Postexercise Hypotension Is Delayed in Men With Obesity and Hypertension (original) (raw)
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Postexercise Hemodynamic Responses in Lean and Obese Men
Medicine and Science in Sports and Exercise, 2018
We assessed resting central/peripheral blood pressure (BP), postexercise BP and hemodynamic responses [stroke volume (SV), cardiac output (CO), systemic vascular resistance (SVR)] after acute exercise and 2 wk of aerobic training in lean and centrally obese men matched for BP. Methods: Eight lean (body mass index (BMI) <25 kg/m 2 ; visceral fat = 279±224 cm 3) and eight centrally obese (BMI>30 kg/m 2 ; visceral fat = 1,471±374 cm 3) men performed 6 training sessions (3d/wk for 40 min at 65-70%HRmax). Resting BP and hemodynamic measurements were obtained at baseline, following exercise for 60 min, and at 24h and 48h after the last training session. Results: Postexercise brachial and central systolic and mean arterial BP decreased 3-4 mmHg below resting in lean (P<0.001), and increased by 3 mmHg in obese (P <0.02). Post-training resting brachial/central systolic BPs were reduced by 3-4 mmHg only in lean men (P <0.05). Pretraining PEH was significantly correlated with the training-induced change in resting brachial SBP at 48h (r=0.58, P =0.02), but not at 24h (r=0.38, P =0.15). Similar correlations were observed between acute reductions in central systolic BP (SBP) and central SBP at 24h (r=0.43, P =0.09) and 48h (r=0.54, P =0.03) post-training. Conclusions: In contrast to the consistent results for lean men, PEH was not observed in centrally obese men, and resting SBP was not reduced after a short aerobic training program. Considerable individual variation in postexercise BP response among obese men may have implications for design of exercise interventions to lower BP in these individuals.
2016
PURPOSE: Lean hypertension (HTN) is characterized by a mechanistically different HTN when compared to obese HTN. The purpose of this study is to assess whether body phenotype influences blood pressure (BP) responses following both acute and chronic exercise. METHODS: Obese (body mass index (BMI) > 30 kg/m 2) and lean (BMI < 25 kg/m 2) men with pre-hypertension (PHTN) (systolic BP (SBP) 120-139 or diastolic BP (DBP) 80-89 mm Hg) were asked to participate in a two-phase trial. Phase 1 assessed differences in post-exercise hypotension between groups in response to an acute exercise bout. Phase 2 consisted of a two-week aerobic exercise intervention at 65-70% of heart rate (HR) max on a cycle ergometer. Primary outcome measures were: brachial BP, central (aortic) BP, cardiac output (CO), and systemic vascular resistance (SVR) measured acutely after one exercise session and following two weeks of training. RESULTS: There were no differences between groups for baseline resting brachial BP, central BP, age, or VO2 peak (all P > 0.05). At rest, obese PHTN had greater CO compared to lean PHTN (6.3 ± 1 vs 4.7 ± 1 L/min-1 , P = 0.005) and decreased SVR compared to lean PHTN (1218 ± 263 vs 1606 ± 444 Dyn. s/cm 5 , P = 0.003). Average 60minute post-exercise brachial and central SBP reduced by 3 mm Hg in Lean PHTN in response to acute exercise (P < 0.005), while significantly increasing 4 mm Hg for brachial and 3 mm Hg for central SBP (P < 0.05). SVR had a significantly greater reduction following acute exercise in lean PHTN (-223 Dyn•s/cm 5) compared to obese PHTN (-75 Dyn•s/cm 5 , P < 0.001). In lean subjects chronic training reduced brachial BP by 4 mm Hg and central BP by 3 mm Hg but training had no effect on the BP's in obese subjects. Resting BP reduction in response to training was accompanied by reductions in CHAPTER ONE
Frontiers in Physiology
Background: Postexercise hypotension (PEH) is a common physiological phenomenon occurring immediately after endurance training (ET), resistance training (RT), and ET plus RT, also termed concurrent training (CT); however, there is little knowledge about the interindividual and magnitude response of PEH in morbidly obese patients.Aim: The aims of this study were (1) to investigate the effect of CT order (ET + RT vs. RT + ET) on the blood pressure responses; 2) characterize these responses in responders and nonresponders, and 3) identify potential baseline outcomes for predicting blood pressure decreases as responders.Methods: A quasi-experimental study developed in sedentary morbidly obese men and women (age 43.6 ± 11.3 years; body mass index [BMI] ≥40 kg/m2) was assigned to a CT group of ET plus RT (ET + RT; n = 19; BMI 47.8 ± 16.7) or RT plus ET order group (RT + ET; n = 17; BMI 43.0 ± 8.0). Subjects of both groups received eight exercise sessions over four weeks. Primary outcomes ...
Postexercise hypotension after continuous, aerobic interval, and sprint interval exercise
Journal of Strength and Conditioning Research, 2015
We examined the effects of 3 exercise bouts, differing markedly in intensity, on postexercise hypotension (PEH). Eleven young adults (age: 24.6 6 3.7 years) completed 4 randomly assigned experimental conditions: (a) control, (b) 30-minute steady-state exercise (SSE) at 75-80% maximum heart rate (HRmax), (4) aerobic interval exercise (AIE): four 4-minute bouts at 90-95% HRmax, separated by 3 minutes of active recovery, and (d) sprint interval exercise (SIE): six 30-second Wingate sprints, separated by 4 minutes of active recovery. Exercise was performed on a cycle ergometer. Blood pressure (BP) was measured before exercise and every 15-minute postexercise for 3 hours. Linear mixed models were used to compare BP between trials. During the 3-hour postexercise, systolic BP (SBP) was lower (p , 0.001) after AIE (118 6 10 mm Hg), SSE (121 6 10 mm Hg), and SIE (121 6 11 mm Hg) compared with control (124 6 8 mm Hg). Diastolic BP (DBP) was also lower (p , 0.001) after AIE (66 6 7 mm Hg), SSE (69 6 6 mm Hg), and SIE (68 6 8 mm Hg) compared with control (71 6 7 mm Hg). Only AIE resulted in sustained (.2 hours) PEH, with SBP (120 6 9 mm Hg) and DBP (68 6 7 mm Hg) during the third-hour postexercise being lower (p # 0.05) than control (124 6 8 and 70 6 7 mm Hg). Although all exercise bouts produced similar reductions in BP at 1-hour postexercise, the duration of PEH was greatest after AIE.
Postexercise hypotension and hemodynamics: the role of exercise intensity
The Journal of sports medicine and physical fitness, 2004
Although postexercise hypotension (PEH) has already been extensively demonstrated, the influence of exercise intensity on its magnitude and mechanisms is still controversial. Twenty-three normotensive subjects were submitted to a control (45 minutes of rest) and 3 exercise sessions (cycle ergometer, 45 minutes at 30%, 50% and 75% of .VO(2peak)) to investigate the role of exercise intensity on PEH. Blood pressure (BP - auscultatory), heart rate (HR - ECG), and cardiac output (CO - CO2 rebreathing) were measured before and after the control and exercise sessions. Systolic BP decreased significantly after exercise at 50% and 75% of .VO(2peak). Diastolic BP increased significantly during the control session, did not change after exercise at 30% of .VO(2peak), and decreased significantly after exercise at 50% and 75% of .VO(2peak). This fall was greater and longer after more intense exercise. CO and systemic vascular resistance (SVR) responses were similar between sessions, CO increased ...
Postexercise hypotension and sympathoinhibition in borderline hypertensive men
Hypertension, 1989
To determine if there would be a decrease in blood pressure after exercise in patients with borderline hypertension and if this decrease would be accompanied by a decrease in sympathetic nerve activity to muscle, we recorded multifiber postganglionic muscle sympathetic activity from the peroneal nerve at rest in nine men with borderline hypertension (age 25 +/- 1 years, mean +/- SEM) before and 60 minutes after 45 minutes of submaximal treadmill exercise. In addition, responses to a cold pressor test, handgrip, and the Valsalva maneuver were recorded before and after exercise. Four subjects were also studied before and after "sham" exercise. Sham exercise had no effect on blood pressure or sympathetic nerve activity whereas resting systolic blood pressure was lower after treadmill exercise in seven subjects (from 136 +/- 4 before to 123 +/- 2 mm Hg 60 minutes after exercise; p less than 0.01). Sixty minutes after exercise, sympathetic nerve activity was lower in all seven ...
Clinical Interventions in Aging, 2015
Among all nonpharmacological treatments, aerobic or resistance training (RT) has been indicated as a significantly important strategy to control hypertension. However, postexercise hypotension responses after intensity alterations in RT are not yet fully understood. The purpose of this study was to compare the outcomes of differing intensities of RT on hypertensive older women. Twenty hypertensive older women participated voluntarily in this study. After a maximum voluntary contraction test (one repetition maximum) and determination of 40% and 80% experimental loads, the protocol (3 sets/90″ interset rest) was performed in a single session with the following exercises: leg press, leg extension, leg curl, chest press, elbow flexion, elbow extension, upper back row, and abdominal flexion. Systolic and diastolic blood pressures were evaluated at rest, during exercise peak, and after 5, 10, 15, 30, 45, and 60 minutes of exercise and compared to the control. Both experimental loads were effective (P,0.01) in promoting postexercise systolic hypotension (mmHg) compared to controls, after 30, 45, and 60 minutes, respectively, at 40% (113±2, 112±4, and 110±3 mmHg) and 80% (111±3, 111±4, and 110±4 mmHg). Both procedures promoted hypotension with similar systolic blood pressures (40%: −11%±1.0% and 80%: −13%±0.5%), mean arterial blood pressures (40%: −12%±5.5% and 80%: −12%±3.4%), and rate-pressure products (40%: −15%±2.1% and 80%: −17%±2.4%) compared to control measures (systolic blood pressure: 1%±1%, mean arterial blood pressure: 0.6%±1.5%, rate-pressure product: 0.33%±1.1%). No differences were found in diastolic blood pressure and heart rate measures. In conclusion, hypertensive older women exhibit postexercise hypotension independently of exercise intensity without expressed cardiovascular overload during the session.
International Journal of Cardiology, 2006
Hypertensive response at peak-exercise and during the recovery phase of exercise stress test (ET) is associated with poor cardiovascular prognosis. We investigated whether decrease in blood pressure (BP) from peak to post-exercise would identify a subgroup at higher cardiovascular risk. Eighty-six non-hypertensive patients (0-4 cardiovascular risk factors) with hypertensive reaction at peak-ET (systolic&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;180 mm Hg and/or diastolic&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;100 mm Hg) were divided based on BP 5 min after exercise termination into two groups: Normal response (NrmR) (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;160/90 mm Hg), Hypertensive response (HypR) (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;/=160/90 mm Hg). Five years later the prevalence of cardiovascular risk factors and cardiovascular morbidity and mortality was assessed for each group. Both groups had similar pre- and peak-exercise BP. However the HypR group had higher post-exercise BP (systolic: 163+/-13 vs. 125+/-14 mm Hg, respectively, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01, and diastolic: 74+/-6 vs. 75+/-4 mm Hg, respectively, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01), smaller decrease in BP after exercise (Delta systolic: 46.9+/-3.1 vs. 73.9+/-3.6 mm Hg, respectively, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01, Delta diastolic: 12.4+/-1.5 vs. 26.5+/-2.2 mm Hg, respectively, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01), and higher post- than pre-exercise BP (Delta systolic: 24.5+/-3.5 vs. -6+/-4.1 mm Hg, respectively, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01, A diastolic: 19+/-2.1 vs. -13+/-2.3 mm Hg, respectively, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01). Five years later, HypR group had higher prevalence of abnormal cholesterol serum level (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01), hypertension (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01) and combined ischemic heart disease and cerebrovascular disease (RR 1.32, 95% CI=1.13-1.54, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01). During ET evaluation, it is important to evaluate the BP at 5 min after exercise because reduced BP drop, at this routinely measured point, identifies a subgroup with higher cardiovascular risk.
Clinical Interventions in Aging, 2015
Among all nonpharmacological treatments, aerobic or resistance training (RT) has been indicated as a significantly important strategy to control hypertension. However, postexercise hypotension responses after intensity alterations in RT are not yet fully understood. The purpose of this study was to compare the outcomes of differing intensities of RT on hypertensive older women. Twenty hypertensive older women participated voluntarily in this study. After a maximum voluntary contraction test (one repetition maximum) and determination of 40% and 80% experimental loads, the protocol (3 sets/90″ interset rest) was performed in a single session with the following exercises: leg press, leg extension, leg curl, chest press, elbow flexion, elbow extension, upper back row, and abdominal flexion. Systolic and diastolic blood pressures were evaluated at rest, during exercise peak, and after 5, 10, 15, 30, 45, and 60 minutes of exercise and compared to the control. Both experimental loads were effective (P,0.01) in promoting postexercise systolic hypotension (mmHg) compared to controls, after 30, 45, and 60 minutes, respectively, at 40% (113±2, 112±4, and 110±3 mmHg) and 80% (111±3, 111±4, and 110±4 mmHg). Both procedures promoted hypotension with similar systolic blood pressures (40%: −11%±1.0% and 80%: −13%±0.5%), mean arterial blood pressures (40%: −12%±5.5% and 80%: −12%±3.4%), and rate-pressure products (40%: −15%±2.1% and 80%: −17%±2.4%) compared to control measures (systolic blood pressure: 1%±1%, mean arterial blood pressure: 0.6%±1.5%, rate-pressure product: 0.33%±1.1%). No differences were found in diastolic blood pressure and heart rate measures. In conclusion, hypertensive older women exhibit postexercise hypotension independently of exercise intensity without expressed cardiovascular overload during the session.
Journal of Human Hypertension, 2010
A single bout of exercise lowers blood pressure (BP) for up to 24 h afterwards. The magnitude of this post-exercise hypotension (PEH) has been reported to be correlated most strongly to pre-exercise BP, and this apparent relationship has influenced position statements about the value of exercise in arterial hypertension. Nevertheless, this correlation could be adversely affected by mathematical coupling and regression-to-the-mean artefacts. Therefore, we aimed to examine the degree to which BP status moderates PEH while, for the first time, controlling for these statistical artefacts. A total of 32 participants, with preexercise mean arterial pressures of 65-110 mm Hg, cycled for 30 min at 70% peak oxygen uptake. Systolic BP and diastolic BP were measured (Portapres) before exercise and for 20 min after exercise. Changes in BP were regressed against pre-exercise values, and against the mean of pre-and post-exercise BP, among other indices that are also known not to be prone to artefacts. Correlations between pre-exercise BP and the exercisemediated reductions were typical of those previously reported (r ¼ 0.37-0.62, Po0.05), but not large enough to rule out spuriousness (P40.05). Artefact-free indices of BP status (pre-and post-exercise mean as well as an earlier independent measurement) did not correlate with reductions in BP (P40.05), which were moderated more by peak oxygen uptake and time of day (Po0.05). These data indicate that, if statistical artefacts are not controlled for, the influence of BP status on the degree of PEH can be spuriously exaggerated to the extent that other more important moderators of BP change are masked.