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Alessandro C, Sarabadani Tafreshi A, Riener R. Cardiovascular responses to leg-press exercises during head-down tilt. Front Sports Act Living 2024; 6:1396391. [PMID: 39290333 PMCID: PMC11406980 DOI: 10.3389/fspor.2024.1396391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 08/12/2024] [Indexed: 09/19/2024] Open
Abstract
Introduction Physical exercise and gravitational load affect the activity of the cardiovascular system. How these factors interact with one another is still poorly understood. Here we investigate how the cardiovascular system responds to leg-press exercise during head-down tilt, a posture that reduces orthostatic stress, limits gravitational pooling, and increases central blood volume. Methods Seventeen healthy participants performed leg-press exercise during head-down tilt at different combinations of resistive force, contraction frequency, and exercise duration (30 and 60 s), leading to different exercise power. Systolic (sBP), diastolic (dBP), mean arterial pressure (MAP), pulse pressure (PP) and heart rate (HR) were measured continuously. Cardiovascular responses were evaluated by comparing the values of these signals during exercise recovery to baseline. Mixed models were used to evaluate the effect of exercise power and of individual exercise parameter on the cardiovascular responses. Results Immediately after the exercise, we observed a clear undershoot in sBP (Δ = -7.78 ± 1.19 mmHg), dBP (Δ = -10.37 ± 0.84 mmHg), and MAP (Δ = -8.85 ± 0.85 mmHg), an overshoot in PP (Δ = 7.93 ± 1.13 mmHg), and elevated values of HR (Δ = 33.5 ± 0.94 bpm) compared to baseline (p < 0.0001). However, all parameters returned to similar baseline values 2 min following the exercise (p > 0.05). The responses of dBP, MAP and HR were significantly modulated by exercise power (correlation coefficients: rdBP = -0.34, rMAP = -0.25, rHR = 0.52, p < 0.001). All signals' responses were modulated by contraction frequency (p < 0.05), increasing the undershoot in sBP (Δ = -1.87 ± 0.98 mmHg), dBP (Δ = -4.85 ± 1.01 and Δ = -3.45 ± 0.98 mmHg for low and high resistive force respectively) and MAP (Δ = -3.31 ± 0.75 mmHg), and increasing the overshoot in PP (Δ = 2.57 ± 1.06 mmHg) as well as the value of HR (Δ = 16.8 ± 2.04 and Δ = 10.8 ± 2.01 bpm for low and high resistive force respectively). Resistive force affected only dBP (Δ = -4.96 ± 1.41 mmHg, p < 0.0001), MAP (Δ = -2.97 ± 1.07 mmHg, p < 0.05) and HR (Δ = 6.81 ± 2.81 bpm, p < 0.0001; Δ = 15.72 ± 2.86 bpm, p < 0.0001; Δ = 15.72 ± 2.86 bpm, p < 0.05, depending on the values of resistive force and contraction frequency), and exercise duration affected only HR (Δ = 9.64 ± 2.01 bpm, p < 0.0001). Conclusion Leg exercises caused only immediate cardiovascular responses, potentially due to facilitated venous return by the head-down tilt position. The modulation of dBP, MAP and HR responses by exercise power and that of all signals by contraction frequency may help optimizing exercise prescription in conditions of limited orthostatic stress.
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Affiliation(s)
- Cristiano Alessandro
- School of Medicine and Surgery, Sport and Exercise Medicine, University of Milano-Bicocca, Milan, Italy
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, Institute of Robotics and Intelligent Systems, ETH Zurich, Zurich, Switzerland
| | - Amirehsan Sarabadani Tafreshi
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, Institute of Robotics and Intelligent Systems, ETH Zurich, Zurich, Switzerland
| | - Robert Riener
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, Institute of Robotics and Intelligent Systems, ETH Zurich, Zurich, Switzerland
- Spinal Cord Injury Center, Medical Faculty, University of Zurich, Zurich, Switzerland
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Teixeira J, Krustrup P, Castagna C, Mohr M, Pereira R, Carneiro I, Coelho E, Oliveira R, Póvoas S. Post-exercise hypotension and recreational futsal: Effects of a 3-month intervention and association with resting blood pressure adaptations. J Sports Sci 2024; 42:1519-1528. [PMID: 39299934 DOI: 10.1080/02640414.2024.2400806] [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: 10/04/2023] [Accepted: 08/29/2024] [Indexed: 09/22/2024]
Abstract
To investigate i) if a recreational futsal (RF) training session elicits post-exercise hypotension (PEH), ii) the impact of a 3-month RF intervention on PEH, and iii) the association between PEH in the early phase of the intervention with resting blood pressure (BP) chronic adaptions in men with treated hypertension. BP was measured before and after a RF training session every 5-min (total of 30-min) in the early (weeks 1-2) and the final phases (weeks 11-12) of a 3-month RF intervention, comprising 3 weekly one-hour sessions. Thirty-three men (48 ± 7 years; mean arterial pressure [MAP]: 96 ± 8 mmHg; BMI: 32.2 ± 4.9 kg/m2) participated. In the intervention early phase, systolic BP ([SBP]; -15.4 mmHg; 95% CI: -10.9, -16.8), diastolic BP ([DBP]; -5.4 mmHg; 95% CI: -7.8, -3.0), and MAP (-8.8 mmHg; 95% CI: -11.2, -6.4) significantly decreased 30-min post- compared to pre-training session (n = 33). In the intervention final phase (n = 24), SBP (-8.1 mmHg; 95% CI: -12.0, -3.9) and MAP (-3.0 mmHg; 95% CI: -5.4, -0.7) significantly decreased 30-min post- compared to pre-training session, but not DBP (-0.5 mmHg; 95% CI: -3.7, 2.7). PEH in the final phase was significantly inferior compared to the early phase. PEH in the early phase of the intervention was not consistently associated with chronic BP changes.
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Affiliation(s)
- Jorge Teixeira
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark
- Sport and Health Sciences, College of Life and Environment Sciences, University of Exeter, Exeter, UK
- Danish Institute for Advanced Study (DIAS), University of Southern Denmark, Odense, Denmark
| | - Carlo Castagna
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark
- Department of Biomolecular Sciences, School of Exercise and Health Sciences, Carlo Bo Urbino University, Urbino, Italy
| | - Magni Mohr
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark
- Centre of Health Science, Faculty of Health, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Rita Pereira
- Laboratory of Metabolism and Exercise, Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
- University of Maia, Maia, Portugal
| | - Ivone Carneiro
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal
| | | | | | - Susana Póvoas
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark
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Le Bourvellec M, Delpech N, Hervo J, Bosquet L, Enea C. Effect of exercise modalities on postexercise hypotension in pre- and postmenopausal women: a systematic review and meta-analysis. J Appl Physiol (1985) 2024; 136:864-876. [PMID: 38328822 DOI: 10.1152/japplphysiol.00684.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/16/2024] [Accepted: 01/31/2024] [Indexed: 02/09/2024] Open
Abstract
Hormonal changes associated with menopause increase the risk of hypertension. Postexercise hypotension (PEH) is an important tool in the prevention and management of hypertension; however, menopause may alter this response. The aim of this systematic review and meta-analysis [International Prospective Registered of Systematic Review (PROSPERO): CRD42023297557] was to evaluate the effect of exercise modalities (aerobic, AE; resistance, RE; and combined exercise, CE: AE + RE) on PEH in women, according to their menopausal status (premenopausal or postmenopausal). We searched controlled trials in PubMed, Web of Science, EBSCO, and Science Direct published between 1990 and March 2023. Inclusion criteria were normotensive, pre- and hypertensive, pre- and postmenopausal women who performed an exercise session compared with a control session and reported systolic blood pressure (SBP) and diastolic blood pressure (DBP) for at least 30 min after the sessions. Methodological quality was assessed using the PEDro scale. Standardized mean differences (Hedge's g) and their 95% confidence intervals (CIs) were calculated, and Q-test and Z-test were conducted to assess differences between moderators. Forty-one trials with 718 women (474 menopausal) were included. Overall, we found with moderate evidence that SBP and DBP decreased significantly after exercise session (SBP: g = -0.69, 95% CI -0.87 to -0.51; DBP: g = -0.31, 95% CI -0.47 to -0.14), with no difference between premenopausal and postmenopausal women. Regarding exercise modalities, RE is more effective than AE and CE in lowering blood pressure (BP) in women regardless of menopausal status. In conclusion, women's menopausal status does not influence the magnitude of PEH, and the best modality to reduce BP in women seems to be RE.NEW & NOTEWORTHY This meta-analysis has demonstrated that a single bout of exercise induces postexercise hypotension (PEH) in women and that the hormonal shift occurring with menopause does not influence the magnitude of PEH. However, we have shown with moderate evidence that the effectiveness of exercise modalities differs between pre- and postmenopausal women. Resistance and combined exercises are the best modalities to induce PEH in premenopausal women, whereas resistance and aerobic exercises are more effective in postmenopausal women.
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Affiliation(s)
- Morgane Le Bourvellec
- Laboratory MOVE (UR20296), Faculté des Sciences du Sport, Université de Poitiers, Poitiers, France
| | - Nathalie Delpech
- Laboratory MOVE (UR20296), Faculté des Sciences du Sport, Université de Poitiers, Poitiers, France
| | - Jéromine Hervo
- Laboratoire de Traitement de l'information Médicale (LaTIM), UMR1101, Université Bretagne Occidentale, Brest, France
| | - Laurent Bosquet
- Laboratory MOVE (UR20296), Faculté des Sciences du Sport, Université de Poitiers, Poitiers, France
| | - Carina Enea
- Laboratory MOVE (UR20296), Faculté des Sciences du Sport, Université de Poitiers, Poitiers, France
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Oliveira-Silva L, Fecchio RY, Silva Junior NDD, Pio-Abreu A, Silva GVD, Drager LF, Silva de Sousa JC, Forjaz CLDM. Post-dynamic, isometric and combined resistance exercise responses in medicated hypertensive men. J Hum Hypertens 2024; 38:52-61. [PMID: 37670145 DOI: 10.1038/s41371-023-00859-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/07/2023]
Abstract
This study investigated the effects of dynamic resistance exercise (DRE), isometric handgrip exercise (IHE) and combined resistance exercise (DRE+IHE) on post-exercise hypotension (PEH) and its hemodynamic, autonomic, and vascular mechanisms. For that, 70 medicated hypertensives men (52 ± 8 years) were randomly allocated to perform one of the following interventions: DRE (3 sets, 8 exercises, 50% of 1RM), IHE (4 sets, 2 min, 30% of MVC), CRE (DRE+IHE) and control (CON, seated rest). Before and after the interventions, blood pressure (BP), systemic hemodynamics, cardiovascular autonomic modulation and brachial vascular parameters were evaluated. After the DRE and CRE, systolic and mean BP decreased (SBP = -7 ± 6 and -8 ± 8 mmHg; MBP -4 ± 5 and -5 ± 5 mmHg, respectively, all P < 0.05), vascular conductance increased (+ 0.47 ± 0.61 and +0.40 ± 0.47 ml.min-1.mmHg-1, respectively, both P < 0.05) and baroreflex sensitivity decreased (-0.15 ± 0.38 and -0.29 ± 0.47 ms/mmHg, respectively, both P < 0.05) in comparison to pre-exercise values. No variable presented any significant change after IHE. The responses observed after CRE were similar to DRE and significantly different from CON and IHE. In conclusion, DRE, but not IHE, elicits PEH, which happens concomitantly to skeletal muscle vasodilation and decreased baroreflex sensitivity. Moreover, adding IHE to DRE does not potentiate PEH and neither changes its mechanisms.Clinical Trial Registration: Data from this study derived from an ongoing longitudinal clinical trial approved by the Institution's Ethics Committee of Human Research (process 2.870.688) and registered at the Brazilian Clinical Trials (RBR-4fgknb) at http://www.ensaiosclinicos.gov.br .
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Affiliation(s)
- Laura Oliveira-Silva
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Rafael Yokoyama Fecchio
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Natan Daniel da Silva Junior
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Andrea Pio-Abreu
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Giovânio Vieira da Silva
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Luciano Ferreira Drager
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
- Unidade de Hipertensão, Instituto do Coração (InCor), Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Julio Cesar Silva de Sousa
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
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Bersaoui M, Bisai A, Baldew SM, Toelsie J, Goessler K, Cornelissen VA. Can postexercise hypotension also be observed in African and Asian populations: a systematic review and meta-analysis of randomized controlled trials. J Hum Hypertens 2023; 37:1076-1085. [PMID: 37468543 DOI: 10.1038/s41371-023-00844-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 05/16/2023] [Accepted: 06/19/2023] [Indexed: 07/21/2023]
Abstract
Worldwide, raised blood pressure (BP) or hypertension is the global leading risk factor for the development of cardiovascular diseases and all-cause mortality, with the highest prevalence found in Asian and African origin populations. Post-exercise hypotension (PEH), defined as a sustained reduction in BP after a single bout of exercise is an important physiological phenomenon in BP management. However, little is known about the hypotensive effect of a single bout of exercise in non-Caucasian populations. We systematically summarized the acute effects of a single bout of aerobic exercise on BP in a population of African or Asian origin. We searched the MEDLINE database identifying randomized controlled trials investigating the effect of a single bout of aerobic exercise on BP in African or Asian populations with optimal BP, high normal BP or hypertension published in a peer reviewed journal up to August 2021. A subsequent meta-analysis was performed using random-effect models fitted to estimate effect sizes. We identified 10 aerobic exercise trials performed in individuals of Asian origin (n = 136; mean age: 29.51 (21.2-69) years: 78% male; baseline systolic BP/diastolic BP: 118.9 ± 9.64/68.9 ± 2.69 mmHg) and 11 aerobic exercise trials involving individuals of African origin (n = 157; mean age: 41.05 (29.9-49) years; 59% male; baseline systolic BP/diastolic BP: 134.5 ± 8.65 mmHg/82.2 ± 3.24 mmHg). Non-significant reductions in office systolic BP and diastolic BP at 30 min post exercise (-2.25 [-6.38, 1.88] mmHg, p = 0.28/-1.02 [-2.51, 0.47] mmHg, p = 0.18) and 60 min post exercise (-2.80 [-7.90, 2.28], p = 0.27/-1.95, [-5.66, 1.75], p = 0.3) were observed compared to the control intervention. No statistically significant differences were found between both ethnic groups (p > 0.05). Ambulatory BP was reported only in a few African groups. No effect was found on 24h-systolic BP post exercise, but 24h-diastolic BP was statistically significantly reduced (-1.89 [-3.47, -0.31] mmHg, p < 0.01) after a bout of aerobic exercise compared to the control intervention. The available evidence is insufficient to recommend a single session of aerobic exercise as an efficient tool to lower BP in African and Asian populations. Though, the paucity of data in non-Caucasian populations underscores the need for additional efforts to establish the efficacy of single bouts of exercise, including isometric and dynamic resistance exercise, as a potential non-pharmacological adjunct to help lowering BP in the daily life of descendants of Asian or African origin.
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Affiliation(s)
- M Bersaoui
- Department of Physical Therapy, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname.
- Department of Rehabilitation Sciences, Cardiovascular Exercise Physiology Unit, KU Leuven, Leuven, Belgium.
| | - A Bisai
- Department of Physical Therapy, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - S M Baldew
- Department of Physical Therapy, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - J Toelsie
- Department of Physiology, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - K Goessler
- Applied Physiology and Nutrition Research Group - Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil
| | - V A Cornelissen
- Department of Rehabilitation Sciences, Cardiovascular Exercise Physiology Unit, KU Leuven, Leuven, Belgium
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Gottlieb R, Arnskov K, Henriksen M, Prescott E, Rasmusen H, Dall CH. Hemodynamic Response in Ascending Aorta Surgery Patients during Moderate Intensity Resistance Training. TRANSLATIONAL SPORTS MEDICINE 2023; 2023:7616007. [PMID: 38654911 PMCID: PMC11022775 DOI: 10.1155/2023/7616007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/18/2023] [Accepted: 10/03/2023] [Indexed: 04/26/2024]
Abstract
Background In patients undergoing ascending aortic surgery (AAS), postsurgical physical exercise with a safe and effective exercise prescription is recommended. Resistance training is associated with blood pressure (BP) elevations that may increase the risk of new aortic dissection or rupture. However, the acute hemodynamic response to resistance training for this patient group is unknown. Aim The aim of this study was to investigate peak systolic BP (SBP) increases in AAS patients during moderate intensity resistance training. Methods SBP was measured continuously beat-to-beat with a noninvasive method during three sets of leg presses at moderate intensity. A 15-repetition maximum strength test was performed to estimate the maximal amount of resistance a participant could manage 15 times consecutively (equivalent to approximately 60-65% of their maximum strength). Results The study had 48 participants in total, i.e., 24 cases and 24 controls. Both groups consisted of 10 females (42%) and 14 males (58%). The case group had a mean age of 60.0 (SD ± 11.9) years and a mean of 16.3 months since surgery (minimum 4.4 and maximum 39.6 months). 22 of the 24 cases received antihypertensive medication. The median baseline BP was 119/74 mmHg among cases and 120/73 mmHg among controls. During the first set of leg presses, the median peak SBP was 152 mmHg, in the second set 154 mmHg, and in the third set 165 mmHg. Corresponding values in controls were 170 mmHg, 181 mmHg, and 179 mmHg. The highest peak SBP registered in an AAS patient was 190 mmHg and in any healthy control was 287 mmHg. Conclusion The findings indicate that AAS patients in control of their BP have the endurance to perform 3 sets of resistance training at moderate intensity as their SBP increases with a maximum of 39% from the baseline compared to the 51% increase in the control group.
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Affiliation(s)
- Rikke Gottlieb
- Department of Physical Therapy and Occupational Therapy, Copenhagen University Hospital, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
- Department of Occupational Therapy and Physical Therapy, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Kasper Arnskov
- Department of Physical Therapy and Occupational Therapy, Copenhagen University Hospital, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
| | - Marius Henriksen
- Department of Physical Therapy and Occupational Therapy, Copenhagen University Hospital, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
- The Parker Institute, Copenhagen University Hospital, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
| | - Eva Prescott
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
| | - Hanne Rasmusen
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
| | - Christian Have Dall
- Department of Physical Therapy and Occupational Therapy, Copenhagen University Hospital, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
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Isath A, Koziol KJ, Martinez MW, Garber CE, Martinez MN, Emery MS, Baggish AL, Naidu SS, Lavie CJ, Arena R, Krittanawong C. Exercise and cardiovascular health: A state-of-the-art review. Prog Cardiovasc Dis 2023; 79:44-52. [PMID: 37120119 DOI: 10.1016/j.pcad.2023.04.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 05/01/2023]
Abstract
Cardiovascular (CV) disease (CVD) is the leading cause of global morbidity and mortality, and low levels of physical activity (PA) is a leading independent predictor of poor CV health and associated with an increased prevalence of risk factors that predispose to CVD development. In this review, we evaluate the benefits of exercise on CV health. We discuss the CV adaptations to exercise, focusing on the physiological changes in the heart and vasculature. We review the impact and benefits of exercise on specific CV prevention, including type II diabetes, hypertension, hyperlipidemia, coronary artery disease, and heart failure, in addition to CVD-related and all-cause mortality. Lastly, we evaluate the current PA guidelines and various modes of exercise, assessing the current literature for the effective regimens of PA that improve CVD outcomes.
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Affiliation(s)
- Ameesh Isath
- Department of Cardiology, Westchester Medical Centre and New York Medical College, Valhalla, NY, United States of America
| | - Klaudia J Koziol
- New York Medical College, School of Medicine, Valhalla, NY, United States of America
| | - Matthew W Martinez
- Department of Cardiovascular Medicine, Sports Cardiology and Hypertrophic Cardiomyopathy, Atlantic Health, Morristown Medical Center, Morristown, NJ, United States of America
| | - Carol Ewing Garber
- Department of Biobehavioral Sciences, Program in Applied Physiology, Teachers College, Columbia University, United States of America
| | - Matthew N Martinez
- Department of Pediatric Cardiology, NYU Grossman School of Medicine and Langone Medical Center, NYU Langone Health, New York, NY, United States of America
| | - Michael S Emery
- Vascular and Thoracic Institute, Section of Clinical Cardiology, Cleveland Clinic, Cleveland, OH, United States of America
| | - Aaron L Baggish
- Cardiovascular Performance Program, Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States of America
| | - Srihari S Naidu
- Department of Cardiology, Westchester Medical Centre and New York Medical College, Valhalla, NY, United States of America
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, United States of America
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, United States of America
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Shariful Islam M, Fardousi A, Sizear MI, Rabbani MG, Islam R, Saif-Ur-Rahman KM. Effect of leisure-time physical activity on blood pressure in people with hypertension: a systematic review and meta-analysis. Sci Rep 2023; 13:10639. [PMID: 37391436 PMCID: PMC10313796 DOI: 10.1038/s41598-023-37149-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 06/16/2023] [Indexed: 07/02/2023] Open
Abstract
High blood pressure is a major risk factor for premature death. Leisure-time physical activities have been recommended to control hypertension. Studies examining how leisure-time physical activity affects blood pressure have found mixed results. We aimed to conduct a systematic review examining the effect of leisure-time physical activity (LTPA) on lowering blood pressure among adults living with hypertension. We searched studies in Embase, Medline/PubMed, Web of Science, Physical Education Index, Scopus and CENTRAL (the Cochrane Library). The primary outcome variables were systolic blood pressure (SBP) and diastolic blood pressure (DBP). This systematic review is registered on PROSPERO (CRD42021260751). We included 17 studies out of 12,046 screened articles in this review. Moderate-intensity LTPA (all types) reduced SBP compared to the non-intervention control group (MD -5.35 mm Hg, 95% CI -8.06 to -2.65, nine trials, n = 531, low certainty of the evidence). Mean DBP was reduced by -4.76 mm Hg (95% CI -8.35 to -1.17, nine trials, n = 531, low certainty of the evidence) in all types of LTPA (moderate intensity) group compared to the non-intervention control group. Leisure-time walking reduced mean SBP by -8.36 mmHg, 95% CI -13.39 to -3.32, three trials, n = 128, low certainty of the evidence). Walking during leisure time reduced -5.03 mmHg mean DBP, 95% CI -8.23 to -1.84, three trials, n = 128, low certainty of the evidence). Performing physical activity during free time probably reduces SBP and DBP (low certainty of the evidence) among adults with hypertension.
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Affiliation(s)
| | - Ammatul Fardousi
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Monaemul Islam Sizear
- Health Systems for Tuberculosis, Dhaka, Bangladesh
- Public Health Foundation, Bangladesh, Dhaka, Bangladesh
| | - Md Golam Rabbani
- Health Economics Unit, Health Services Division, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | | | - K M Saif-Ur-Rahman
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh.
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de Oliveira Carpes L, Domingues LB, Fuchs SC, Ferrari R. Rate of Responders for Post-Exercise Hypotension after Beach Tennis, Aerobic, Resistance and Combined Exercise Sessions in Adults with Hypertension. Sports (Basel) 2023; 11:sports11030058. [PMID: 36976944 PMCID: PMC10058339 DOI: 10.3390/sports11030058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/24/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
Post-exercise hypotension (PEH) is typically reported as mean values, but a great inter-individual variation in blood pressure (BP) response after a single exercise session is expected, especially when comparing different modalities of exercise. The purpose was to evaluate the inter-individual BP responses after beach tennis, aerobic, resistance and combined exercise sessions in adults with hypertension. We conducted a post hoc analysis of pooled crossover randomized clinical trials from six previously published studies of our research group, and analyzed data from 154 participants with hypertension (≥35 years). BP was assessed using office BP, and the mean changes throughout the 60 min after recreational beach tennis (BT, n = 23), aerobic (AE, n = 18), combined (COMB, n = 18), and resistance (RES, n = 95) exercise sessions were compared to a non-exercising control session (C). To categorize the participants as responders and non-responders for PEH, the typical error (TE) was calculated as follows: TE = SDdifference/√2, where SDdifference is the standard deviation of the differences in BP measured before the interventions in the exercise and control sessions. Participants who presented PEH greater than TE were classified as responders. The TE was 7 and 6 mmHg for baseline systolic and diastolic BP, respectively. The rate of responders for systolic BP was as follows: BT: 87%; AE: 61%; COMB: 56%; and RES: 43%. For diastolic BP, the rate of responders was as follows: BT: 61%; AE: 28%; COMB: 44%; and RES: 40%. Results evidenced that there was a high inter-individual variation of BP after a single bout of different physical activity modalities in adults with hypertension, suggesting that exercise protocols with aerobic characteristics (i.e., BT, AE, and COMB sessions) presented PEH in most of its practitioners.
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Affiliation(s)
- Leandro de Oliveira Carpes
- Graduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-903, Brazil
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
| | - Lucas Betti Domingues
- Graduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-903, Brazil
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
| | - Sandra Costa Fuchs
- Graduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-903, Brazil
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
| | - Rodrigo Ferrari
- Graduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-903, Brazil
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
- Postgraduate Program in Human Movement Sciences, School of Physical Education, Universidade Federal do Rio Grande do Sul, Porto Alegre 90690-200, Brazil
- Correspondence:
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10
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Tan A, Thomas RL, Campbell MD, Prior SL, Bracken RM, Churm R. Effects of exercise training on metabolic syndrome risk factors in post-menopausal women - A systematic review and meta-analysis of randomised controlled trials. Clin Nutr 2023; 42:337-351. [PMID: 36736057 DOI: 10.1016/j.clnu.2023.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/11/2023]
Abstract
BACKGROUND & AIMS Alterations in the hormonal profiles as women transition to the menopause predisposes individuals to the metabolic syndrome (MetS). In post-menopausal women, this can be exacerbated by sedentary behaviour and physical inactivity. Physical activity can convey many health benefits including improvement in MetS risk factors. However, it remains to be elucidated how differing exercise intensities and its mode of delivery can ameliorate MetS risk factors and resultant progression amongst post-menopausal women. The purpose of this systematic review and meta-analysis was to investigate the effects and efficacy of exercise training on MetS risk factors in post-menopausal women. METHODS Database searches using PubMed, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials were conducted from inception to December 2021 for randomised controlled studies (RCTs) investigating exercise training (>8 weeks) in at least one of the MetS risk factors in post-menopausal women. Utilising the random-effects model, appropriate standardised mean differences (SMD) or mean differences (MD) with 95% confidence interval (CI) for each MetS risk factor were used to calculate the overall effect size between the exercise and control groups. Sub-group analyses were performed for exercise intensity, modality, and duration for each risk factor. Meta-regression was performed for categorical (health status) and continuous (body mass index) covariates. RESULTS 39 RCTs (40 studies) involving 2132 participants were identified as eligible. Overall, the meta-analysis shows that exercise training significantly improved all MetS risk factors: waist circumference (WC) [MD: -2.61 cm; 95% CI: -3.39 to -1.86 cm; p < 0.001; 21 studies]; triglycerides (TG) [SMD: -0.40 mmol/L; 95% CI: -0.71 to -0.09 mmol/L; p = 0.01; 25 studies]; high-density lipoprotein (HDL) [SMD: 0.84 mmol/L (95% CI: 0.41-1.27 mmol/L; p < 0.001; 26 studies]; fasting glucose (BG) [SMD: -0.38 mmol/L (95% CI: -0.60 to -0.16 mmol/L; p < 0.001; 20 studies]; systolic blood pressure (SBP) [MD: -5.95 mmHg (95% CI: -7.98 to -3.92 mmHg; p < 0.001; 23 studies]; and diastolic blood pressure (DBP) [MD: -4.14 mmHg (95% CI: -6.19 to -2.08 mmHg; p < 0.001; 23 studies]. Furthermore, sub-group analyses identified that moderate intensity and combined exercise training significantly improved MetS risk factors (p < 0.05) except for HDL, with combined exercise being the most effective. Long duration (≥12 weeks) training also significantly improved MetS risk factors except for TG. Meta-regression revealed no moderating effects on any MetS risk variables. CONCLUSION This study reinforces the importance of regular physical activity as a non-pharmacological tool in the reduction of MetS risk in post-menopausal women, with significant metabolic improvements seen in interventions spanning 8-10 weeks. Moderate intensity and combined training significantly benefitted abdominal obesity, dyslipidaemia, dysglycaemia and hypertension in post-menopausal women. Improvements in at least one MetS risk were also seen with other exercise modalities and intensities.
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Affiliation(s)
- Abbigail Tan
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, Faculty of Science and Engineering, Swansea University, Swansea, UK.
| | - Rebecca L Thomas
- Diabetes Research Group, Grove Building, Swansea University, Swansea, UK
| | - Matthew D Campbell
- School of Nursing and Health Sciences, Sciences Complex, University of Sunderland, Sunderland, UK; Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Sarah L Prior
- Diabetes Research Group, Grove Building, Swansea University, Swansea, UK
| | - Richard M Bracken
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - Rachel Churm
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, Faculty of Science and Engineering, Swansea University, Swansea, UK
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11
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Krzesiak A, Lavoie JL, Sebille S, Cognard C, Bosquet L, Delpech N. Post-exercise hypotension in male spontaneously hypertensive rats: The issue of calculation method. Physiol Rep 2023; 11:e15524. [PMID: 36807709 PMCID: PMC9937782 DOI: 10.14814/phy2.15524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/30/2022] [Accepted: 11/07/2022] [Indexed: 02/19/2023] Open
Abstract
In spontaneously hypertensive rats, exercise can lead to a post-exercise decrease in blood pressure, named post-exercise hypotension (PEH). This can be following physical training but also after a single bout of mild to moderate exercise when measured with tail-cuff or externalized catheter methods. Our aim was to assess the PEH obtained with different calculation methods and to compare the magnitude of this effect induced by a moderate-intensity continuous exercise or a high-intensity intermittent exercise. Thirteen 16-week-old male spontaneously hypertensive rats performed two types of aerobic exercise (continuous or intermittent) on a treadmill. Arterial pressure was recorded by telemetry for 24 h which was started 3 h before physical exercise. Based on the literature, PEH was first evaluated with two different baseline values, and then with three different approaches. We observed that the identification of PEH depended on the method used to measure the rest value, and that its amplitude was also influenced by the calculation approach and the type of exercise performed. Hence, the calculation method and the amplitude of the detected PEH can significantly influence their physiological and pathophysiological inferences.
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Affiliation(s)
- Amandine Krzesiak
- Laboratoire MObilité, Vieillissement et Exercice; EA 6314, Faculté des Sciences du SportPoitiersFrance
- Laboratoire Signalisation & Transports Ioniques MembranairesERL CNRS/Université de Poitiers no 7368PoitiersFrance
| | - Julie L. Lavoie
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM)MontréalCanada
- École de kinésiologie et des sciences de l'activité physiqueUniversité de MontréalMontréalCanada
| | - Stéphane Sebille
- Laboratoire Signalisation & Transports Ioniques MembranairesERL CNRS/Université de Poitiers no 7368PoitiersFrance
| | - Christian Cognard
- Laboratoire Signalisation & Transports Ioniques MembranairesERL CNRS/Université de Poitiers no 7368PoitiersFrance
| | - Laurent Bosquet
- Laboratoire MObilité, Vieillissement et Exercice; EA 6314, Faculté des Sciences du SportPoitiersFrance
- École de kinésiologie et des sciences de l'activité physiqueUniversité de MontréalMontréalCanada
| | - Nathalie Delpech
- Laboratoire MObilité, Vieillissement et Exercice; EA 6314, Faculté des Sciences du SportPoitiersFrance
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12
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Menezes JL, Aidar FJ, Badicu G, Cataldi S, Carvutto R, Silva AF, Clemente FM, Cerulli C, de Jesus JB, Vieira-Souza LM, Tranchita E, Brito CJ, Fischetti F, Greco G. Does Caffeine Supplementation Associated with Paralympic Powerlifting Training Interfere with Hemodynamic Indicators? BIOLOGY 2022; 11:biology11121843. [PMID: 36552351 PMCID: PMC9775763 DOI: 10.3390/biology11121843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/16/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
Exercise, including resistance exercise with high loads, has positive hemodynamic responses such as reduced systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), Pressure Product Rate (PPR), and estimated myocardial oxygen volume (MVO2). Caffeine (CA), used to improve performance, tends to interfere with BP and HR. This study aimed to analyze the effects of CA supplementation on hemodynamic indicators in Paralympic weightlifting (PP). The exercise was performed on 14 male athletes (32.4 ± 8.5 years; 81.7 ± 21.9 kg) for three weeks. Two conditions were evaluated: supplementation with CA Anhydrous 9 mg/kg and with placebo (PL). The adapted bench press was used, with 5 × 5 at 80% 1RM. We evaluated BP, HR, PPR, and MVO2, before, after, 5, 10, 20, 30, 40, 50, 60 min, and 24 h later. The CA presented higher absolute values in the pressure indicators than the PL, and after 24 h there was an inversion. The HR was higher in the CA and showed a reduction after 10 min. The PPR and MVO2 in the CA presented absolute values greater than the PL, and 24 h later there was an inversion. There was no hypotensive effect, but the use of CA did not present risks related to PPR and MVO2, demonstrating the safe use of this supplement in adapted strength sports.
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Affiliation(s)
- Jainara Lima Menezes
- Graduate Program of Physiological Science, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports (GEPEPS), Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
| | - Felipe J. Aidar
- Graduate Program of Physiological Science, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports (GEPEPS), Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
- Graduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
| | - Georgian Badicu
- Department of Physical Education and Special Motricity, Faculty of Physical Education and Mountain Sports, Transilvania University of Braşov, 500068 Braşov, Romania
| | - Stefania Cataldi
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Study of Bari, 70124 Bari, Italy
- Correspondence:
| | - Roberto Carvutto
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Study of Bari, 70124 Bari, Italy
| | - Ana Filipa Silva
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun’Álvares, 4900-347 Viana do Castelo, Portugal
- Research Center in Sports Performance, Recreation, Innovation and Technology (SPRINT), 4960-320 Melgaço, Portugal
- Research Centre in Sport Sciences, Health Sciences and Human Development, Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
| | - Filipe Manuel Clemente
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun’Álvares, 4900-347 Viana do Castelo, Portugal
- Research Center in Sports Performance, Recreation, Innovation and Technology (SPRINT), 4960-320 Melgaço, Portugal
- Instituto de Telecomunicações, Delegação da Covilhã, 1049-001 Lisboa, Portugal
| | - Claudia Cerulli
- Laboratory of Physical Exercise and Sport Science, Department of Exercise, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy
| | - Joseane Barbosa de Jesus
- Graduate Program of Physiological Science, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
- Graduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
| | - Lucio Marques Vieira-Souza
- Graduate Program of Physiological Science, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
- Physical Education Course, State University of Minas Gerais, Passos 37900-106, Brazil
| | - Eliana Tranchita
- Laboratory of Physical Exercise and Sport Science, Department of Exercise, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy
| | - Ciro José Brito
- Department of Physical Education, Federal University of Juiz de Fora, Governador Valadares 35010-180, Brazil
| | - Francesco Fischetti
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Study of Bari, 70124 Bari, Italy
| | - Gianpiero Greco
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Study of Bari, 70124 Bari, Italy
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13
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Carpes LO, Domingues LB, Bertoletti O, Fuchs SC, Ferrari R. Inter-individual responses of post-exercise hypotension in older adults with hypertension: An exploratory analysis of different exercise modalities. Front Physiol 2022; 13:1050609. [PMID: 36505064 PMCID: PMC9727289 DOI: 10.3389/fphys.2022.1050609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/09/2022] [Indexed: 11/24/2022] Open
Abstract
Background: Various physical exercise modalities can acutely reduce blood pressure (BP). However, not all individuals respond similarly after an exercise session. Purpose: To measure inter-individual variations in 24-h BP after a single bout of various exercise modalities in older adults with hypertension. Methods: This retrospective study analyzed data from participants with hypertension (≥60 years) previously included in three randomized controlled trials on this topic. BP was assessed using ambulatory BP monitoring. We compared the mean changes in total 24-h, daytime, and nighttime BP after aerobic (AE, n = 19), combined (COMB, n = 19), resistance (RES, n = 23), and isometric handgrip (ISO, n = 18) exercise sessions to a non-exercising control session (C). The minimum detectable changes to classify the participant as a "Responder" for the corresponding exercise protocol were 4 and 2 mmHg for systolic and diastolic BP, respectively. Results: The prevalence of Responders for systolic BP was as follows: AE 24-h: 37%, daytime: 47% and nighttime: 37%; COMB 24-h: 26%, daytime: 21% and nighttime: 32%; RES 24-h: 26%, daytime: 26% and nighttime: 35%; and ISO 24-h: 22%, daytime: 22% and nighttime: 39%. For diastolic BP, the prevalence of Responders was as follows: AE 24-h: 53%, daytime: 53% and nighttime: 31%; COMB 24-h: 26%, daytime: 26% and nighttime: 31%; RES 24-h: 35%, daytime: 22% and nighttime: 52%; and ISO 24-h: 44%, daytime: 33% and nighttime: 33%. Conclusion: There was a high inter-individual variation of BP after a single bout of various exercises in older adults. Responders had higher BP values on the control day without exercise. Various exercise modalities might acutely reduce 24-h BP in older adults with hypertension.
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Affiliation(s)
- Leandro O. Carpes
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil,Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Lucas B. Domingues
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil,Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Otávio Bertoletti
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sandra C. Fuchs
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil,Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil,Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Rodrigo Ferrari
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil,Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil,*Correspondence: Rodrigo Ferrari,
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14
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David GB, Schaun GZ, Mendes AR, Nunes GN, Bocalini DS, Pinto SS, Alberton CL. Short-Term Effects of Land-Based Versus Water-Based Resistance Training Protocols on Post-Exercise Hypotension in Normotensive Men: A Crossover Study. Sports (Basel) 2022; 10:sports10110181. [PMID: 36422950 PMCID: PMC9698456 DOI: 10.3390/sports10110181] [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: 10/20/2022] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022] Open
Abstract
Considering that water immersion may acutely reduce blood pressure (BP) and that exercise may elicit positive post-exercise hypotension (PEH) responses, we aimed to analyze the presence of PEH in normotensive individuals and compare its magnitude between two resistance training sessions performed in aquatic or land environments. Ten physically active men (23.2 ± 3.1 years) performed the two training protocols in a randomized, counterbalanced fashion. BP measurements were performed for 30 min (at 5 min intervals) both prior to (resting) and after each of the protocols. No differences were observed between protocols at baseline (p > 0.05). Only the water-based resistance training protocol resulted in a systolic BP reduction from 10 to 20 min post-exercise (all p < 0.05) compared to baseline. Compared to the land-based session, systolic BP was lower in the water-based protocol from 10 to 25 min post-exercise (all p < 0.05). On the other hand, diastolic BP showed a similar PEH effect between water and land-based protocols for the entire 30 min post-session period (all p < 0.001). Our results suggest that water-based resistance training holds the potential as a nonpharmacological strategy to lower BP levels following exercise.
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Affiliation(s)
- Gabriela Barreto David
- Department of Sports, Physical Education School, Federal University of Pelotas, Pelotas 96055-630, Brazil
| | - Gustavo Zaccaria Schaun
- Department of Sports, Physical Education School, Federal University of Pelotas, Pelotas 96055-630, Brazil
- Centre for Sport Science and University Sports, University of Vienna, 1150 Vienna, Austria
| | - Amanda Ricardo Mendes
- Department of Sports, Physical Education School, Federal University of Pelotas, Pelotas 96055-630, Brazil
| | - Gabriela Neves Nunes
- Department of Sports, Physical Education School, Federal University of Pelotas, Pelotas 96055-630, Brazil
| | - Danilo Sales Bocalini
- Physiology and Biochemistry Laboratory, Physical Education and Sport Center, Federal University of Espírito Santo, Vitoria 29075-810, Brazil
| | - Stephanie Santana Pinto
- Department of Sports, Physical Education School, Federal University of Pelotas, Pelotas 96055-630, Brazil
| | - Cristine Lima Alberton
- Department of Sports, Physical Education School, Federal University of Pelotas, Pelotas 96055-630, Brazil
- Correspondence:
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15
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Gargallo P, Casaña J, Suso-Martí L, Cuenca-Martínez F, López-Bueno R, Andersen LL, López-Bueno L, Cuerda-del Pino A, Calatayud J. Minimal Dose of Resistance Exercise Required to Induce Immediate Hypotension Effect in Older Adults with Hypertension: Randomized Cross-Over Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14218. [PMID: 36361100 PMCID: PMC9658099 DOI: 10.3390/ijerph192114218] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
To determine the optimal exercise volume to generate a hypotension response after the execution of a single strength exercise in elderly subjects with hypertension (HT), a randomized crossover design was performed. A total of 19 elderly subjects with HT performed one control session and three experimental sessions of resistance training with different volumes in a randomized order: three, six, and nine sets of 20 repetitions maximum (RM) of a single elbow flexion exercise with elastic bands. The systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean heart rate (MHR) were tested at the beginning and immediately afterwards, at 30 and 60 min, and at 4, 5, and 6 h after the resistance exercise. The results show that the volumes of six and nine sets of 20 RM obtained statistically significant differences in the SBP at 30 and 60 min post-exercise (p < 0.05); in the DBP at 30 min after exercise (p < 0.05); and in the MHR immediately after exercise at 30 and 60 min (p < 0.05), compared to a control session. A single resistance exercise with a minimum volume of six sets of 20 RM generated an acute post-exercise antihypertensive response that was maintained for 60 min in elderly people with controlled HT.
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Affiliation(s)
- Pedro Gargallo
- Department of Physiotherapy, Faculty of Medicine and Health Science, Catholic University of Valencia, 46001 Valencia, Spain
| | - José Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46001 Valencia, Spain
| | - Luis Suso-Martí
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46001 Valencia, Spain
| | - Ferran Cuenca-Martínez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46001 Valencia, Spain
| | - Rubén López-Bueno
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46001 Valencia, Spain
- Department of Physical Medicine and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark
- Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
| | - Laura López-Bueno
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46001 Valencia, Spain
| | | | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46001 Valencia, Spain
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark
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16
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Wattanapisit A, Ng CJ, Angkurawaranon C, Wattanapisit S, Chaovalit S, Stoutenberg M. Summary and application of the WHO 2020 physical activity guidelines for patients with essential hypertension in primary care. Heliyon 2022; 8:e11259. [PMID: 36325139 PMCID: PMC9618974 DOI: 10.1016/j.heliyon.2022.e11259] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/15/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
Abstract
The new World Health Organization (WHO) 2020 guidelines on physical activity (PA) and sedentary behavior include recommendations for adults with chronic conditions. The guidelines provide adaptable and general recommendations for people living with chronic medical conditions. This article summarizes the content and provides suggestions for the application of the guidelines for patients with essential hypertension in primary care. The WHO 2020 PA guidelines recommend broad advice for adults and older adults with chronic conditions. The key recommendations are consistent with other hypertension guidelines. A systemic approach to promote PA in primary care (i.e., PA assessment, safety considerations, PA prescription, behavioral counseling, and referral) along with applying the WHO guidelines is required. Health risk assessment and safety issues related to hypertension (e.g., current PA levels, level of blood pressure, treatment plans, comorbidities) should be concerned. The FITT Pro (frequency, intensity, time, type, and progression) can be adopted as a framework to break down the guidelines into specific PA prescription. The WHO 2020 PA guidelines address the importance of PA in clinical populations. The guidelines can be adapted for patients with hypertension in primary care settings.
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Affiliation(s)
- Apichai Wattanapisit
- Department of Clinical Medicine, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand,Family Medicine Clinic, Walailak University Hospital, Nakhon Si Thammarat, Thailand
| | - Chirk Jenn Ng
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia,SingHealth Polyclinics, Singapore, Singapore,Duke-NUS Medical School, Singapore, Singapore
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand,Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand,Corresponding author.
| | | | - Sirawee Chaovalit
- Department of Physical Therapy, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Mark Stoutenberg
- Department of Kinesiology, College of Public Health, Temple University, Philadelphia, USA
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17
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Ramis TR, Boeno FP, Leal-Menezes R, Munhoz SV, Farinha JB, Ribeiro JL, Reischak-Oliveira A. Effects of exercise modalities on decreased blood pressure in patients with hypertension. Front Physiol 2022; 13:993258. [PMID: 36311227 PMCID: PMC9614347 DOI: 10.3389/fphys.2022.993258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/26/2022] [Indexed: 11/23/2022] Open
Abstract
This study aimed to evaluate the acute effects of aerobic and resistance exercises on blood pressure and endothelial blood markers. We also correlated post-exercise blood pressure response with baseline cardiovascular parameters in middle-aged patients with hypertension. This cross-sectional study randomized 54 volunteers into the aerobic exercise group (AG, n = 27; 45.6 ± 7.7 years) or dynamic resistance exercise group (RG, n = 27; 45.8 ± 8.4 years). Blood marker evaluation, cardiopulmonary exercise tests, resting blood pressure monitoring, ambulatory blood pressure monitoring (ABPM), flow-mediated dilatation monitoring, and body composition evaluation were carried out. Exercise sessions were performed to evaluate post-exercise hypotension (PEH) and endothelial marker responses, in addition to post-exercise ABPM (ABPMex). This study is an arm of the study which was approved by the local ethics committee (No. 69373217.3.0000.5347) in accordance with the Helsinki Declaration and was registered at ClinicalTrials.gov (NCT03282942). The AG performed walking/running at 60% of the reserve heart rate, while the RG performed 10 exercises with two sets of 15-20 repetitions. The mean 24 h ABPM and ABPMex values showed no significant statistical differences. Systolic and diastolic blood pressure hypotension after aerobic and dynamic resistance were -10.59 ± 5.24/-6.15 ± 6.41 mmHg and -5.56 ± 7.61/-6.20 ± 8.25 mmHg, respectively. For an up-to-7 h assessment of resting pressure, there was a positive effect in the aerobic group. The concentrations of nitrites/nitrates (NOx) and endothelin-1 (ET-1) did not change during hypotension. Moreover, PEH and ABPMex were significantly correlated with baseline health variables. Thus, when middle-aged patients with hypertension perform aerobic or resistance exercise, the NOx/ET-1 pathway does not provide the best explanation for PEH. Finally, we found associations between baseline cardiovascular variables and endothelial vasoconstrictors with PEH.
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Affiliation(s)
- Thiago Rozales Ramis
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Franccesco Pinto Boeno
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Rodrigo Leal-Menezes
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Samuel Vargas Munhoz
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliano Boufleur Farinha
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Jerri Luiz Ribeiro
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Alvaro Reischak-Oliveira
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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18
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COVID-19, cardiac involvement and cardiac rehabilitation: Insights from a rehabilitation perspective - State of the Art. Turk J Phys Med Rehabil 2022; 68:317-335. [DOI: 10.5606/tftrd.2022.11435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/04/2022] [Indexed: 11/25/2022] Open
Abstract
Since the beginning of the pandemic, many novel coronavirus disease 2019 (COVID-19) patients have experienced multisystem involvement or become critically ill and treated in intensive care units, and even died. Among these systemic effects, cardiac involvement may have very important consequences for the patient’s prognosis and later life. Patients with COVID-19 may develop cardiac complications such as heart failure, myocarditis, pericarditis, vasculitis, acute coronary syndrome, and cardiac arrhythmias or trigger an accompanying cardiac disease. The ratio of COVID-19 cardiac involvement ranges between 7 and 28% in hospitalized patients with worse outcomes, longer stay in the intensive care unit, and a higher risk of death. Furthermore, deconditioning due to immobility and muscle involvement can be seen in post-COVID-19 patients and significant physical, cognitive and psychosocial impairments may be observed in some cases. Considering that the definition of health is “a state of complete physical, mental and social well-being”, individuals with heart involvement due to COVID-19 should be rehabilitated by evaluating all these aspects of the disease effect. In the light of the rehabilitation perspective and given the increasing number of patients with cardiac manifestations of COVID-19, in this review, we discuss the rehabilitation principles in this group of patients.
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Corso M, Miarka B, Figueiredo T, Bragazzi N, Carvalho D, Dias I. Effects of aerobic, strength, and combined training during pregnancy in the blood pressure: A systematic review and meta-analysis. Front Physiol 2022; 13:916724. [PMID: 36111150 PMCID: PMC9468920 DOI: 10.3389/fphys.2022.916724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 08/01/2022] [Indexed: 11/16/2022] Open
Abstract
Gestational hypertension can lead to fetal complications, and, if untreated, high blood pressure during pregnancy may cause eclampsia and even death in the mother and fetus. Exercise is a strategy for preventing blood pressure disorders. There is little knowledge about the physiological impacts of different physical types of training on blood pressure during pregnancy. For that, this meta-analysis aimed to compare the effects of different physical exercise modalities (i.e., aerobic training-AT, strength training-ST, and combined training-AT + ST) on systolic blood pressure (SBP) and diastolic blood pressure (DBP) of pregnant women. A search was performed on PUBMED, LILACS, CINAHL, Sport discus, EMBASE, SCOPUS, and Cochrane Central Register of Controlled Trials to identify researchers. From 3,450 studies, 20 and 19 were included in the qualitative and quantitative analyses. AT studies presented a medium effect size (ES) on SBP [-0.29 (-2.95 to 2.36) p = 0.83], with substantial heterogeneity (I2 = 64%), and had a large impact on DBP [-1.34 (-2.98 to 0.30) p = 0.11], with moderate heterogeneity (I2 = 30%). ST researchers showed a large ES on SBP [-1.09 (-3.66 to 1.49) p = 0.41], with a reduced heterogeneity (I2 = 0%), and a medium ES on DBP [-0.26 (-2.77 to 2.19) p = 0.83] with moderate heterogeneity (I2 = 38%). AT + ST studies had a large ES on SBP [-1.69 (-3.88 to 0.49) p = 0.13] and DBP [-01.29 (-2.26 to 0.31) p = 0.01] with considerable (I2 = 83%) and moderate heterogeneity (I2 = 47%), respectively. These findings are essential for developing new research protocols to avoid gestational hypertension and preeclampsia. AT + ST had a large impact on the SBP and DBP reduction; however, there is a need for more similar procedures to reduce heterogeneity between studies, promoting consensual results. Systematic Review Registration: [PROSPERO], identifier [CRD42021256509].
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Affiliation(s)
- Marcelo Corso
- Physical Education Postgraduate Program, School of Physical Education and Sports, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bianca Miarka
- Physical Education Postgraduate Program, School of Physical Education and Sports, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tiago Figueiredo
- Physical Education Program, Estácio de Sá University, Rio de Janeiro, Brazil
| | - Nicola Bragazzi
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Danilo Carvalho
- Physical Education Postgraduate Program, School of Physical Education and Sports, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ingrid Dias
- Physical Education Postgraduate Program, School of Physical Education and Sports, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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20
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Carmichael KE, O’Connor PJ, Gay JL. Stair walking effects on feelings of energy and fatigue: Is 4-min enough for benefits? Front Psychol 2022; 13:895446. [PMID: 36059746 PMCID: PMC9434211 DOI: 10.3389/fpsyg.2022.895446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/29/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose Even low intensity exercise bouts of at least 15 min can improve feelings of energy (FOE) and reduce systolic blood pressure. However, little is known about the psychological outcomes of briefer exercise bouts, particularly for modes of exercise that are more intense than level walking, and readily available to many working adults. This study assessed the effects of a 4-min bout of stair walking on FOE and feelings of fatigue (FOF). Methods Thirty-six young adult participants were randomized to either stair walking or seated control groups. All participants walked on level-ground from a laboratory to a nearby stairwell (~90 s) and were seated for 4 min before beginning their experimental condition. Stair-walking participants walked up and down one flight of 16 stairs at their own pace for 4 min, while control participants remained seated during that time. Participants walked back to the laboratory for post-condition assessments. Measures of blood pressure, heart rate, rated perceived exertion (RPE), and the intensity of feelings of mental energy, mental fatigue, physical energy, and physical fatigue were assessed pre-and post-condition. Separate one-way ANOVAs were conducted on change scores for all variables. Results The stair climbing group experienced significant increases in heart rate [F(1,34) = 13.167, p < 0.001] and RPE [F(1,34) = 93.844, p < 0.001] that were not observed in the seated control group. Four minutes of self-paced stair climbing resulted in small changes and non-significant differences within and between groups in blood pressure as well as FOE and FOF. Conclusion Although a 4-min self-paced exercise bout can convey short-term physiological health benefits, a 4-min bout of self-paced indoor stair walking in a stairwell was insufficient to lower blood pressure or change subjective FOE and fatigue in a sample that exhibited better than typical FOE and FOF at the pre-test.
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Affiliation(s)
| | - Patrick J. O’Connor
- Department of Health Promotion and Behavior, University of Georgia, Athens, GA, United States
| | - Jennifer L. Gay
- Department of Health Promotion and Behavior, University of Georgia, Athens, GA, United States
- *Correspondence: Jennifer L. Gay,
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21
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Corso M, de Figueiredo TC, Carvalho D, Brown AF, de Salles BF, Simão R, Willardson JM, Dias I. Effects of Strength Training on Blood Pressure and Heart Rate Variability—A Systematic Review. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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22
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Casonatto J, Cavalari JV. A Single Dosage of l-Arginine Oral Supplementation Induced Post-Aerobic Exercise Hypotension in Hypertensive Patients. J Diet Suppl 2022; 20:735-748. [PMID: 35903950 DOI: 10.1080/19390211.2022.2106006] [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] [Indexed: 10/16/2022]
Abstract
Lowering of peripheral vascular resistance is one of the primary processes involved in blood pressure decrease. Nitric oxide plays a significant role in this process and the availability of l-arginine is a crucial element in nitric oxide biosynthesis. Oral l-arginine supplementation may therefore be a potentiating element in post-exercise hypotension, mediated by its vasodilator action. Thus, the purpose of this study was to investigate if a single dose of l-arginine oral supplementation might impact the post-aerobic exercise blood pressure responses in treated hypertensive individuals. A double-blind, randomized, placebo-controlled crossover trial was conducted. The sample included male (4) and female (6) subjects [62 ± 10 years]. The participants were randomized to ingest one sachet containing 8 grams of l-arginine or placebo (corn starch) dissolved in water (100 ml). The substances were self-administered 120 min before the experimental or control session. The exercise was conducted on a treadmill and consisted of: a 5 min warm-up (50-65% HRreserve); 40 min of running/walking at 60-70% HRreserve; and a 5 min progressive cooldown. After the exercise sessions, blood pressure was measured every 10 min for 60 min. The l-arginine supplementation arm led to significant post-exercise systolic hypotension (mean post-exercise) in relation to rest period (117 ± 12 vs 125 ± 15 mmHg - p = 0.004 [l-arginine] and 121 ± 11 vs 125 ± 15 - p = 0.341 [placebo]). In addition, a systolic net effect of -6.9 ± 3.6 mmHg [p = 0.046] was identified for the mean post-exercise values. Therefore, this study showed that a single dosage of l-arginine oral supplementation induced post-aerobic exercise hypotension in hypertensive patients.
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Affiliation(s)
- Juliano Casonatto
- Research Group in Physiology and Physical Activity, University of Northern Paraná, Londrina, Brazil
| | - João Vagner Cavalari
- Research Group in Physiology and Physical Activity, University of Northern Paraná, Londrina, Brazil
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Denche-Zamorano Á, Pérez-Gómez J, Mendoza-Muñoz M, Carlos-Vivas J, Oliveira R, Brito JP. Risk of Hypertension and Use of Antihypertensive Drugs in the Physically Active Population under-70 Years Old—Spanish Health Survey. Healthcare (Basel) 2022; 10:healthcare10071283. [PMID: 35885810 PMCID: PMC9319692 DOI: 10.3390/healthcare10071283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 06/28/2022] [Accepted: 07/07/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction: Reducing the prevalence of hypertension is a major priority of the World Health Organization (WHO). Its high prevalence and associated risks generate high economic and social costs. Physical activity (PA) is associated with a decrease in hypertension and in the use of antihypertensive drugs. Objective: To explore the association between PA levels (PAL), prevalence of hypertension and the use of antihypertensive drugs in Spanish population. To calculate risks of hypertension and use of antihypertensive in the inactive versus physically active population. Method: This cross-sectional study used data from 17717 individuals, sampled in the 2017 National Health Survey. Interaction by sex, age groups, body mass index (BMI), hypertension prevalence, antihypertensive drugs use and PAL, using a pairwise z-test, and dependence relationships between variables, were studied using a chi square test. Odds ratios of hypertension and antihypertensive drug use were calculated among the inactive and the physically active populations. Results: The findings showed a significant inverse association between prevalence of hypertension, antihypertensive use, and PAL in both sexes and different age and BMI groups, with lower prevalence of hypertension and antihypertensive use when PAL were higher. The risks of hypertension and antihypertensive use seems to be reduced when related to higher PAL compared to inactive people. Conclusions: High PAL is associated with lower prevalence of hypertension and lower antihypertensive use. Thus, being physically active or very active may reduce the risks of suffering from hypertension and the need to use antihypertensives compared to inactive people or walkers.
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Affiliation(s)
- Ángel Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Jorge Pérez-Gómez
- Health Economy Motricity and Education (HEME) Research Group, Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain
| | - Maria Mendoza-Muñoz
- Research Group on Physical and Health Literacy and Health-Related Quality of Life (PHYQOL), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal
| | - Jorge Carlos-Vivas
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Rafael Oliveira
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development, Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
- Life Quality Research Centre, 2040-403 Rio Maior, Portugal
| | - João Paulo Brito
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development, Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
- Life Quality Research Centre, 2040-403 Rio Maior, Portugal
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24
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Gonzalez JE, Cooke WH. The Influence of an Acute Fast on Ambulatory Blood Pressure and Autonomic Cardiovascular Control. Am J Physiol Regul Integr Comp Physiol 2022; 322:R542-R550. [PMID: 35380473 PMCID: PMC9512108 DOI: 10.1152/ajpregu.00283.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Evidence suggests that intermittent fasting improves cardiovascular health by reducing arterial blood pressure, but contributing mechanisms are unclear. The purpose of this study was to determine the influence of an acute fast on hemodynamics, muscle sympathetic nerve activity (MSNA), and autonomic control at rest and during an arterial pressure challenge. Twenty-five young normotensive volunteers were tested twice, in the fed and fasted (24 h) states (randomized). Twenty-four hour ambulatory blood pressure was measured before an autonomic function test, which consisted of a 10-min period of controlled breathing (CB) at 0.25 Hz followed by 3, 15-s Valsalva maneuvers (VMs). We recorded the ECG, beat-to-beat arterial pressure, and MSNA throughout the autonomic test. Vagal-cardiac modulation via heart rate variability (HRV) was assessed in both time and frequency domains, cardiovagal baroreflex sensitivity (cvBRS) was assessed with linear regression, and stroke volume was estimated from pulse contour. All fed versus fasted comparisons presented are different at P < 0.05. Fasting reduced ambulatory mean arterial pressure (81 ± 1 vs. 78 ± 1 mmHg) and heart rate (69 ± 2 vs. 65 ± 2 beats/min). CB revealed enhanced HRV through increased R-R intervals (992 ± 30 vs. 1,059 ± 37 ms) and normalized high frequency (HFnu) R-R interval spectral power (55 ± 3 vs. 62 ± 3%). Estimated stroke volume was higher after fasting (by 13%) as was cvBRS (20 ± 2 vs. 26 ± 5 ms/mmHg) and cvBRS during phase IV of the VM (9 ± 1 vs. 12 ± 1 ms/mmHg). MSNA (n = 12) did not change (16 ± 11 vs. 15 ± 8 bursts/min; P = 0.18). Our results show that acute fasting is consistent with improved cardiovascular health: such improvements are driven by reduced ambulatory arterial pressure and enhanced vagal-cardiac modulation.
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Affiliation(s)
- Joshua Eric Gonzalez
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, United States
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
| | - William Harold Cooke
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
- Health Research Institute, Michigan Technological University, Houghton MI, United States
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25
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Lavin KM, Coen PM, Baptista LC, Bell MB, Drummer D, Harper SA, Lixandrão ME, McAdam JS, O’Bryan SM, Ramos S, Roberts LM, Vega RB, Goodpaster BH, Bamman MM, Buford TW. State of Knowledge on Molecular Adaptations to Exercise in Humans: Historical Perspectives and Future Directions. Compr Physiol 2022; 12:3193-3279. [PMID: 35578962 PMCID: PMC9186317 DOI: 10.1002/cphy.c200033] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
For centuries, regular exercise has been acknowledged as a potent stimulus to promote, maintain, and restore healthy functioning of nearly every physiological system of the human body. With advancing understanding of the complexity of human physiology, continually evolving methodological possibilities, and an increasingly dire public health situation, the study of exercise as a preventative or therapeutic treatment has never been more interdisciplinary, or more impactful. During the early stages of the NIH Common Fund Molecular Transducers of Physical Activity Consortium (MoTrPAC) Initiative, the field is well-positioned to build substantially upon the existing understanding of the mechanisms underlying benefits associated with exercise. Thus, we present a comprehensive body of the knowledge detailing the current literature basis surrounding the molecular adaptations to exercise in humans to provide a view of the state of the field at this critical juncture, as well as a resource for scientists bringing external expertise to the field of exercise physiology. In reviewing current literature related to molecular and cellular processes underlying exercise-induced benefits and adaptations, we also draw attention to existing knowledge gaps warranting continued research effort. © 2021 American Physiological Society. Compr Physiol 12:3193-3279, 2022.
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Affiliation(s)
- Kaleen M. Lavin
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Center for Human Health, Resilience, and Performance, Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Paul M. Coen
- Translational Research Institute for Metabolism and Diabetes, Advent Health, Orlando, Florida, USA
- Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida, USA
| | - Liliana C. Baptista
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Margaret B. Bell
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Devin Drummer
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sara A. Harper
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Manoel E. Lixandrão
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jeremy S. McAdam
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Samia M. O’Bryan
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sofhia Ramos
- Translational Research Institute for Metabolism and Diabetes, Advent Health, Orlando, Florida, USA
- Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida, USA
| | - Lisa M. Roberts
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Rick B. Vega
- Translational Research Institute for Metabolism and Diabetes, Advent Health, Orlando, Florida, USA
- Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida, USA
| | - Bret H. Goodpaster
- Translational Research Institute for Metabolism and Diabetes, Advent Health, Orlando, Florida, USA
- Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida, USA
| | - Marcas M. Bamman
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Center for Human Health, Resilience, and Performance, Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Thomas W. Buford
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, The University of Alabama at Birmingham, Birmingham, Alabama, USA
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26
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Aidar FJ, Dantas EF, Almeida-Neto PF, Neto FR, Garrido ND, Cabral BG, Figueiredo T, Reis VM. Can Post-Exercise Hemodynamic Response Be Influenced by Different Recovery Methods in Paraplegic Sportsmen? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031772. [PMID: 35162794 PMCID: PMC8834798 DOI: 10.3390/ijerph19031772] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 11/27/2022]
Abstract
Post-exercise hypotension is of great clinical relevance and also in sports training settings, as recovery speed is important. The aim of this study was to compare the influence of different recovery methods on post-exercise hemodynamic response. Twelve male paraplegic sportsmen (25.40 ± 3.30 years) performed a strength training (ST) session using the bench press exercise. After the ST, three recovery methods were randomly performed over a 15-min period: passive recovery (PR), cold-water (CW) and dry needle (DN). Blood pressure (BP), heart rate (HR) and myocardial oxygen were measured before and post ST, as well as post the recovery method. Results: Dry needling induced lower systolic blood pressure (SBP) immediately after the treatment when compared with the other recovery methods, but the contrary was observed at 50 and 60-min post recovery, where records with DN exhibit higher mean values (η2p = 0.330). There were no differences in post-exercise diastolic BP and mean BP between recovery methods. There was a significantly higher HR after the PR method, when compared with CW and with DN (η2p = 0.426). The same was observed for double product and for myocardial oxygen, though with a larger effect size (η2p = 0.446). We conclude that dry needling seems to induce a faster SBP lowering immediately after the procedure but at 50-min post procedure the cold-water method showed better result. As for HR, both procedures (DN and CW) showed a better recovery when compared with passive recovery, along the several moments of measurement.
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Affiliation(s)
- Felipe J. Aidar
- Department of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil; (F.J.A.); (E.F.D.)
| | - Edilson F. Dantas
- Department of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil; (F.J.A.); (E.F.D.)
| | - Paulo F. Almeida-Neto
- Department of Physical Education, Health Sciences Center, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil; (P.F.A.-N.); (B.G.C.)
| | - Frederico R. Neto
- Paralympic Sports Program, SARAH Rehabilitation Hospital Network, Brasilia 71535-005, Brazil;
| | - Nuno D. Garrido
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Trás os Montes and Alto Douro University, 5001-801 Vila Real, Portugal;
| | - Breno G. Cabral
- Department of Physical Education, Health Sciences Center, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil; (P.F.A.-N.); (B.G.C.)
| | - Tiago Figueiredo
- Exercise Physiology Laboratory, Estacio de Sá University, Rio de Janeiro 22790-710, Brazil;
| | - Victor M. Reis
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Trás os Montes and Alto Douro University, 5001-801 Vila Real, Portugal;
- Correspondence: ; Tel.: +351-927542814
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27
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Swift HT, O'Driscoll JM, Coleman DD, Caux AD, Wiles JD. Acute cardiac autonomic and haemodynamic responses to leg and arm isometric exercise. Eur J Appl Physiol 2022; 122:975-985. [PMID: 35089384 DOI: 10.1007/s00421-022-04894-7] [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: 09/09/2021] [Accepted: 01/13/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Acute cardiovascular responses following a single session of isometric exercise (IE) have been shown to predict chronic adaptations in blood pressure (BP) regulation. It was hypothesised that exercises which recruit more muscle mass induce greater reductions in BP compared to exercises using smaller muscle mass. To test this hypothesis, the current study aimed to compare the acute haemodynamic and autonomic responses to a single session of isometric wall squat (IWS) and isometric handgrip (IHG) training. METHODS Twenty-six sedentary participants performed a single IWS and IHG session in a randomised cross-over design, with training composed of 4 × 2-min contractions, with 2-min rest, at 95 HRpeak and 30% MVC respectively. Haemodynamic and cardiac autonomic variables were recorded pre, during, immediately post, and 1-h post-exercise, with the change from baseline for each variable used for comparative analysis. RESULTS During IWS exercise, there was a significantly greater increase in systolic BP (P < 0.001), diastolic BP (P < 0.001), mean BP (P < 0.001), heart rate (P < 0.001), and cardiac output (P < 0.001), and a contrasting decrease in baroreflex effectiveness index (BEI) and cardiac baroreceptor sensitivity (cBRS). In the 10-min recovery period following IWS exercise, there was a significantly greater reduction in systolic BP (P = 0.005), diastolic BP (P = 0.006), mean BP (P = 0.003), total peripheral resistance (TPR) (P < 0.001), BEI (P = 0.003), and power spectral density (PSD-RRI) (P < 0.001). There were no differences in any variables between conditions 1-h post exercise. CONCLUSIONS Isometric wall squat exercise involving larger muscle mass is associated with a significantly greater post-exercise hypotensive response during a 10-min recovery window compared to smaller muscle mass IHG exercise. The significantly greater reduction in TPR may be an important mechanism for the differences in BP response.
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Affiliation(s)
- Harry T Swift
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK
| | - Jamie M O'Driscoll
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK
| | - Damian D Coleman
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK
| | - Anthony De Caux
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK
| | - Jonathan D Wiles
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK.
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Kircher E, Ketelhut S, Ketelhut K, Röglin L, Hottenrott K, Martin-Niedecken AL, Ketelhut RG. A Game-Based Approach to Lower Blood Pressure? Comparing Acute Hemodynamic Responses to Endurance Exercise and Exergaming: A Randomized Crossover Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031349. [PMID: 35162372 PMCID: PMC8834849 DOI: 10.3390/ijerph19031349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 01/27/2023]
Abstract
The present randomized crossover study aimed to determine whether an exergaming session in an innovative, functional fitness game could be an effective exercise approach that elicits favorable blood pressure (BP) responses, such as a typical moderate endurance exercise (ET). Therefore, acute hemodynamic responses after a training session in the ExerCube and an ET on a treadmill were assessed and compared. Twenty-eight healthy recreational active participants (13 women; aged 24.8 ± 3.9 years) completed an exergaming session (EX) and an ET in a randomized and counterbalanced order. Before and throughout the 45 min after the training, the peripheral and central BP were measured. After the ET, there was a moderate decrease in both peripheral systolic (-1.8 mmHg; p = 0.14) and diastolic (-0.8 mmHg; p = 0.003), as well as central diastolic (-1.5 mmHg; p = 0.006) pressure compared to the resting value before the exercise. After the EX, there was a significant decrease in peripheral systolic (-6.3 mmHg; p < 0.001) and diastolic (-4.8 mmHg; p < 0.001), as well as central systolic (-5.8 mmHg; p < 0.001) and diastolic (-5.3 mmHg; p < 0.001) pressure compared to baseline. The interaction effects showed significant differences in peripheral and central systolic BP as well as in peripheral diastolic BP (p = 0.05). The EX seems to be an effective training approach that triggers relevant peripheral and central BP-responses, which are more pronounced than after a typical ET. Therefore, the ExerCube can be a time-efficient training tool to improve cardiovascular health.
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Affiliation(s)
- Eva Kircher
- Department of Medical Sciences, Charité University Medicine Berlin, 10117 Berlin, Germany; (E.K.); (R.G.K.)
| | - Sascha Ketelhut
- Institute of Sport Science, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany; (L.R.); (K.H.)
- Correspondence:
| | - Kerstin Ketelhut
- Faculty of Natural Science, MSB Medical School Berlin, 14197 Berlin, Germany;
| | - Lisa Röglin
- Institute of Sport Science, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany; (L.R.); (K.H.)
| | - Kuno Hottenrott
- Institute of Sport Science, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany; (L.R.); (K.H.)
| | - Anna Lisa Martin-Niedecken
- Department of Design, Institute for Design Research, Zurich University of the Arts, 8031 Zurich, Switzerland;
| | - Reinhard G. Ketelhut
- Department of Medical Sciences, Charité University Medicine Berlin, 10117 Berlin, Germany; (E.K.); (R.G.K.)
- Cardiology and Sports Medicine, Medical Center Berlin (MCB), 10559 Berlin, Germany
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29
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Anghel R, Adam CA, Marcu DTM, Mitu O, Mitu F. Cardiac Rehabilitation in Patients with Peripheral Artery Disease-A Literature Review in COVID-19 Era. J Clin Med 2022; 11:416. [PMID: 35054109 PMCID: PMC8778009 DOI: 10.3390/jcm11020416] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 12/12/2022] Open
Abstract
Cardiac rehabilitation (CR) is an integral part of the management of various cardiovascular disease such as coronary artery disease (CAD), peripheral artery disease (PAD), or chronic heart failure (CHF), with proven morbidity and mortality benefits. This article aims to review and summarize the scientific literature related to cardiac rehabilitation programs for patients with PAD and how they were adapted during the COVID-19 pandemic. The implementation of CR programs has been problematic since the COVID-19 pandemic due to social distancing and work-related restrictions. One of the main challenges for physicians and health systems alike has been the management of PAD patients. COVID-19 predisposes to coagulation disorders that can lead to severe thrombotic events. Home-based walking exercises are more accessible and easier to accept than supervised exercise programs. Cycling or other forms of exercise are more entertaining or challenging alternatives to exercise therapy. Besides treadmill exercises, upper- and lower-extremity ergometry also has great functional benefits, especially regarding walking endurance. Supervised exercise therapy has a positive impact on both functional capacity and also on the quality of life of such patients. The most effective manner to acquire this seems to be by combining revascularization therapy and supervised exercise. Rehabilitation programs proved to be a mandatory part of the integrative approach in these cases, increasing quality of life, and decreasing stress levels, depression, and anxiety.
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Affiliation(s)
- Razvan Anghel
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr 14, 700661 Iasi, Romania; (R.A.); (C.A.A.); (F.M.)
| | - Cristina Andreea Adam
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr 14, 700661 Iasi, Romania; (R.A.); (C.A.A.); (F.M.)
| | - Dragos Traian Marius Marcu
- Department of Internal Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street nr 16, 700115 Iasi, Romania;
| | - Ovidiu Mitu
- Department of Internal Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street nr 16, 700115 Iasi, Romania;
- “Sf. Spiridon” Clinical Emergency Hospital, Independence Boulevard nr 1, 700111 Iasi, Romania
| | - Florin Mitu
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr 14, 700661 Iasi, Romania; (R.A.); (C.A.A.); (F.M.)
- Department of Internal Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street nr 16, 700115 Iasi, Romania;
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30
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Zhdan VМ, Kitura YM, Babanina МY, Kitura ОY, Tkachenko MV, Kyrian OA, Ivanytskyi IV. MEDICAL REHABILITATION OF PATIENTS WITH ARTERIAL HYPERTENSION IN GENERAL MEDICAL PRACTICE. BULLETIN OF PROBLEMS BIOLOGY AND MEDICINE 2022. [DOI: 10.29254/2077-4214-2022-4-167-59-65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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31
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Graça Á, Oliveira DVD, Ribeiro AS, Lopes WA, Fiorillo RG, Fonseca HS, Mayhew JL, Nascimento MAD. Impact of resistance exercise order on postexercise hemodynamic measures in middle-aged and older women. MOTRIZ: REVISTA DE EDUCACAO FISICA 2022. [DOI: 10.1590/s1980-657420220020921] [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)
| | | | | | | | | | - Higor Santos Fonseca
- Universidade Estadual de Maringá, Brazil; Universidade Estadual do Paraná, Brazil
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32
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Travassos A, Osório NB, Avelino-dos-Santos C, Figueiredo AB, Nunes DP, Rosa TDS, Frauzino FC, Vidal-de-Santana W, Sesti LF, Nunes GF, Ribeiro EM, Pontes-Silva A, Maciel EDS, Quaresma FRP, Sera EAR, Silva-Neto LS. Hemodynamics and functional outcomes after resistance training in hypertensive and normotensive elderly: An experimental study. MOTRIZ: REVISTA DE EDUCACAO FISICA 2022. [DOI: 10.1590/s1980-657420220020021] [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)
| | | | | | | | | | | | | | | | | | | | | | - André Pontes-Silva
- Universidade Federal de São Carlos, Brazil; Universidade Federal do Maranhão, Brazil
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33
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Acute Blood Pressure Response to High- and Moderate-Speed Resistance Exercise in Older Adults With Hypertension. J Aging Phys Act 2021; 30:689-696. [PMID: 34856535 DOI: 10.1123/japa.2021-0214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/20/2021] [Accepted: 10/02/2021] [Indexed: 11/18/2022]
Abstract
An increase in blood pressure (BP) occurs during resistance exercise; attention to this response may be necessary in older individuals with hypertension. We compared the BP responses following high- (HSRE) and moderate-speed resistance exercise (MSRE) (4 × 8 repetitions at 60% one-repetition maximum) and control protocol in 15 older adults with hypertension. HSRE and MSRE increased systolic BP (SBP) by the end of each set compared with preexercise and control protocol. Immediately after the fourth set, a higher SBP was observed in MSRE than HSRE (147 ± 14 vs. 141 ± 12 mmHg; p = .01). Taking an exploratory analysis of the individual response, we observed that MSRE resulted in greater mean changes and number of SBP exposures to values ≥150 mmHg (22-fold) than HSRE (10-fold). Diastolic BP increased (p < .05) with exercise, but only MSRE increased compared with the control condition (p < .05). HSRE may be an alternative for individuals in which SBP peak should be avoided.
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34
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Fecchio RY, Queiroz ACC, Ritti-Dias R, Costa EC, Forjaz CLM. Post-dynamic Resistance Exercise Hypotension: Exploring Individual Responses and Predictors. Front Physiol 2021; 12:787444. [PMID: 35615287 PMCID: PMC9126191 DOI: 10.3389/fphys.2021.787444] [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: 09/30/2021] [Accepted: 11/10/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Post-dynamic resistance exercise hypotension (PREH) has been largely demonstrated. However, little is known regarding the interindividual variation of PREH magnitude and its predictors (i.e. factors of influence).Aims: To assess the interindividual variation of PREH and its predictors related to the characteristics of the individuals and the exercise protocol.Methods: This study retrospectively analysed data from 131 subjects included in seven controlled trials about PREH (including at least one dynamic resistance exercise and one control session) conducted by two research laboratories. The interindividual variation was assessed by the standard deviation of the individual responses (SDIR), and linear regression analyses were conducted to explore the predictors.Results: PREH showed moderate interindividual variation for systolic (SBP, SDIR=4.4mmHg; 0.35 standardised units) and diastolic blood pressures (DBP, SDIR=3.6mmHg; 0.32 standardised units). For systolic PREH, multivariate regression analysis (R2=0.069) revealed higher baseline SBP (B=−0.157, p=0.008) and higher number of sets (B=−3.910, p=0.041) as significant predictors. For diastolic PREH, multivariate regression analysis (R2=0.174) revealed higher baseline DBP (B=−0.191, p=0.001) and higher exercise volume (i.e. number of exercises *sets per exercise *repetitions per sets >150; B=−4.212, p=0.001) as significant predictors.Conclusion: PREH has a considerable interindividual variation. Greater PREH magnitude is observed in individuals with higher baseline blood pressure and after exercise protocols that comprehend higher number of sets and exercise volume.
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Affiliation(s)
- Rafael Y. Fecchio
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Andreia C. C. Queiroz
- Physical Education Department, Federal University of Juiz de Fora, Governador Valadares, Brazil
| | - Raphael Ritti-Dias
- Post-Graduate Program in Rehabilitation Science, University Nove de Julho, São Paulo, Brazil
| | - Eduardo Caldas Costa
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Cláudia L. M. Forjaz
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
- *Correspondence: Cláudia Lúcia de Moraes Forjaz,
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35
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Pinto AJ, Meireles K, Peçanha T, Mazzolani BC, Smaira FI, Rezende D, Benatti FB, Ribeiro ACM, Pinto ALS, Lima FR, Shinjo SK, Dantas WS, Mellett NA, Meikle PJ, Owen N, Dunstan DW, Roschel H, Gualano B. Acute cardiometabolic effects of brief active breaks in sitting for patients with rheumatoid arthritis. Am J Physiol Endocrinol Metab 2021; 321:E782-E794. [PMID: 34693756 DOI: 10.1152/ajpendo.00259.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Exercise is a treatment in rheumatoid arthritis, but participation in moderate-to-vigorous exercise is challenging for some patients. Light-intensity breaks in sitting could be a promising alternative. We compared the acute effects of active breaks in sitting with those of moderate-to-vigorous exercise on cardiometabolic risk markers in patients with rheumatoid arthritis. In a crossover fashion, 15 women with rheumatoid arthritis underwent three 8-h experimental conditions: prolonged sitting (SIT), 30-min bout of moderate-to-vigorous exercise followed by prolonged sitting (EX), and 3-min bouts of light-intensity walking every 30 min of sitting (BR). Postprandial glucose, insulin, c-peptide, triglycerides, cytokines, lipid classes/subclasses (lipidomics), and blood pressure responses were assessed. Muscle biopsies were collected following each session to assess targeted proteins/genes. Glucose [-28% in area under the curve (AUC), P = 0.036], insulin (-28% in AUC, P = 0.016), and c-peptide (-27% in AUC, P = 0.006) postprandial responses were attenuated in BR versus SIT, whereas only c-peptide was lower in EX versus SIT (-20% in AUC, P = 0.002). IL-1β decreased during BR, but increased during EX and SIT (P = 0.027 and P = 0.085, respectively). IL-1ra was increased during EX versus BR (P = 0.002). TNF-α concentrations decreased during BR versus EX (P = 0.022). EX, but not BR, reduced systolic blood pressure (P = 0.013). Lipidomic analysis showed that 7 of 36 lipid classes/subclasses were significantly different between conditions, with greater changes being observed in EX. No differences were observed for protein/gene expression. Brief active breaks in sitting can offset markers of cardiometabolic disturbance, which may be particularly useful for patients who may find it difficult to adhere to exercise.NEW & NOTEWORTHY Exercise is a treatment in rheumatoid arthritis but is challenging for some patients. Light-intensity breaks in sitting could be a promising alternative. Our findings show beneficial, but differential, cardiometabolic effects of active breaks in sitting and exercise in patients with rheumatoid arthritis. Breaks in sitting mainly improved glycemic and inflammatory markers, whereas exercise improved lipidomic and hypotensive responses. Breaks in sitting show promise in offsetting aspects of cardiometabolic disturbance associated with prolonged sitting in rheumatoid arthritis.
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Affiliation(s)
- Ana J Pinto
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Kamila Meireles
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Tiago Peçanha
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Bruna C Mazzolani
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Fabiana I Smaira
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Diego Rezende
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Fabiana B Benatti
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- School of Applied Sciences, State University of Campinas, Limeira, Brazil
| | - Ana C M Ribeiro
- Rheumatology Division, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, Brazil
| | - Ana L S Pinto
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, Brazil
| | - Fernanda R Lima
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, Brazil
| | - Samuel K Shinjo
- Rheumatology Division, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, Brazil
| | - Wagner S Dantas
- Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Natalie A Mellett
- Physical Activity, Behavioural Epidemiology and/or Metabolomics Laboratories, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Peter J Meikle
- Physical Activity, Behavioural Epidemiology and/or Metabolomics Laboratories, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Neville Owen
- Physical Activity, Behavioural Epidemiology and/or Metabolomics Laboratories, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - David W Dunstan
- Physical Activity, Behavioural Epidemiology and/or Metabolomics Laboratories, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- School of Applied Sciences, State University of Campinas, Limeira, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- School of Applied Sciences, State University of Campinas, Limeira, Brazil
- Food Research Center, University of São Paulo, Sao Paulo, Brazil
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Saco-Ledo G, Valenzuela PL, Ramírez-Jiménez M, Morales JS, Castillo-García A, Blumenthal JA, Ruilope LM, Lucia A. Acute Aerobic Exercise Induces Short-Term Reductions in Ambulatory Blood Pressure in Patients With Hypertension: A Systematic Review and Meta-Analysis. Hypertension 2021; 78:1844-1858. [PMID: 34719262 DOI: 10.1161/hypertensionaha.121.18099] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Gonzalo Saco-Ledo
- Bioenergy and Motion Analysis Laboratory, National Research Center on Human Evolution (CENIEH), Burgos, Spain (G.S.-L.)
| | - Pedro L Valenzuela
- Faculty of Sport Sciences, European University of Madrid, Spain (P.L.V., L.M.R., A.L.)
| | - Miguel Ramírez-Jiménez
- Exercise Physiology Laboratory, University of Castilla-La Mancha, Toledo, Spain (M.R.-J.).,Faculty of Social Sciences and Law, Catholic University of Avila, Avila, Spain (M.R.-J.)
| | - Javier S Morales
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Spain (J.S.M.)
| | | | - James A Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC (J.A.B.)
| | - Luis M Ruilope
- Faculty of Sport Sciences, European University of Madrid, Spain (P.L.V., L.M.R., A.L.).,Hypertension Unit and Cardiorenal Translational Laboratory, Madrid, Spain (L.M.R.).,Research Institute of the Hospital Universitario 12 de Octubre ('imas12'), Madrid, Spain (L.M.R., A.L.)
| | - Alejandro Lucia
- Faculty of Sport Sciences, European University of Madrid, Spain (P.L.V., L.M.R., A.L.).,Research Institute of the Hospital Universitario 12 de Octubre ('imas12'), Madrid, Spain (L.M.R., A.L.)
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37
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Dietary and Lifestyle Modification for the Prevention and Treatment of Hypertension. CURRENT CARDIOVASCULAR RISK REPORTS 2021. [DOI: 10.1007/s12170-021-00683-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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38
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Apkarian MR. Blood Pressure Characteristics and Responses During Resistance Exercise. Strength Cond J 2021. [DOI: 10.1519/ssc.0000000000000607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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39
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de Oliveira Carpes L, Domingues LB, Schimitt R, Fuchs SC, Alhalimi T, Tanaka H, Ferrari R. Sex Differences in Post-exercise Hypotension, Ambulatory Blood Pressure Variability, and Endothelial Function After a Power Training Session in Older Adults. Front Physiol 2021; 12:657373. [PMID: 34335289 PMCID: PMC8322608 DOI: 10.3389/fphys.2021.657373] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/11/2021] [Indexed: 01/04/2023] Open
Abstract
Background: The efficacy of power training (PT) to acutely reduce blood pressure (BP) in participants with hypertension is controversial, and no studies have assessed the influence of sex on post-exercise hypotension and its mechanisms in older adults. Purpose: The aims of this secondary, exploratory analysis were to compare the effects of a single bout of PT on post-exercise hypotension, BP variability, and endothelial function between older men and women with hypertension. Methods: Twenty-four participants with hypertension (12 men and 12 women aged to >60 years old) took part in this crossover study and randomly performed two experimental sessions: power exercise training (PT) and non-exercising control session (Con). The PT protocol was composed of 3 sets of 8–10 repetitions of five exercises performed in the following order: leg press, bench press, knee extension, upright row, and knee flexion, using an intensity corresponding to 50% of one repetition maximal test (1RM) and 2-min intervals between sets and exercises. The concentric phase of exercises during each repetition was performed “as fast as possible,” while the eccentric phase lasted 1 to 2 s. During Con, the participants remained at seated rest on the same exercise machines, but without any exercise. Each protocol lasted 40 min. Office BP, flow-mediated dilatation (FMD), 24-h ambulatory BP, and the average real variability (ARV) of systolic and diastolic BP were assessed before and after experimental sessions. Results: Comparing PT with Con, a reduced office BP after exercise was found in men (systolic BP—average post 1 h: −14 mmHg, p < 0.001; diastolic BP—average post 1 h: −8 mmHg, p < 0.001) and only a reduced systolic BP in women (average post 1 h: −7 mmHg, p = 0.04). Comparing men and women, a reduced systolic BP (post 60': −15 mmHg, p = 0.048; average post 1 h: −7 mmHg, p = 0.046) and diastolic BP (post 60': −9 mmHg, p = 0.049) after the first hour were found in men. In relation to 24-h ambulatory BP, ARV, and FMD, no statistically significant differences were found between men and women. Conclusion: In older adults with hypertension, the office BP response after the experimental sessions was different in men and women, showing that the PT protocol is more effective to acutely reduce BP in men. Additionally, the mechanisms behind this reduction remain unclear. This finding suggests that sex cannot be combined to analyze post-exercise hypotension. Clinical Trial Registration: ClinicalTrials.gov, Identifier: NCT03615625.
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Affiliation(s)
- Leandro de Oliveira Carpes
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Lucas Betti Domingues
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Renato Schimitt
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Sandra C Fuchs
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Taha Alhalimi
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, United States
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, United States
| | - Rodrigo Ferrari
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Loaiza-Betancur AF, Chulvi-Medrano I, Díaz-López VA, Gómez-Tomás C. The effect of exercise training on blood pressure in menopause and postmenopausal women: A systematic review of randomized controlled trials. Maturitas 2021; 149:40-55. [PMID: 34108092 DOI: 10.1016/j.maturitas.2021.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 03/25/2021] [Accepted: 05/19/2021] [Indexed: 12/26/2022]
Abstract
The prevalence of hypertension is higher in postmenopausal than in premenopausal women. Regular exercise training has been shown to be effective in addressing hypertension. The aim of this systematic review was to synthesize the effect of exercise training on systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) in menopausal and postmenopausal women. This review was reported according to the PRISMA statement and registered in PROSPERO. The literature search was done in MEDLINE, Embase, Cochrane CENTRAL and ClinicalTrials. Randomized controlled trials involving menopausal and postmenopausal women undergoing exercise training were included. Two blinded reviewers assessed risk of bias in the included studies by using the Cochrane Risk of Bias tool. A random-effects model was used for all analyses. Significance was set at P < 0.05. Compared with the control group, exercise training resulted in clinically significant reductions on SBP (MD -3.43 mmHg; 95% CI, -5.16, -1.71; P < 0.0001), DBP (MD, -2.25 mmHg; 95% CI, -3.40, -1.11; P = 0.0001) and MAP (MD, -3.48 mmHg; 95% CI, -5.84, -1.11; P = 0.004). Aerobic training (AT) did not produce a significant reduction in SBP, DBP and MAP (P >0.05). Combined training (CT) generated larger reductions. Exercise training generated small but clinically relevant reductions in SBP, DBP and MAP in menopausal and postmenopausal women, younger or older than 65 years, with prehypertension or hypertension. AT did not lead to a clinically relevant improvement in blood pressure (BP) in this population. In addition, CT showed the largest reductions in SBP, DBP and MAP.
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Affiliation(s)
| | - Iván Chulvi-Medrano
- Universitat de Valencia - Campus Blasco Ibanez: Universitat de Valencia, Valencia, Spain.
| | | | - Cinta Gómez-Tomás
- Physiotherapy and Sports Rehabilitation Research Group, Catholic University of Murcia.| San Antonio Catholic University of Murcia: Universidad Catolica San Antonio de Murcia
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41
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Marçal IR, Goessler KF, Buys R, Casonatto J, Ciolac EG, Cornelissen VA. Post-exercise Hypotension Following a Single Bout of High Intensity Interval Exercise vs. a Single Bout of Moderate Intensity Continuous Exercise in Adults With or Without Hypertension: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Front Physiol 2021; 12:675289. [PMID: 34262474 PMCID: PMC8274970 DOI: 10.3389/fphys.2021.675289] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/20/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Post-exercise hypotension (PEH) is an important tool in the daily management of patients with hypertension. Varying the exercise parameters is likely to change the blood pressure (BP) response following a bout of exercise. In recent years, high-intensity interval exercise (HIIE) has gained significant popularity in exercise-based prevention and rehabilitation of clinical populations. Yet, to date, it is not known whether a single session of HIIE maximizes PEH more than a bout of moderate-intensity continuous exercise (MICE). Objective: To compare the effect of HIIE vs. MICE on PEH by means of a systematic review and meta-analysis. Methods: A systematic search in the electronic databases MEDLINE, Embase, and SPORTDiscus was conducted from the earliest date available until February 24, 2020. Randomized clinical trials comparing the transient effect of a single bout of HIIE to MICE on office and/or ambulatory BP in humans (≥18 years) were included. Data were pooled using random effects models with summary data reported as weighted means and 95% confidence interval (CIs). Results: Data from 14 trials were included, involving 18 comparisons between HIIE and MICE and 276 (193 males) participants. The immediate effects, measured as office BP at 30- and 60-min post-exercise, was similar for a bout of HIIE and MICE (p > 0.05 for systolic and diastolic BP). However, HIIE elicited a more pronounced BP reduction than MICE [(−5.3 mmHg (−7.3 to −3.3)/ −1.63 mmHg (−3.00 to −0.26)] during the subsequent hours of ambulatory daytime monitoring. No differences were observed for ambulatory nighttime BP (p > 0.05). Conclusion: HIIE promoted a larger PEH than MICE on ambulatory daytime BP. However, the number of studies was low, patients were mostly young to middle-aged individuals, and only a few studies included patients with hypertension. Therefore, there is a need for studies that involve older individuals with hypertension and use ambulatory BP monitoring to confirm HIIE's superiority as a safe BP lowering intervention in today's clinical practice. Systematic Review Registration: PROSPERO (registration number: CRD42020171640).
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Affiliation(s)
- Isabela Roque Marçal
- Exercise and Chronic Disease Research Laboratory, Department of Physical Education, School of Sciences, São Paulo State University (UNESP), Bauru, Brazil.,Research Group for Cardiovascular Rehabilitation, Department of Rehabilitation Sciences, University of Leuven, KU Leuven, Leuven, Belgium
| | - Karla Fabiana Goessler
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Faculty of Medicine (FMUSP), University of Saõ Paulo, Saõ Paulo, Brazil
| | - Roselien Buys
- Research Group for Cardiovascular Rehabilitation, Department of Rehabilitation Sciences, University of Leuven, KU Leuven, Leuven, Belgium
| | - Juliano Casonatto
- Research Group in Physiology and Physical Activity, University of Northern Paraná, Londrina, Brazil
| | - Emmanuel Gomes Ciolac
- Exercise and Chronic Disease Research Laboratory, Department of Physical Education, School of Sciences, São Paulo State University (UNESP), Bauru, Brazil
| | - Véronique A Cornelissen
- Research Group for Cardiovascular Rehabilitation, Department of Rehabilitation Sciences, University of Leuven, KU Leuven, Leuven, Belgium
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42
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Farinatti P, Polito MD, Massaferri R, Monteiro WD, Vasconcelos D, Johnson BT, Pescatello LS. Postexercise hypotension due to resistance exercise is not mediated by autonomic control: A systematic review and meta-analysis. Auton Neurosci 2021; 234:102825. [PMID: 34118764 DOI: 10.1016/j.autneu.2021.102825] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/29/2021] [Accepted: 05/20/2021] [Indexed: 10/21/2022]
Abstract
Changes in autonomic control have been suggested to mediate postexercise hypotension (PEH). We investigated through meta-analysis the after-effects of acute resistance exercise (RE) on blood pressure (BP) and autonomic activity in individuals with normal and elevated BP. Electronic databases were searched for trials including: adults; exclusive RE interventions; and BP and autonomic outcomes measured pre- and postintervention for at least 30 min. Analyses incorporated random-effects assumptions. Thirty trials yielded 62 interventions (N = 480). Subjects were young (33.6 ± 15.6 yr), with systolic BP (SBP)/diastolic BP (DBP) of 124.2 ± 8.9/71.5 ± 6.6 mm Hg. Overall, RE moderately reduced SBP (normal BP: ~1 to 4 mm Hg, p < 0.01; elevated BP: ~1 to 12 mm Hg, p < 0.01) and DBP (normal BP: ~1 to 4 mm Hg, p < 0.03; elevated BP: ~0.5 to 7 mm Hg, p < 0.01), which was in general parallel to sympathetic increase (normal BP: g = 0.49 to 0.51, p < 0.01; elevated BP: g = 0.41 to 0.63, p < 0.01) and parasympathetic decrease (normal BP: g = -0.52 to -0.53, p < 0.01; elevated BP: g = -0.46 to -0.71, p < 0.01). The meta-regression showed inverse associations between the effect sizes of BP vs. sympathetic (SBP: slope - 0.19 to -3.45, p < 0.01; DBP: slope - 0.30 to -1.60, p < 0.01), and direct associations vs. parasympathetic outcomes (SBP: slope 0.17 to 2.59, p < 0.01; DBP: slope 0.21 to 1.38, p < 0.01). In conclusion, changes in BP were concomitant to sympathetic increase and parasympathetic decrease, which questions the role of autonomic fluctuations as potential mechanisms of PEH after RE.
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Affiliation(s)
- Paulo Farinatti
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, RJ, Brazil; Graduate Program in Physical Activity Sciences, Salgado de Oliveira University, RJ, Brazil.
| | - Marcos D Polito
- Department of Physical Education, Londrina State University, PR, Brazil
| | - Renato Massaferri
- Graduate Program in Operational Human Performance, AirForce University, RJ, Brazil
| | - Walace D Monteiro
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, RJ, Brazil; Graduate Program in Physical Activity Sciences, Salgado de Oliveira University, RJ, Brazil
| | - Denilson Vasconcelos
- School of Physical Education and Sports, Federal University of Rio de Janeiro, RJ, Brazil
| | - Blair T Johnson
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
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43
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Silva ALD, de Oliveira SN, Vieira BA, Leite C, Martins DM, Moro ARP, Gerage AM, Delevatti RS. Acute effect of bodyweight-based strength training on blood pressure of hypertensive older adults: A randomized crossover clinical trial. Clin Exp Hypertens 2021; 43:223-229. [PMID: 33198514 DOI: 10.1080/10641963.2020.1847130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Strength Training (ST) reduces the cardiovascular risk of hypertensive elderly people; however, there is a need for efficient and low-cost ST programs that aim to reduce blood pressure (BP) in elderly people with adherence and affectivity in this population. Objective: Evaluate the acute effect on BP and satisfaction with the practice of bodyweight-based strength training (BWST) in hypertensive older adults. Methods: Participants performed a BWST session and a control session (CS). The BWST consisted of six exercises, with three sets of 30 seconds. In the CS, no activity was performed. BP was measured before and at 0, 10, 20, and 30 minutes post-session. Participants' satisfaction was assessed. Results: Eleven older adults (65.8 ± 4.6 years; 7 men) participated in the study. There was an increase (p = .028) in systolic BP immediately after BWST, returning to baseline values in the intervals 10, 20, and 30 post-section. In the CS there was an increase (p = .009) 30 minutes post-session compared to 20 minutes. Between sessions, a lower systolic BP was found in BWST (-6.54 ± 3.31; p = .048) 30 minutes post-sessions. For satisfaction, 82% of participants were "totally satisfied" with BWST. Conclusion: The SBP is lower 30 minutes after BWST session than control session, and BWST promoted a pleasant affective response in hypertensive older adults.
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Affiliation(s)
- Adriano L da Silva
- Centro de Desportos, Universidade Federal de Santa Catarina , Florianópolis, Brazil
| | - Silas N de Oliveira
- Laboratório de Biomecânica, Universidade Federal de Santa Catarina , Florianópolis, Brazil
| | - Bruno A Vieira
- Grupo de Estudo e Pesquisa em Exercício Físico e Doenças Crônicas Não Transmissíveis, Universidade Federal de Santa Catarina , Florianópolis, Brazil
| | - Chayana Leite
- Grupo de Estudo e Pesquisa em Exercício Físico e Doenças Crônicas Não Transmissíveis, Universidade Federal de Santa Catarina , Florianópolis, Brazil
| | - Doglas M Martins
- Grupo de Estudo e Pesquisa em Exercício Físico e Doenças Crônicas Não Transmissíveis, Universidade Federal de Santa Catarina , Florianópolis, Brazil
| | - Antônio R P Moro
- Laboratório de Biomecânica, Universidade Federal de Santa Catarina , Florianópolis, Brazil
| | - Aline M Gerage
- Grupo de Estudo e Pesquisa em Exercício Físico e Doenças Crônicas Não Transmissíveis, Universidade Federal de Santa Catarina , Florianópolis, Brazil
| | - Rodrigo S Delevatti
- Grupo de Estudo e Pesquisa em Exercício Físico e Doenças Crônicas Não Transmissíveis, Universidade Federal de Santa Catarina , Florianópolis, Brazil
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44
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Exercise Training and Cardiac Rehabilitation in COVID-19 Patients with Cardiovascular Complications: State of Art. Life (Basel) 2021; 11:life11030259. [PMID: 33801080 PMCID: PMC8004041 DOI: 10.3390/life11030259] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 02/06/2023] Open
Abstract
Recent scientific literature has investigated the cardiovascular implications of COVID-19. The mechanisms of cardiovascular damage seem to involve the protein angiotensin-converting enzyme 2 (ACE2), to which severe acute respiratory syndrome (SARS) coronavirus-2 (CoV-2) binds to penetrate cells and other mechanisms, most of which are still under study. Cardiovascular sequelae of COVID-19 include heart failure, cardiomyopathy, acute coronary syndrome, arrhythmias, and venous thromboembolism. This article aims to collect scientific evidence by exploiting PubMed, Scopus, and Pedro databases to highlight the cardiovascular complications of COVID-19 and to define the physiotherapy treatment recommended for these patients. Exercise training (ET), an important part of cardiac rehabilitation, is a powerful tool in physiotherapy, capable of inducing significant changes in the cardiovascular system and functional in the recovery of endothelial dysfunction and for the containment of thromboembolic complications. In conclusion, due to the wide variety of possible exercise programs that can be obtained by combining intensity, duration, and speed in various ways, and by adjusting the program based on continuous patient monitoring, exercise training is well suited to the treatment of post-COVID patients with an impaired cardiovascular system of various degrees.
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45
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Conceição AF, Muniz DL, Santos CPCD, Queiroz CO. Acute Blood Pressure Response to Different Resistance Programs in Trained Men. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.36660/ijcs.20190215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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46
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Silva PHM, de Brito LC, Cabral LLP, Farias-Junior LF, Browne RAV, Vianna LC, Costa EC. Effects of Isometric Biceps Exercise on Blood Pressure in Adults with Hypertension. Int J Sports Med 2021; 42:985-993. [PMID: 33618392 DOI: 10.1055/a-1337-2998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We investigated the acute effects of isometric biceps exercise on resting and ambulatory blood pressure in hypertensive adults. A total of 12 medicated hypertensive adults (aged 47±7 years; body mass index 27.2±2.7 kg/m2; resting blood pressure 123±12/74±6 mmHg) performed an isometric biceps exercise session (bilateral biceps exercise; 4×1 min at 30% of 1-RM, 2 min recovery) and a control session (without exercise) in a randomized order separated by a 7 to 10-day period. Resting blood pressure, heart rate, and heart rate variability indexes (SDNN, RMSSD, LF, HF, and LF/HF) were measured pre- and up to 30 min post-sessions. Next, ambulatory blood pressure was monitored during 22-hour post-sessions (awake and asleep periods). No significant changes were observed for resting blood pressure, heart rate, or heart rate variability indexes up to 30 min post-sessions (p>0.05). Furthermore, no significant differences were observed in average ambulatory blood pressure values in 22-hour (126±11/71±6 mmHg vs. 126±15/71±9 mmHg), awake (127±10/74±6 mmHg vs. 130±14/75±10 mmHg), and asleep (123±15/68±6 mmHg vs. 120±17/66±9 mmHg) periods between the control and isometric sessions, respectively (p>0.05). In conclusion, an isometric biceps exercise session does not elicit an acute antihypertensive effect in adults with hypertension, which suggests that its prescription to improve the acute BP control is limited.
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Affiliation(s)
| | | | | | | | | | - Lauro C Vianna
- NeuroVASQ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasilia, Brazil
| | - Eduardo Caldas Costa
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal, Brazil.,Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil.,Department of Physical Education, Federal University of Rio Grande do Norte, Natal, Brazil
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47
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Carpes L, Jacobsen A, Domingues L, Jung N, Ferrari R. Recreational beach tennis reduces 24-h blood pressure in adults with hypertension: a randomized crossover trial. Eur J Appl Physiol 2021; 121:1327-1336. [PMID: 33590342 DOI: 10.1007/s00421-021-04617-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 02/05/2021] [Indexed: 01/23/2023]
Abstract
PURPOSE To evaluate the effect of a beach tennis session on 24-h ambulatory blood pressure in adults with hypertension. METHODS In this randomized crossover trial, 24 participants (12 men and 12 women) randomly performed two experimental sessions: a beach tennis session and a non-exercise control session. The beach tennis session started with a standardized 5-min warm-up consisting of basic techniques, followed by three 12-min beach tennis matches with 2-min intervals between them. Heart rate was continuously recorded and rating of perceived exertion was assessed in the middle and at the end of each set during the beach tennis session. Enjoyment was also assessed after the beach tennis session. The control session was performed in seated rest. Both experimental sessions lasted 45 min. Ambulatory blood pressure was measured continuously for 24 h after sessions. RESULTS Systolic blood pressure (24-h: 6 mmHg, P = 0.008; daytime: 6 mmHg, P = 0.031; nighttime: 6 mmHg, P = 0.042) and diastolic blood pressure (24-h: 3 mmHg, P = 0.021; daytime: 3 mmHg, P = 0.036; nighttime: 4 mmHg, P = 0.076) decreased after beach tennis when compared with control. The participants presented a reserve heart rate of 59-68%, and a rating of perceived exertion score of 3.4-4.7 using Borg's CR10 Scale. The enjoyment scores after beach tennis session were higher than 90%. CONCLUSION A single session of recreational beach tennis reduces 24-h ambulatory blood pressure in adults with hypertension. Additionally, the participants can achieve a high physiological stress but perceive less effort during the practice. TRIAL REGISTRATION Date: April 10, 2019; identifier number NCT03909308 (Clinicaltrials.gov).
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Affiliation(s)
- Leandro Carpes
- Graduate Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, RS, 90035-903, Brazil
| | - Alexandre Jacobsen
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, RS, 90035-903, Brazil
| | - Lucas Domingues
- Graduate Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, RS, 90035-903, Brazil
| | - Nathalia Jung
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, RS, 90035-903, Brazil
| | - Rodrigo Ferrari
- Graduate Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, RS, 90035-903, Brazil.
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48
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Barbosa-Netto S, d'Acelino-E-Porto OS, Almeida MB. Self-Selected Resistance Exercise Load: Implications for Research and Prescription. J Strength Cond Res 2021; 35:S166-S172. [PMID: 29112055 DOI: 10.1519/jsc.0000000000002287] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Barbosa-Netto, S, d'Acelino-e-Porto, OS, and Almeida, MB. Self-selected resistance exercise load: implications for research and prescription. J Strength Cond Res 35(2S): S166-S172, 2021-Resistance training has been widely used for maintaining or improving the quality of life and sports performance. It is not clear, however, whether the load commonly used in these exercises is equivalent to the number of repetitions determined for execution, that is, the level of effort applied to the self-selected load. Ergo, the aim of this study was to identify the number of maximum repetitions that strength training practitioners can perform with the load commonly used (self-selected) to perform 10 repetitions in their training routines. The sample consisted of 160 healthy trained men (25.7 ± 4.5 years, 81.2 ± 10.4 kg, 177.9 ± 6.2 cm). Subjects answered the question "What weight do you usually lift for 10 repetitions on free-weight bench press exercise?" The answer was considered the self-selected 10 repetitions load (S10RL). After a brief warm-up, each individual was instructed to perform as many repetitions as possible at S10RL (repetition maximum [RMS10RL]) at a single bout of free-weight bench press. The RMS10RL was analyzed with the single sample t test, adopting the reference value of 10 repetitions. Individuals performed 16 ± 5RMS10RL (median = 15), which represent a statistical difference for the 10-repetition reference value (p < 0.001). The most prevalent RMS10RL range was from 13 to 15 repetitions (31%), and only 22% performed between 10 and 12 repetitions. It was concluded that most individuals can perform a number of repetitions well above the 10 repetitions predicted for the selected load. Therefore, the training routines are not compatible with maximum effort.
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Affiliation(s)
- Sebastião Barbosa-Netto
- Physical Education Post-graduate Program/Department of Physical Education, Federal University of Sergipe, Brazil
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49
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Domingues LB, Cadore EL, Ferrari R. Hemodynamic responses of resistance exercise performed with repetitions to failure and not to failure in adults with hypertension. Blood Press Monit 2021; 26:46-52. [PMID: 32740293 DOI: 10.1097/mbp.0000000000000478] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate and compare the hemodynamic responses of resistance exercise (RE) performed with repetitions to failure vs. not to failure in individuals with hypertension. METHODS Twenty participants were randomly allocated to perform three experimental sessions: a RE session performed with repetitions to failure (RF); a RE session performed with repetitions not to failure (NRF); and a non-exercise control session (Con). RE sessions were composed of four sets of 10 repetitions in four exercises involving large muscle groups. To ensure that the sets could be performed with RF or NRF, intensities corresponding to 75% and 50% of one-repetition maximum test were adopted in RF and NRF sessions, respectively. The Con was performed in seated rest. Blood pressure and rate-pressure product were measured before, during and after the experimental sessions for 1 h. RESULTS SBP and DBP decreased after NRF compared with Con (systolic post 1 h: -7.7 ± 1.1 mmHg, P < 0.001; diastolic post 1 h: -4.2 ± 0.7 mmHg, P = 0.001), and after RF compared with Con (systolic post 1 h: -8.2 ± 1.3 mmHg, P < 0.001; diastolic post 1 h: -7.4 ± 1.4 mmHg, P < 0.001). No significant difference was found in blood pressure between RF and NRF sessions after 1 h. Rate-pressure product was lower during NRF compared with RF (P = 0.001), suggesting a higher cardiovascular demand during the RF session. CONCLUSION The RF and NRF sessions are equally effective to promote post-exercise hypotension. In addition, NRF session can reduce cardiac demand during the exercise and should be recommended in adults with hypertension.
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Affiliation(s)
- Lucas B Domingues
- Postgraduate Program in Cardiology, Universidade Federal do Rio Grande do Sul
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre
- Faculdade Sogipa de Educação Física
| | - Eduardo L Cadore
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre
- Postgraduate Program in Human Movement Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rodrigo Ferrari
- Postgraduate Program in Cardiology, Universidade Federal do Rio Grande do Sul
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre
- Faculdade Sogipa de Educação Física
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50
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Hintsala HE, Valtonen RIP, Kiviniemi A, Crandall C, Perkiömäki J, Hautala A, Mäntysaari M, Alén M, Ryti N, Jaakkola JJK, Ikäheimo TM. Central aortic hemodynamics following acute lower and upper-body exercise in a cold environment among patients with coronary artery disease. Sci Rep 2021; 11:2550. [PMID: 33510373 PMCID: PMC7843633 DOI: 10.1038/s41598-021-82155-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 01/14/2021] [Indexed: 12/20/2022] Open
Abstract
Exercise is beneficial to cardiovascular health, evidenced by reduced post-exercise central aortic blood pressure (BP) and wave reflection. We assessed if post-exercise central hemodynamics are modified due to an altered thermal state related to exercise in the cold in patients with coronary artery disease (CAD). CAD patients (n = 11) performed moderate-intensity lower-body exercise (walking at 65–70% of HRmax) and rested in neutral (+ 22 °C) and cold (− 15 °C) conditions. In another protocol, CAD patients (n = 15) performed static (five 1.5 min work cycles, 10–30% of maximal voluntary contraction) and dynamic (three 5 min workloads, 56–80% of HRmax) upper-body exercise at the same temperatures. Both datasets consisted of four 30-min exposures administered in random order. Central aortic BP and augmentation index (AI) were noninvasively assessed via pulse wave analyses prior to and 25 min after these interventions. Lower-body dynamic exercise decreased post-exercise central systolic BP (6–10 mmHg, p < 0.001) and AI (1–6%, p < 0.001) both after cold and neutral and conditions. Dynamic upper-body exercise lowered central systolic BP (2–4 mmHg, p < 0.001) after exposure to both temperatures. In contrast, static upper-body exercise increased central systolic BP after exposure to cold (7 ± 6 mmHg, p < 0.001). Acute dynamic lower and upper-body exercise mainly lowers post-exercise central BP in CAD patients irrespective of the environmental temperature. In contrast, central systolic BP was elevated after static exercise in cold. CAD patients likely benefit from year-round dynamic exercise, but hemodynamic responses following static exercise in a cold environment should be examined further. Clinical trials.gov: NCT02855905 04/08/2016.
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Affiliation(s)
- Heidi E Hintsala
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.,Centria University of Applied Sciences, Kokkola, Finland
| | - Rasmus I P Valtonen
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Antti Kiviniemi
- Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Craig Crandall
- Department of Internal Medicine, Texas Health Presbyterian Hospital, University of Texas Southwestern Medical Center and the Institute for Exercise and Environmental Medicine, Dallas, USA
| | - Juha Perkiömäki
- Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Arto Hautala
- Cardiovascular Research Group, Division of Cardiology, Oulu University Hospital, University of Oulu, Oulu, Finland
| | | | - Markku Alén
- Department of Medical Rehabilitation, Oulu University Hospital and Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Tiina M Ikäheimo
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, P.O. Box 5000, 90014, Oulu, Finland. .,Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.
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