approach for associations with PEH among a large, ethnically diverse sample of adults with hypertension.
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Affiliation(s)
- Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
- Institute for Systems Genomics, University of Connecticut, Storrs, Connecticut
| | | | - Garrett I Ash
- School of Nursing, Yale University, New Haven, Connecticut
| | - Gregory A Panza
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
- Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut
| | - Lauren Lamberti
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
| | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, Storrs, Connecticut
| | - Ved Deshpande
- Department of Statistics, University of Connecticut, Storrs, Connecticut
| | - Amanda Zaleski
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
- Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut
| | - Paulo Farinatti
- Department of Physical Activity Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Beth A Taylor
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
- Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut
| | - Paul D Thompson
- Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut
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17
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Pescatello LS, MacDonald HV, Lamberti L, Johnson BT. Exercise for Hypertension: A Prescription Update Integrating Existing Recommendations with Emerging Research. Curr Hypertens Rep 2015; 17:87. [PMID: 26423529 PMCID: PMC4589552 DOI: 10.1007/s11906-015-0600-y] [Citation(s) in RCA: 228] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Hypertension is the most common, costly, and preventable cardiovascular disease risk factor. Numerous professional organizations and committees recommend exercise as initial lifestyle therapy to prevent, treat, and control hypertension. Yet, these recommendations differ in the components of the Frequency, Intensity, Time, and Type (FITT) principle of exercise prescription (Ex Rx); the evidence upon which they are based is only of fair methodological quality; and the individual studies upon which they are based generally do not include people with hypertension, which are some of the limitations in this literature. The purposes of this review are to (1) overview the professional exercise recommendations for hypertension in terms of the FITT principle of Ex Rx; (2) discuss new and emerging research related to Ex Rx for hypertension; and (3) present an updated FITT Ex Rx for adults with hypertension that integrates the existing recommendations with this new and emerging research.
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Affiliation(s)
- Linda S Pescatello
- Department of Kinesiology, College of Agriculture, Health, and Natural Resources, University of Connecticut, 2095 Hillside Rd, U-1110, Storrs, CT, 06269-1110, USA.
| | - Hayley V MacDonald
- Department of Kinesiology, College of Agriculture, Health, and Natural Resources, University of Connecticut, 2095 Hillside Rd, U-1110, Storrs, CT, 06269-1110, USA.
| | - Lauren Lamberti
- Department of Kinesiology, College of Agriculture, Health, and Natural Resources, University of Connecticut, 2095 Hillside Rd, U-1110, Storrs, CT, 06269-1110, USA.
| | - Blair T Johnson
- Department of Psychological Sciences, College of Liberal Arts and Sciences, University of Connecticut, 406 Babbidge Rd, U-1020, Storrs, CT, 06269-1020, USA.
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18
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Goessler KF, Cornelissen VA, de Oliveira EM, de F Mota G, Polito MD. ACE polymorphisms and the acute response of blood pressure to a walk in medicated hypertensive patients. J Renin Angiotensin Aldosterone Syst 2015; 16:720-9. [DOI: 10.1177/1470320315600086] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 06/20/2015] [Indexed: 11/15/2022] Open
Affiliation(s)
- Karla F Goessler
- Research Group of Cardiovascular Response and Exercise, State University of Londrina, Brazil
- Research Group of Cardiovascular Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Belgium
| | - Véronique A Cornelissen
- Research Group of Cardiovascular Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Belgium
| | | | - Glória de F Mota
- School of Physical Education and Sport, University of São Paulo, Brazil
| | - Marcos D Polito
- Research Group of Cardiovascular Response and Exercise, State University of Londrina, Brazil
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19
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Mota MR, Oliveira RJ, Terra DF, Pardono E, Dutra MT, de Almeida JA, Silva FM. Acute and chronic effects of resistance exercise on blood pressure in elderly women and the possible influence of ACE I/D polymorphism. Int J Gen Med 2013; 6:581-7. [PMID: 23885179 PMCID: PMC3716478 DOI: 10.2147/ijgm.s40628] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This study investigated the chronic effect of blood pressure (BP) and post-exercise hypotension (PEH) during resistance training (RT) and its relation with the angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism in hypertensive elderly women. Participants were divided into two groups: an experimental group (EG) with exercise and a control group (CG) without exercise. The EG performed one adaptation month and one repetition maximum load (1RM) test at the end of this period. After the first month, the EG conducted a three-month program of RT at 60%, 70%, and 80% of 1RM, respectively, for each month. The CG was evaluated at the end of each month. Systolic (SBP) and diastolic (DBP) blood pressure (Microlife BP 3AC1-1) were measured, with the subject in a seated position, during an acute session for both GE and CG as follows: every 5 minutes for 20 minutes at pre-exercise rest, immediately after the resistance exercise and control, and every 15 minutes during 1 hour of recovery after exercise and CG. Analysis of covariance showed reduction in SBP and DBP (P ≤ 0.05) rest values after the RT program. PEH was observed only for the EG in acute sessions, for SBP after the second and third months (P ≤ 0.05), and for DBP after the second and fourth months (P ≤ 0.05). No significant differences in main effects and interaction effects between blood pressure and ACE I/D were observed. The occurrence of chronic reduction of blood pressure and PEH through EG may have a protective effect on the cardiovascular system with no ACE I/D polymorphism influence for this population.
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Affiliation(s)
- Márcio Rabelo Mota
- University Center of Brasília (UniCeub), Brasília, Brazil ; Catholic University of Brasília (UCB), Brasília, Brazil
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Almeida JA, Petriz BDA, da Costa Gomes CP, Pereira RW, Franco OL. Assessment of maximal lactate steady state during treadmill exercise in SHR. BMC Res Notes 2012. [PMID: 23194345 PMCID: PMC3544571 DOI: 10.1186/1756-0500-5-661] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background Spontaneously hypertensive rats (SHR) are one of the main animal models used for studying the effects of exercise on hypertension. Therefore, the determination of adequate intensity has been essential for secure and optimized exercise prescriptions concerning hypertensive subjects. This study aimed to identify the MLSS in SHR by using a treadmill test to improve the protocols and further prescriptions of exercise intensity. Findings In order to carry out this determination, SHR (n = 10) animals (~17.5 weeks; 227.4 ± 29.3 g; 172.4 ± 8.1 mmHg systolic blood pressure) were divided into two groups (G1 n = 5; G2 n = 5). Rats underwent a test with three different velocities to determine the MLSS. The MLSS was considered as the highest effort intensity where the blood lactate did not vary more than 1 mmol.L-1 from the 10th to the 25th minute. The MLSS was reached at a velocity of 20 m.min-1 with 3.8 ± 0.5 mmol.L-1 of lactate for G1. Additionally, the results were validated in G2. However, when the test was applied at 25 m.min-1, there was no stabilization of BLC in G1 and G2. Conclusions In this study it was possible to identify the MLSS in SHR rats, which is an excellent evaluation tool to control exercise intensity. These data are of considerable importance in studies using physical exercise as a means of research in hypertension and may lead to the intensity of exercise being prescribed more appropriately.
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Affiliation(s)
- Jeeser Alves Almeida
- Centro de Análises Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, SGAN, Quadra 916, Módulo B, Brasília, DF, 70790-160, Brazil
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Halliwill JR, Buck TM, Lacewell AN, Romero SA. Postexercise hypotension and sustained postexercise vasodilatation: what happens after we exercise? Exp Physiol 2012; 98:7-18. [PMID: 22872658 DOI: 10.1113/expphysiol.2011.058065] [Citation(s) in RCA: 230] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A single bout of aerobic exercise produces a postexercise hypotension associated with a sustained postexercise vasodilatation of the previously exercised muscle. Work over the last few years has determined key pathways for the obligatory components of postexercise hypotension and sustained postexercise vasodilatation and points the way to possible benefits that may result from these robust responses. During the exercise recovery period, the combination of centrally mediated decreases in sympathetic nerve activity with a reduced signal transduction from sympathetic nerve activation into vasoconstriction, as well as local vasodilator mechanisms, contributes to the fall in arterial blood pressure seen after exercise. Important findings from recent studies include the recognition that skeletal muscle afferents may play a primary role in postexercise resetting of the baroreflex via discrete receptor changes within the nucleus tractus solitarii and that sustained postexercise vasodilatation of the previously active skeletal muscle is primarily the result of histamine H(1) and H(2) receptor activation. Future research directions include further exploration of the potential benefits of these changes in the longer term adaptations associated with exercise training, as well as investigation of how the recovery from exercise may provide windows of opportunity for targeted interventions in patients with hypertension and diabetes.
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Affiliation(s)
- John R Halliwill
- Department of Human Physiology, University of Oregon, Eugene, OR 97403-1240, USA.
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Rodriguez D, Silva V, Prestes J, Rica RL, Serra AJ, Bocalini DS, Pontes FL. Hypotensive response after water-walking and land-walking exercise sessions in healthy trained and untrained women. Int J Gen Med 2011; 4:549-54. [PMID: 21887107 PMCID: PMC3160863 DOI: 10.2147/ijgm.s23094] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Indexed: 11/24/2022] Open
Abstract
Background: The aim of this study was to compare post-exercise hypotension after acute sessions of water-walking and land-walking in healthy trained and untrained women. Methods: Twenty-three untrained (n = 12) and trained (n = 11) normotensive women performed two walking sessions in water and on land at 40% of peak VO2 for 45 minutes. Systolic and diastolic blood pressure and mean arterial pressure were measured 15, 30, 45, and 60 minutes after the exercise sessions. Results: No differences were found between the groups for age and anthropometric parameters, but peak VO2 for the trained women (45 ± 8 mL/kg/minute) was higher than for the untrained women (31 ± 3 mL/kg/minute). No differences were found between the groups with regard to systolic and diastolic blood pressure and mean arterial pressure after water immersion. The heart rate in the trained group (62 ± 3 beats per minute [bpm]) was significantly lower (P < 0.05) than in the untrained group (72 ± 4 bpm) on land, and after water immersion, this difference disappeared (58 ± 5 bpm in the trained women and 66 ± 5 bpm in the untrained women). Sixty minutes after water-walking, systolic blood pressure (108 ± 8 mmHg vs 97 ± 3 mmHg), diastolic blood pressure (69 ± 5 mmHg vs 62 ± 5 mmHg), and mean arterial pressure (82 ± 6 mmHg vs 74 ± 4 mmHg) decreased significantly with rest in the untrained group, and no differences were found after land-walking. In the trained group, significant (P < 0.05) differences were found only for systolic blood pressure (110 ± 9 mmHg vs 100 ± 9 mmHg) after 60 minutes of water-walking; decreases in systolic blood pressure were found after 45 minutes (99 ± 7 mmHg) and 60 minutes (99 ± 6 mmHg) compared with rest (107 ± 5 mmHg) after land-walking. Conclusion: Single water-walking and land-walking sessions induced important hypotension following exercise. Additionally, walking performed in chest-deep water has a better effect on exercise-induced hypotension in untrained healthy women than walking at a similar intensity on land.
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Abstract
A single bout of exercise can lead to a postexercise decrease in blood pressure in hypertensive individuals, called postexercise hypotension. Compelling evidence suggests that the central baroreflex pathway plays a crucial role in the development of postexercise hypotension. This review focuses on the exercise-induced changes in brainstem nuclei involved in blood pressure regulation.
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Affiliation(s)
- Chao-Yin Chen
- Department of Pharmacology, University of California, Davis, CA 95616, USA.
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Ogihara CA, Schoorlemmer GHM, Levada AC, Pithon-Curi TC, Curi R, Lopes OU, Colombari E, Sato MA. Exercise changes regional vascular control by commissural NTS in spontaneously hypertensive rats. Am J Physiol Regul Integr Comp Physiol 2010; 299:R291-7. [DOI: 10.1152/ajpregu.00055.2009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Inhibition of the commissural nucleus of the solitary tract (commNTS) induces a fall in sympathetic nerve activity and blood pressure in spontaneously hypertensive rats (SHR), which suggests that this subnucleus of the NTS is a source of sympathoexcitation. Exercise training reduces sympathetic activity and arterial pressure. The purpose of the present study was to investigate whether the swimming exercise can modify the regional vascular responses evoked by inhibition of the commNTS neurons in SHR and normotensive Wistar-Kyoto (WKY) rats. Exercise consisted of swimming, 1 h/day, 5 days/wk for 6 wks, with a load of 2% of the body weight. The day after the last exercise session, the rats were anesthetized with intravenous α-chloralose, tracheostomized, and artificially ventilated. The femoral artery was cannulated for mean arterial pressure (MAP) and heart rate recordings, and Doppler flow probes were placed around the lower abdominal aorta and superior mesenteric artery. Microinjection of 50 mM GABA into the commNTS caused similar reductions in MAP in swimming and sedentary SHR (−25 ± 6 and −30 ± 5 mmHg, respectively), but hindlimb vascular conductance increased twofold in exercised vs. sedentary SHR (54 ± 8 vs. 24 ± 5%). GABA into the commNTS caused smaller reductions in MAP in swimming and sedentary WKY rats (−20 ± 4 and −16 ± 2 mmHg). Hindlimb conductance increased fourfold in exercised vs. sedentary WKY rats (75 ± 2% vs. 19 ± 3%). Therefore, our data suggest that the swimming exercise induced changes in commNTS neurons, as shown by a greater enhancement of hindlimb vasodilatation in WKY vs. SHR rats in response to GABAergic inhibition of these neurons.
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Affiliation(s)
| | | | - Adriana C. Levada
- Department of Physiology, Biomedical Sciences Institute–University of Sao Paulo, Sao Paulo, Brazil; and
| | - Tania C. Pithon-Curi
- Department of Physiology, Biomedical Sciences Institute–University of Sao Paulo, Sao Paulo, Brazil; and
| | - Rui Curi
- Department of Physiology, Biomedical Sciences Institute–University of Sao Paulo, Sao Paulo, Brazil; and
| | | | - Eduardo Colombari
- Department of Physiology, Federal University of Sao Paulo, Sao Paulo, Brazil
- Faculdade de Medicina do ABC, Santo Andre, Brazil
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DiCarlo SE, Collins HL, Howard MG, Chen C, Scislo TJ, Patil RD. Postexertional hypotension: A brief review. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/15438629409511998] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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26
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Abstract
Hypertension is a major health dilemma in the world today because of its high rate of incidence. Exercise training is usually mentioned as a useful nonpharmacological therapy for essential hypertension. Seventeen studies have assessed the effect of exercise training in individuals with essential hypertension. The majority of the results indicate that both systolic and diastolic blood pressure may be lowered by approximately 10 mmHg with training, however, this conclusion must be interpreted in light of numerous design deficiencies, methodological shortcomings, and the limited populations studied in these investigations. Some studies appear to indicate that mild to moderate intensity training may be as useful in lowering blood pressure as higher intensity training. Very little data is available to indicate if cardiac output and/or total peripheral resistance are reduced to bring about the reduction in blood pressure. Clearly more studies are required to evaluate the belief that exercise training is beneficial in essential hypertension and to determine the responsible mechanisms.
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Exercise reduces GABA synaptic input onto nucleus tractus solitarii baroreceptor second-order neurons via NK1 receptor internalization in spontaneously hypertensive rats. J Neurosci 2009; 29:2754-61. [PMID: 19261870 DOI: 10.1523/jneurosci.4413-08.2009] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A single bout of mild to moderate exercise can lead to a postexercise decrease in blood pressure in hypertensive subjects, namely postexercise hypotension (PEH). The full expression of PEH requires a functioning baroreflex, hypertension, and activation of muscle afferents (exercise), suggesting that interactions in the neural networks regulating exercise and blood pressure result in this fall in blood pressure. The nucleus tractus solitarii (NTS) is the first brain site that receives inputs from nerves carrying blood pressure and muscle activity information, making it an ideal site for integrating cardiovascular responses to exercise. During exercise, muscle afferents excite NTS GABA neurons via substance P and microinjection of a substance P-neurokinin 1 receptor (NK1-R) antagonist into the NTS attenuates PEH. The data suggest that an interaction between the substance P NK1-R and GABAergic transmission in the NTS may contribute to PEH. We performed voltage clamping on NTS baroreceptor second-order neurons in spontaneously hypertensive rats (SHRs). All animals were killed within 30 min and the patch-clamp recordings were performed 2-8 h after the sham/exercise protocol. The data showed that a single bout of exercise reduces (1) the frequency but not the amplitude of GABA spontaneous IPSCs (sIPSCs), (2) endogenous substance P influence on sIPSC frequency, and (3) sIPSC frequency response to exogenous application of substance P. Furthermore, immunofluorescence labeling in NTS show an increased substance P NK1-R internalization on GABA neurons. The data suggest that exercise-induced NK1-R internalization results in a reduced intrinsic inhibitory input to the neurons in the baroreflex pathway.
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Kallikrein kinin system activation in post-exercise hypotension in water running of hypertensive volunteers. Int Immunopharmacol 2008; 8:261-6. [DOI: 10.1016/j.intimp.2007.09.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2007] [Revised: 08/31/2007] [Accepted: 09/02/2007] [Indexed: 11/21/2022]
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29
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Cornelissen VA, Fagard RH. What should the clinician tell patients with mild hypertension about physical activity? CURRENT CARDIOVASCULAR RISK REPORTS 2007. [DOI: 10.1007/s12170-007-0039-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Enweze L, Oke LM, Thompson T, Obisesan TO, Blakely R, Adams RG, Millis RM, Khan M, Banks M, Bond V. Acute exercise and postexercise blood pressure in African American women. Ethn Dis 2007; 17:664-668. [PMID: 18072376 PMCID: PMC3160821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Limited data suggest that physical activity increases postexercise blood pressure in African-American women. The purpose of this study was to evaluate the postexercise blood pressure response to acute exercise in normotensive young adult African-American women. METHODS Eight healthy women (age 22.5+/-.9 years) performed a cycle ergometer bout of 30 minutes at 60% of peak ventilatory oxygen uptake (VO2 peak). Control arterial blood pressure, heart rate, lower leg blood flow, cardiac output, spectral analysis of blood pressure, heart rate variability, and baroreceptor sensitivity were measured for 5 minutes before exercise and were compared to postexercise measurements performed at rest intervals of 15-20, 35-40 and 55-60 minutes after exercise. RESULTS Exercise performed at 60% VO2 peak produced an arterial pressure of 172+/-10/ 70.1+/-4.0 mm Hg. Postexercise recovery values were not significantly different than the baseline control values. CONCLUSION These results do not support the hypothesis that acute physical activity exerts an adverse effect on postexercise blood pressure in African American women.
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Affiliation(s)
- Lawrence Enweze
- Howard University, College of Medicine, Washington, DC 20059, USA
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31
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Guidry MA, Blanchard BE, Thompson PD, Maresh CM, Seip RL, Taylor AL, Pescatello LS. The influence of short and long duration on the blood pressure response to an acute bout of dynamic exercise. Am Heart J 2006; 151:1322.e5-12. [PMID: 16781245 DOI: 10.1016/j.ahj.2006.03.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2005] [Accepted: 03/20/2006] [Indexed: 10/24/2022]
Abstract
BACKGROUND The minimum duration of exercise needed to acutely lower blood pressure (BP) has not been established. The purpose of this study is to compare the effects of short and long duration on the BP response to a session of aerobic exercise. METHODS Subjects were 45 men (mean +/- SEM, 43.4 +/- 1.5 years) with elevated BP (144.6 +/- 1.6/85.2 +/- 1.1 mm Hg). Using a parallel design, men were randomly assigned to 40% (LITE, n = 23) or 60% (MOD, n = 22) of maximal oxygen consumption. Following assignment, they completed 3 experiments: a no-exercise control, and a 15-minute SHORT and 30-minute LONG cycle bout. Subjects left the laboratory wearing an ambulatory BP monitor. Repeated measure analysis of variance tested if BP differed among experimental conditions (no-exercise control, LONG, and SHORT) and over time within groups (LITE and MOD). RESULTS For 9 hours, systolic BP increased from baseline after all conditions (P < .001); however, systolic BP was reduced by 5.6 +/- 2.0 and 4.3 +/- 1.6 mm Hg after SHORT and LONG with LITE, and 4.1 +/- 1.6 and 4.9 +/- 1.9 mm Hg with MOD, respectively, compared with no-exercise control (P < .05). For 9 hours, diastolic BP (DBP) decreased from baseline after all conditions (P < .001). DBP was reduced by 2.1 +/- 1.0 and 3.6 +/- 1.4 mm Hg after SHORT and LONG with MOD for 3 hours (P < .05), and average DBP was lower by 2.4 +/- 1.0 mm Hg after LONG with LITE for 9 hours versus no-exercise control (P < .05). CONCLUSIONS The immediate BP-lowering effects of short-duration, lower intensity exercise are comparable to those of higher amounts of exercise. Additional investigation is needed to better quantify the dose of exercise needed to lower BP.
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Abstract
Despite the pervasiveness of hypertension (HTN), the exercise dose needed to lower blood pressure (BP) remains to be quantified. The purpose of this manuscript is to discuss recent advances in exercise prescription (ExR x) for HTN. The take-home message in ExR x for those with HTN is that the antihypertensive effect is: immediate; elicited by low intensity, short-duration aerobic exercise; one of many health benefits; and individually tailored. With this message and the general rules of ExR x as a guide, those with HTN should exercise on most, preferably all, days of the week, with moderate intensity (40% to <60% of VO2 Reserve), for 30 minutes or more of continuous or accumulated physical activity per day, primarily of the endurance type, supplemented by resistance exercise. Additionally, those who are overweight should progress to a caloric energy expenditure of a minimum of 1000 kcal to more than 2000 kcal per week or more than 2.5 hours per week of moderate-intensity, aerobic exercise.
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Affiliation(s)
- Linda S Pescatello
- Center of Health Promotion, University of Connecticut, School of Allied Health, Storrs, CT 06269-2101, USA.
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33
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Krediet CTP, Wilde AAM, Wieling W, Halliwill JR. Exercise related syncope, when it's not the heart. Clin Auton Res 2005; 14 Suppl 1:25-36. [PMID: 15480927 DOI: 10.1007/s10286-004-1005-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Syncope or pre-syncope in association with physical exercise may be the first indication of a dangerous underlying cardiovascular condition. Thus, the diagnostic workup of patients presenting with exercise-related syncope must include assessment of the risk for acute cardiac death. When potentially lethal conditions have been ruled out, several hypotensive syndromes that are associated with exercise should be considered. This review aims to give a concise overview of several forms of exercise- related functional hypotensive syndromes causing syncope, including the physiology of post-exercise hypotension. The focus is on underlying mechanisms, clinical considerations, and outlining treatment strategies for these syndromes.
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Affiliation(s)
- C T Paul Krediet
- Dept. of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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34
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Pescatello LS, Franklin BA, Fagard R, Farquhar WB, Kelley GA, Ray CA. American College of Sports Medicine position stand. Exercise and hypertension. Med Sci Sports Exerc 2004; 36:533-53. [PMID: 15076798 DOI: 10.1249/01.mss.0000115224.88514.3a] [Citation(s) in RCA: 1036] [Impact Index Per Article: 51.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Hypertension (HTN), one of the most common medical disorders, is associated with an increased incidence of all-cause and cardiovascular disease (CVD) mortality. Lifestyle modifications are advocated for the prevention, treatment, and control of HTN, with exercise being an integral component. Exercise programs that primarily involve endurance activities prevent the development of HTN and lower blood pressure (BP) in adults with normal BP and those with HTN. The BP lowering effects of exercise are most pronounced in people with HTN who engage in endurance exercise with BP decreasing approximately 5-7 mm HG after an isolated exercise session (acute) or following exercise training (chronic). Moreover, BP is reduced for up to 22 h after an endurance exercise bout (e.g.postexercise hypotension), with greatest decreases among those with highest baseline BP. The proposed mechanisms for the BP lowering effects of exercise include neurohumoral, vascular, and structural adaptations. Decreases in catecholamines and total peripheral resistance, improved insulin sensitivity, and alterations in vasodilators and vasoconstrictors are some of the postulated explanations for the antihypertensive effects of exercise. Emerging data suggest genetic links to the BP reductions associated with acute and chronic exercise. Nonetheless, definitive conclusions regarding the mechanisms for the BP reductions following endurance exercise cannot be made at this time. Individuals with controlled HTN and no CVD or renal complications may participated in an exercise program or competitive athletics, but should be evaluated, treated and monitored closely. Preliminary peak or symptom-limited exercise testing may be warranted, especially for men over 45 and women over 55 yr planning a vigorous exercise program (i.e. > or = 60% VO2R, oxygen uptake reserve). In the interim, while formal evaluation and management are taking place, it is reasonable for the majority of patients to begin moderate intensity exercise (40-<60% VO2R) such as walking. When pharmacological therapy is indicated in physically active people it should be, ideally: a) lower BP at rest and during exertion; b) decrease total peripheral resistance; and, c) not adversely affect exercise capacity. For these reasons, angiotensin converting enzyme (ACE) inhibitors (or angiotensin II receptor blockers in case of ACE inhibitor intolerance) and calcium channel blockers are currently the drugs of choice for recreational exercisers and athletes who have HTN. Exercise remains a cornerstone therapy for the primary prevention, treatment, and control of HTN. The optimal training frequency, intensity, time, and type (FITT) need to be better defined to optimize the BP lowering capacities of exercise, particularly in children, women, older adults, and certain ethnic groups. based upon the current evidence, the following exercise prescription is recommended for those with high BP: Frequency: on most, preferably all, days of the week. Intensity: moderate-intensity (40-<60% VO2R). Time: > or = 30 min of continuous or accumulated physical activity per day. Type: primarily endurance physical activity supplemented by resistance exercise.
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35
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Chen CY, Munch PA, Quail AW, Bonham AC. Postexercise hypotension in conscious SHR is attenuated by blockade of substance P receptors in NTS. Am J Physiol Heart Circ Physiol 2002; 283:H1856-62. [PMID: 12384463 DOI: 10.1152/ajpheart.00827.2001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In hypertensive subjects, a single bout of dynamic exercise results in an immediate lowering of blood pressure back toward normal. This postexercise hypotension (PEH) also occurs in the spontaneously hypertensive rat (SHR). In both humans and SHRs, PEH features a decrease in sympathetic nerve discharge, suggesting the involvement of central nervous system pathways. Given that substance P is released in the nucleus tractus solitarius (NTS) by activation of baroreceptor and skeletal muscle afferent fibers during muscle contraction, we hypothesized that substance P acting at neurokinin-1 (NK-1) receptors in the NTS might contribute to PEH. We tested the hypothesis by determining, in conscious SHRs, whether NTS microinjections of the NK-1 receptor antagonist SR-140333 before exercise attenuated PEH. The antagonist, in a dose (60 pmol) that blocked substance P- and spared D,L-homocysteic acid-induced depressor responses, significantly attenuated the PEH by 37%, whereas it had no effect on blood pressure during exercise. Vehicle microinjection had no effect. The antagonist also had no effect on heart rate responses during both exercise and the PEH period. The data suggest that a substance P (NK-1) receptor mechanism in the NTS contributes to PEH.
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Affiliation(s)
- Chao-Yin Chen
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of California-Davis, TB 172, One Shields Avenue, Davis, CA 95616, USA.
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36
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Kajekar R, Chen CY, Mutoh T, Bonham AC. GABA(A) receptor activation at medullary sympathetic neurons contributes to postexercise hypotension. Am J Physiol Heart Circ Physiol 2002; 282:H1615-24. [PMID: 11959623 DOI: 10.1152/ajpheart.00725.2001] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A single bout of exercise results in a postexercise hypotension (PEH) that is accompanied by a reduced baroreflex function. Based on the role of rostral ventrolateral medulla (RVLM) neurons in controlling sympathetic nerve activity (SNA) and blood pressure, the role of gamma-aminobutyric acid (GABA) in controlling RVLM neuronal activity, and the reduced baroreflex-SNA relationship during PEH, we determined whether: 1) RVLM neuronal activity is decreased during PEH, 2) GABA(A)-receptor mechanisms mediate the decrease, and 3) baroreflex control of RVLM activity is reduced. Spontaneously hypertensive rats (SHR) were subjected to 40 min of treadmill or sham exercise (Sham PEH). PEH lasted 10 h in conscious and anesthetized SHR, indicating that the anesthetics did not affect the expression of PEH. Extracellular RVLM neuronal activity having a cardiac and sympathetic rhythm, lumbar SNA, and blood pressure were recorded at rest and during baroreflex function curves. Resting RVLM neuronal activity was lower and was increased to a greater extent by GABA(A)-receptor antagonism in PEH versus Sham PEH (P < 0.05). Baroreflex control of RVLM neuronal activity operated with a reduced gain (P < 0.05). Thus increased GABA signaling at RVLM neurons may contribute to PEH.
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Affiliation(s)
- Radhika Kajekar
- Department of Internal Medicine, University of California at Davis, Davis, California 95616, USA
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37
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Abstract
Post exercise hypotension (PEH) is a phenomenon of a prolonged decrease in resting blood pressure in the minutes and hours following acute exercise. Knowledge of PEH is potentially useful in designing first line strategies against hypertension as well as allowing a further understanding of blood pressure regulation in both health and disease. Following a brief review of blood pressure responses to exercise, this paper will provide a current and comprehensive summary of PEH and integrate the current state of knowledge surrounding it.
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Affiliation(s)
- J R MacDonald
- Department of Medicine and Kinesiology, McMaster University, Hamilton, Ontario, Canada.
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38
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Abstract
Hypertension is a very prevalent cardiovascular (CV) disease risk factor in developed countries. All current treatment guidelines emphasise the role of nonpharmacological interventions, including physical activity, in the treatment of hypertension. Since our most recent review of the effects of exercise training on patients with hypertension, 15 studies have been published in the English literature. These results continue to indicate that exercise training decreases blood pressure (BP) in approximately 75% of individuals with hypertension, with systolic and diastolic BP reductions averaging approximately 11 and 8mm Hg, respectively. Women may reduce BP more with exercise training than men, and middle-aged people with hypertension may obtain greater benefits than young or older people. Low to moderate intensity training appears to be as, if not more, beneficial as higher intensity training for reducing BP in individuals with hypertension. BP reductions are rapidly evident although, at least for systolic BP, there is a tendency for greater reductions with more prolonged training. However, sustained BP reductions are evident during the 24 hours following a single bout of exercise in patients with hypertension. Asian and Pacific Island patients with hypertension reduce BP, especially systolic BP, more and more consistently than Caucasian patients. The minimal data also indicate that African-American patients reduce BP with exercise training. Some evidence indicates that common genetic variations may identify individuals with hypertension likely to reduce BP with exercise training. Patients with hypertension also improve plasma lipoprotein-lipid profiles and improve insulin sensitivity to the same degree as normotensive individuals with exercise training. Some evidence also indicates that exercise training in hypertensive patients may result in regression of pathological left ventricular hypertrophy. These results continue to support the recommendation that exercise training is an important initial or adjunctive step that is highly efficacious in the treatment of individuals with mild to moderate elevations in BP.
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Affiliation(s)
- J M Hagberg
- Department of Kinesiology, University of Maryland, College Park 20742-2611, USA.
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39
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Spier SA, Laughlin MH, Delp MD. Effects of acute and chronic exercise on vasoconstrictor responsiveness of rat abdominal aorta. J Appl Physiol (1985) 1999; 87:1752-7. [PMID: 10562619 DOI: 10.1152/jappl.1999.87.5.1752] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Reductions in blood pressure that are associated with exercise training have been hypothesized to be the result of a sustained postexertional vascular alteration following single bouts of exercise. The purpose of this study was to determine whether a decrease in vascular sensitivity to vasoconstrictor agonists occurs after a single bout of exercise and whether this vascular alteration is sustained through various periods of exercise training. Vascular responses of abdominal aortic rings to norepinephrine (NE; 10(-9)-10(-4) M) were determined in vitro. Aortas were isolated from sedentary rats immediately after rats performed a single bout of treadmill exercise (30 m/min for 1 h); 24 h after the last exercise bout in rats exercised for 1 day; and 1, 2, 4, and 10 wk of training at 30 m/min, 60 min, 5 days/wk. Sensitivity to NE was only diminished after 10 wk of training. This diminished vascular sensitivity to NE was abolished with the removal of the endothelial cell layer. Furthermore, there were no reductions in developed tension or vascular sensitivity to the vasoconstrictor agonists KCl (10-100 mM), phenylephrine (10(-8)-10(-4) M), and arginine vasopressin (10(-9)-10(-5) M) in vessels either with or without the endothelial layer after a single bout of exercise. These data indicate that a single bout of exercise does not diminish aortic responsiveness to vasoconstrictor agonists and thus is not responsible for the diminished contractile responsiveness that occurs between 4 and 10 wk of moderate-intensity exercise training in rats. This vascular adaptation to exercise training appears to be mediated through an endothelium-dependent mechanism.
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Affiliation(s)
- S A Spier
- Departments of Health and Kinesiology and Medical Physiology, Texas A&M University, College Station, Texas 77843, USA
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40
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FitzGerald WA. Observations on sleeping position and essential hypertension. Med Hypotheses 1997; 49:27-30. [PMID: 9247903 DOI: 10.1016/s0306-9877(97)90247-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A hypertensive black male, at risk for episodic attacks of pseudo-malignant hypertension and self-induced atrial fibrillation, seeks to discover possible clues to the pathogeneses of these strange disorders through self-study and concludes they might be associated with impaired oxygen intake, secondary to sleeping position in bed.
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41
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Rendell MS, Green SS, Catania A, Oliveto J, Wells J, Banset EJ, Wang H. Post-exercise cutaneous hyperaemia resulting from local exercise of an extremity. CLINICAL PHYSIOLOGY (OXFORD, ENGLAND) 1997; 17:213-24. [PMID: 9171962 DOI: 10.1111/j.1365-2281.1997.tb00001.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Large changes in skin blood flow occur after exercise. Most studies have concentrated on the systemic effects of vigorous exercise on skin blood flow. We were interested in the post-exercise response in the neighbourhood of focal exercise. We used a painless neuromuscular electronic stimulator to exercise the muscles of the forearm, producing flexion of the fingers. There was no change in blood pressure and only a small increase in heart rate during this exercise. We measured blood flow during a 5-min pre-exercise period and a 5-min post-exercise period at the forearm, at the dorsum of the index finger and on the pad of the index finger. We also measured values on the contralateral non-exercised extremity during exercise as well as during matched time periods in control experiments with no exercise. Exercise did elicit an increased blood flow in the post-exercise period at all three sites compared with the control experiments with no exercise and on the contralateral extremity. For example, the increase in blood flow at the finger dorsum was 2.1 +/- 0.1 ml (min 100 g)-1 after exercise compared with -0.08 +/- 0.09 ml min-1 100 g-1 during the control experiment and 0.1 +/- 0.1 ml (min 100 g)-1 on the contralateral arm (all P < 0.01). The local application of heat at the site of blood flow monitoring produced a substantial increase in the post-exercise response at the two finger locations [27.4 +/- 0.4 ml (min 100 g)-1 at the finger dorsum], but not at the arm. This is the first demonstration that highly focal exercise, unaccompanied by a systemic haemodynamic response, can elicit a post-exercise cutaneous hyperaemia. Local heating produced a large synergistic increase in the post-exercise hyperaemia at sites with arteriovenous microvascular perfusion but not at sites with primarily nutritive perfusion. These findings show that local vasoregulatory changes occur in response to exercise, even in the absence of whole-body haemodynamic and thermal change.
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Affiliation(s)
- M S Rendell
- Creighton Diabetes Center, Omaha, Nebraska 68131, USA
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42
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Chen Y, Chandler MP, DiCarlo SE. Acute exercise attenuates cardiac autonomic regulation in hypertensive rats. Hypertension 1995; 26:676-83. [PMID: 7558230 DOI: 10.1161/01.hyp.26.4.676] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Dynamic exercise may be used as a safe, therapeutic approach to reduce sympathetic nerve activity at rest and thus may be beneficial for individuals with hypertension. Therefore, we tested the hypothesis that a single bout of mild to moderate dynamic exercise would decrease cardiac sympathetic tonus at rest. We designed two experimental protocols to test this hypothesis in male spontaneously hypertensive rats. In protocol 1 (n = 6) cardiac sympathetic tonus and parasympathetic tonus were determined before and after a single bout of dynamic exercise. We developed protocol 2 (n = 5) to determine the component of the autonomic nervous system responsible for the postexercise reduction in heart rate. Rats were instrumented with catheters inserted into the descending aorta for measurements of arterial pressure, mean arterial pressure, and heart rate and into the jugular vein for infusion of drugs. A single bout of mild to moderate dynamic treadmill exercise (12 m/min, 10% grade for 42 +/- 1 minutes, representing approximately 74% to 79% of maximal heart rate) resulted in a postexercise reduction in mean arterial pressure (163 +/- 7 to 149 +/- 5 mm Hg; P < .05). Associated with the postexercise hypotension was a reduction in sympathetic and parasympathetic tonus (47 +/- 12% and 71 +/- 12%, respectively). The reduction in heart rate during the early recovery phase was due to a withdrawal of sympathetic tonus, because beta 1-adrenergic receptor blockade significantly enhanced the postexercise reduction in heart rate, and muscarinic-cholinergic receptor blockade did not affect the postexercise decrease in heart rate until 20 minutes after exercise.
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Affiliation(s)
- Y Chen
- Department of Physiology, Northeastern Ohio Universities, College of Medicine, Rootstown 44272, USA
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Andersson S, Lundeberg T. Acupuncture--from empiricism to science: functional background to acupuncture effects in pain and disease. Med Hypotheses 1995; 45:271-81. [PMID: 8569551 DOI: 10.1016/0306-9877(95)90117-5] [Citation(s) in RCA: 308] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Acupuncture is part of Traditional Chinese Medicine, a system with an empirical basis which has been used in the treatment and prevention of disease for centuries. A lack of scientific studies to prove or disprove its claimed effects led to rejection by many of the western scientific community. Now that the mechanisms can be partly explained in terms of endogenous pain inhibitory systems, the integration of acupuncture with conventional medicine may be possible. Its use for pain relief has been supported by clinical trials and this has facilitated its acceptance in pain clinics in most countries. Acupuncture effects must devolve from physiological and/or psychological mechanisms with biological foundations, and needle stimulation could represent the artificial activation of systems obtained by natural biological effects in functional situations. Acupuncture and some other forms of sensory stimulation elicit similar effects in man and other mammals, suggesting that they bring about fundamental physiological changes. Acupuncture excites receptors or nerve fibres in the stimulated tissue which are also physiologically activated by strong muscle contractions and the effects on certain organ functions are similar to those obtained by protracted exercise. Both exercise and acupuncture produce rhythmic discharges in nerve fibres, and cause the release of endogenous opioids and oxytocin essential to the induction of functional changes in different organ systems. Beta-endorphin levels, important in pain control as well as in the regulation of blood pressure and body temperature, have been observed to rise in the brain tissue of animals after both acupuncture and strong exercise. Experimental and clinical evidence suggest that acupuncture may affect the sympathetic system via mechanisms at the hypothalamic and brainstem levels, and that the hypothalamic beta-endorphinergic system has inhibitory effects on the vasomotorcenter, VMC. Post-stimulatory sympathetic inhibition which proceeds to a maximum after a few hours and can be sustained for more than 12 hours, has been demonstrated in both man and animals. Experimental and clinical studies suggest that afferent input in somatic nerve fibres has a significant effect on autonomic functions. Hypothetically, the physiological counterpart lies in physical exercise, and the effect can be artificially reproduced via various types of electrical or manual stimulation of certain nerve fibres.
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Affiliation(s)
- S Andersson
- Department of Physiology, University of Göteborg, Sweden
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44
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Walking, but Not Weight Lifting, Acutely Reduces Systolic Blood Pressure in Older, Sedentary Men and Women. J Aging Phys Act 1995. [DOI: 10.1123/japa.3.2.163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
An elderly patient population was used to investigate whether an acute bout of aerobic exercise (AE) would reduce systolic blood pressure (SBP) to a greater extent than would a bout of weight lifting (WL). SBPs were studied in the context of a laboratory Stressor as well as during activities of daily living using ambulatory monitoring devices (AMBPs). Patients participated in a laboratory Stressor and were monitored via AMBP for 8 hr. SBPs were lower for up to 5 hr postexercise for the AE treatment only. In addition, in comparison to no-exercise control data, baseline SBP was lower for the AE group than the WL group prior to the Stressor. Subjects in the AE condition also tended to have lower SBP responses following exercise than patients in the WL group, although these differences did not reach a conventional level of statistical significance. These data provide evidence that single bouts of AE, but not WL, may lower SBP in elderly patients, even for those who have compromised function due to osteoarthritis of the knee.
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45
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Isea JE, Piepoli M, Adamopoulos S, Pannarale G, Sleight P, Coats AJ. Time course of haemodynamic changes after maximal exercise. Eur J Clin Invest 1994; 24:824-9. [PMID: 7705377 DOI: 10.1111/j.1365-2362.1994.tb02026.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The haemodynamic changes during 4 h following maximal upright bicycle exercise were evaluated in six normals in a randomized controlled crossover design. Total peripheral resistance was reduced to 2 h (-6.7 mmHg min l-1, P < 0.05); exercising and non-exercising vascular beds were vasodilated for 2 h (-24.1 and -23.8 mmHg min ml-1 100 ml-1 tissue, respectively, P < 0.05), associated with reductions in systolic (-5.8 mmHg, P < 0.05) and diastolic pressure (-8.3 mmHg, P < 0.05). Rise in cardiac index for 1 h (+0.51 min-1 m-2, P < 0.05) was accounted for by an elevated heart rate (+14.4 beats min-1, P < 0.01) as stroke volume was unchanged. Body temperature was elevated until 40 min (+0.20 degrees C, P < 0.05). The return of all haemodynamic variables to control by 3 h suggests a 3 h limit for a hypotensive effect of exercise. Rise in body temperature is not the only factor responsible for the hypotension.
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Affiliation(s)
- J E Isea
- Department of Cardiovascular Medicine, John Radcliffe Hospital, Oxford, UK
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46
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Piepoli M, Isea JE, Pannarale G, Adamopoulos S, Sleight P, Coats AJ. Load dependence of changes in forearm and peripheral vascular resistance after acute leg exercise in man. J Physiol 1994; 478 ( Pt 2):357-62. [PMID: 7965851 PMCID: PMC1155692 DOI: 10.1113/jphysiol.1994.sp020256] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
1. It is known that acute exercise is often followed by a reduction in arterial blood pressure. Little is known about the time course of the recovery of the blood pressure or the influence of the intensity of the exercise on this response. Controversy exists, in particular, concerning the changes in peripheral resistance that occur during this period. 2. Eight normal volunteers performed, in random order on separate days, voluntary upright bicycle exercise of three different intensities (maximal, moderate and minimal load) and, on another day, a control period of sitting on a bicycle. They were monitored for 60 min after each test. 3. Diastolic pressure fell after maximal exercise at 5 min (-15.45 mmHg) and 60 min (-9.45 mmHg), compared with the control day. Systolic and mean pressure also fell (non-significantly) after 45 min; heart rate was significantly elevated for the whole hour of recovery (at 60 min, +7.23 beats min-1). No changes in post-exercise blood pressure and heart rate were observed on the days of moderate and minimal exercises. 4. An increase in cardiac index was observed after maximal exercise compared with control (at 60 min, 2.6 +/- 0.3 vs. 1.9 +/- 0.2 l min-1 m-2). This was entirely accounted for by the persistent increase in heart rate, with no significant alteration in stroke volume after exercise on any day.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M Piepoli
- Department of Cardiovascular Medicine, John Radcliffe Hospital, Oxford
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47
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Kenney MJ, Seals DR. Postexercise hypotension. Key features, mechanisms, and clinical significance. Hypertension 1993; 22:653-64. [PMID: 8225525 DOI: 10.1161/01.hyp.22.5.653] [Citation(s) in RCA: 290] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Recent investigations have demonstrated that there is a sustained reduction in arterial blood pressure after a single bout of exercise, ie, postexercise hypotension (PEH). The purpose of this discussion is to integrate the available information on this topic and to review studies using sustained stimulation of somatic afferents in experimental rats as a model to study the role of somatic afferents in PEH. PEH occurs in response to several types of large-muscle dynamic exercise (ie, walking, running, leg cycling, and swimming) at submaximal intensities greater than 40% of peak aerobic capacity and exercise durations generally between 20 and 60 minutes. PEH is observed in both normotensive and hypertensive humans and in spontaneously hypertensive rats but is generally greater in magnitude in hypertensive subjects. The maximal exercise-induced reductions in systolic and diastolic arterial blood pressures have been on average 18 to 20 and 7 to 9 mm Hg, respectively, in hypertensive humans and 8 to 10 and 3 to 5 mm Hg, respectively, in normotensive humans. PEH has been reported to persist for 2 to 4 hours under laboratory conditions. Whether PEH is sustained for a prolonged period of time under free-living conditions remains controversial, although the results of one study indicate that PEH can persist for up to 13 hours. Possible mechanisms involved in mediating postexercise and poststimulation reductions in arterial blood pressure include decreased stroke volume and cardiac output; reductions in limb vascular resistance, total peripheral resistance, and muscle sympathetic nerve discharge; group III somatic afferent activation; altered baroreceptor reflex circulatory control; reduced vascular responsiveness to alpha-adrenergic receptor-mediated stimulation; and activation of endogenous opioid and serotonergic systems. It appears that the magnitude of PEH in hypertensive subjects is clinically significant; however, more investigation is required to determine if the duration is sufficient under real-life conditions to contribute to the reduction in blood pressure observed with chronic exercise conditioning.
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Affiliation(s)
- M J Kenney
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan 66506
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48
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Kahn JF, Jouanin JC, Espirito-Santo J, Monod H. Cardiovascular responses to leisure alpine skiing in habitually sedentary middle-aged men. J Sports Sci 1993; 11:31-6. [PMID: 8450583 DOI: 10.1080/02640419308729960] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
In order to evaluate the cardiovascular responses to leisure alpine skiing of habitually sedentary and not particularly active adult men, a series of continuous recordings of heart rate (HR) was performed on 10 subjects aged 51.0 +/- 1.3 years (mean +/- S.E.) during a 6-day ski trip at an altitude of 1000-2485 m. From the very first day, the subjects spontaneously adopted a regimen of intense physical activity, since 17.9% of the HR values recorded on the ski runs were higher than 85% of the maximal theoretical HR [THRmax (beats min-1) = 220--age (years)], which represented 19.5% of the actual skiing time. On day 2, 10.7% of the HR values were higher than 85% THRmax, or 17.9% of actual skiing time. For the entire ski trip, the mean HR during skiing was approximately 126 beats min-1, which corresponds to 75% THRmax. At rest, HR in the morning did not change significantly from days 2 to 6 (from 80 +/- 4 to 75 +/- 4 beats min-1, P > 0.05), whereas HR in the evening correlated significantly with the duration of physical activity during the day (r = 0.487, P < 0.001). In all cases, HR at rest was significantly higher than before the trip, except in the evening of day 4, the day on which the subjects skied less because they were fatigued after skiing in the morning. Systolic blood pressure (SBP) at rest was always lower than the control established before the trip, whether taken in the morning or in the evening.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- J F Kahn
- Laboratoire de Physiologie de la Motricité, URA CNRS 385, Paris, France
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49
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Sleight P. Exercise and the heart. AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE 1992; 22:607-9. [PMID: 1449448 DOI: 10.1111/j.1445-5994.1992.tb00486.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- P Sleight
- University of Oxford, John Radcliffe Hospital, Headington, UK
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50
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Abstract
Physical conditioning has been suggested as a useful adjunct or alternative to pharmacologic therapy in the treatment of borderline or mild hypertension. This recommendation stems from numerous studies that have demonstrated modest decreases in blood pressure in hypertensive individuals. Exercise guidelines should be based on preliminary exercise testing and modified to accommodate those patients who are taking a variety of antihypertensive medications. Although pure isometric exercise is generally contraindicated in hypertensive patients, potentially valuable training activities that involve a substantial static component, including arm crank ergometry and mild-to-moderate load weight training, probably requires individual assessment.
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Affiliation(s)
- B A Franklin
- Division of Cardiology, William Beaumont Hospital, Royal Oak, Michigan
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