RESUMO
Postexercise reduction in blood pressure, termed postexercise hypotension (PEH), is relevant for both acute and chronic health reasons and potentially for peripheral cardiovascular adaptations. We investigated the interactive effects of exercise intensity and recovery postures (seated, supine, and standing) on PEH. Thirteen normotensive men underwent a VÌo2max test on a cycle ergometer and five exhaustive constant load trials to determine critical power (CP) and the gas exchange threshold (GET). Subsequently, work-matched exercise trials were performed at two discrete exercise intensities (10% > CP and 10% < GET), with 1 h of recovery in each of the three postures. For both exercise intensities, standing posture resulted in a more substantial PEH (all P < 0.01). For both standing and seated recovery postures, the higher exercise intensity led to larger reductions in systolic [standing: -33 (11) vs. -21 (8) mmHg; seated: -34 (32) vs. -17 (37) mmHg, P < 0.01], diastolic [standing: -18 (7) vs. -8 (5) mmHg; seated: -10 (10) vs. -1 (4) mmHg, P < 0.01], and mean arterial pressures [-13 (8) vs. -2 (4) mmHg, P < 0.01], whereas in the supine recovery posture, the reduction in diastolic [-9 (9) vs. -4 (3) mmHg, P = 0.08) and mean arterial pressures [-7 (5) vs. -3 (4) mmHg, P = 0.06] was not consistently affected by prior exercise intensity. PEH is more pronounced during recovery from exercise performed above CP versus below GET. However, the effect of exercise intensity on PEH is largely abolished when recovery is performed in the supine posture.NEW & NOTEWORTHY The magnitude of postexercise hypotension is greater following the intensity above the critical power in a standing position.
Assuntos
Pressão Sanguínea , Exercício Físico , Hipotensão Pós-Exercício , Postura , Humanos , Masculino , Exercício Físico/fisiologia , Adulto , Pressão Sanguínea/fisiologia , Postura/fisiologia , Hipotensão Pós-Exercício/fisiopatologia , Adulto Jovem , Decúbito Dorsal , Recuperação de Função Fisiológica , Posição Ortostática , Postura Sentada , Hipotensão/fisiopatologia , Consumo de OxigênioRESUMO
Blood pressure (BP) reduction occurs after a single bout of exercise, referred to as postexercise hypotension (PEH). The clinical importance of PEH has been advocated owing to its potential contribution to chronic BP lowering, and as a predictor of responders to exercise training as an antihypertensive therapy. However, the mechanisms underlying PEH have not been well defined. This study undertook a scoping review of research on PEH mechanisms, as disclosed in literature reviews. We searched the PubMed, Web of Science, Scopus, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and Sport Discus databases until January 2023 to locate 21 reviews - 13 narrative, four systematic with 102 primary trials, and four meta-analyses with 75 primary trials involving 1566 participants. We classified PEH mechanisms according to major physiological systems, as central (autonomic nervous system, baroreflex, cardiac) or peripheral (vascular, hemodynamic, humoral, and renal). In general, PEH has been related to changes in autonomic control leading to reduced cardiac output and/or sustained vasodilation. However, the role of autonomic control in eliciting PEH has been challenged in favor of local vasodilator factors. The contribution of secondary physiological outcomes to changes in cardiac output and/or vascular resistance during PEH remains unclear, especially by exercise modality and population (normal vs. elevated BP, young vs. older adults). Further research adopting integrated approaches to investigate the potential mechanisms of PEH is warranted, particularly when the magnitude and duration of BP reductions are clinically relevant. (PROSPERO CRD42021256569).
Assuntos
Exercício Físico , Hipotensão Pós-Exercício , Humanos , Hipotensão Pós-Exercício/fisiopatologia , Exercício Físico/fisiologia , Pressão Sanguínea/fisiologia , Sistema Nervoso Autônomo/fisiopatologia , Barorreflexo/fisiologia , Hemodinâmica , Hipotensão/fisiopatologiaRESUMO
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.
Assuntos
Pressão Sanguínea , Exercício Físico , Hipotensão Pós-Exercício , Pós-Menopausa , Pré-Menopausa , Humanos , Feminino , Pós-Menopausa/fisiologia , Exercício Físico/fisiologia , Hipotensão Pós-Exercício/fisiopatologia , Pré-Menopausa/fisiologia , Pressão Sanguínea/fisiologia , Hipotensão/fisiopatologia , Pessoa de Meia-Idade , Hipertensão/fisiopatologiaRESUMO
Unstable blood pressure after spinal cord injury (SCI) is not routinely examined but rather predicted by level and completeness of injury (i.e., American Spinal Injury Association Impairment Scale AIS classification). Our aim was to investigate hemodynamic response to a sit-up test in a large cohort of individuals with chronic SCI to better understand cardiovascular function in this population. Continuous blood pressure and ECG were recorded from individuals with SCI (n = 159) and non-injured individuals (n = 48). We found orthostatic hypotension occurred within each level and AIS classification (n = 36). Moreover, 45 individuals with chronic SCI experienced a drop in blood pressure that did not meet the criteria for orthostatic hypotension, but was accompanied by dramatic increases in heart rate, reflecting orthostatic intolerance. A cluster analysis of hemodynamic response to a seated position identified eight distinct patterns of interaction between blood pressure and heart rate during orthostatic stress indicating varied autonomic responses. Algorithmic cluster analysis of heart rate and blood pressure is more sensitive to diagnosing orthostatic cardiovascular dysregulation. This indicates blood pressure instability cannot be predicted by level and completeness of SCI, and the consensus statement definition of orthostatic hypotension is insufficient to characterize the variability of blood pressure and heart rate responses during orthostatic stress. Both blood pressure and heart rate responses are needed to characterize autonomic function after SCI.
Assuntos
Pressão Sanguínea , Frequência Cardíaca , Hipotensão Pós-Exercício/fisiopatologia , Traumatismos da Medula Espinal/fisiopatologia , Adulto , Sistema Nervoso Autônomo/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hipotensão Pós-Exercício/etiologia , Traumatismos da Medula Espinal/complicaçõesRESUMO
BACKGROUND: Post-exercise hypotension (PEH) is greater after evening than morning exercise, but antihypertensive drugs may affect the evening potentiation of PEH. Objective: To compare morning and evening PEH in hypertensives receiving angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARB). METHODS: Hypertensive men receiving ACEi (n = 14) or ARB (n = 15) underwent, in a random order, two maximal exercise tests (cycle ergometer, 15 watts/min until exhaustion) with one conducted in the morning (7 and 9 a.m.) and the other in the evening (8 and 10 p.m.). Auscultatory blood pressure (BP) was assessed in triplicate before and 30 min after the exercises. Changes in BP (post-exercise - pre-exercise) were compared between the groups and the sessions using a two-way mixed ANOVA and considering P < .05 as significant. RESULTS: In the ARB group, systolic BP decrease was greater after the evening than the morning exercise, while in the ACEi group, it was not different after the exercises conducted at the different times of the day. Additionally, after the evening exercise, systolic BP decrease was lower in the ACEi than the ARB group (ARB = -11 ± 8 vs -6 ± 6 and ACEi = -6 ± 7 vs. -8 ± 5 mmHg, evening vs. morning, respectively, P for interaction = 0.014). CONCLUSIONS: ACEi, but not ARB use, blunts the greater PEH that occurs after exercise conducted in the evening than in the morning.
Assuntos
Antagonistas de Receptores de Angiotensina/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Hipotensão Pós-Exercício/tratamento farmacológico , Adulto , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Exercício Físico/fisiologia , Terapia por Exercício , Humanos , Masculino , Pessoa de Meia-Idade , Hipotensão Pós-Exercício/fisiopatologia , Adulto JovemRESUMO
BACKGROUND: Drinking water is recommended before and after exercise to avoid dehydration. However, water ingestion may mitigate or prevent postexercise hypotension. This study investigated the effects of intentional hydration on postaerobic exercise hemodynamics and autonomic modulation. METHODS: A total of 18 young men randomly underwent 4 experimental sessions as follows: (1) control with intentional hydration (1 L of water in the previous night, 500 mL 60 min before the intervention, and 1 mL for each 1 g of body mass lost immediately after the intervention); (2) control without intentional hydration (ad libitum water ingestion before the intervention); (3) exercise (cycle ergometer, 45 min, 50% of VO2peak) with intentional hydration; and (4) exercise without intentional hydration. Hemodynamic and autonomic parameters were measured before and after the interventions and were compared by 3-way analysis of variance. RESULTS: Intentional hydration did not change any postexercise hemodynamic nor autonomic response. Exercise decreased systolic blood pressure and stroke volume (-4.1 [0.8] mm Hg and -4.9 [1.5] mL, P < .05), while increased cardiac sympathovagal balance (0.3 [0.3], P < .05) during the recovery. In addition, it abolished the increase in diastolic blood pressure and the decrease in heart rate observed in the control sessions. CONCLUSION: Intentional hydration does not modify the hypotensive effect promoted by previous aerobic exercise and did not alter its hemodynamic and autonomic mechanisms.
Assuntos
Exercício Físico/fisiologia , Hipotensão Pós-Exercício/fisiopatologia , Adulto , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Adulto JovemRESUMO
Background and objective: Post-exercise hypotension, the reduction of blood pressure after a bout of exercise, is of great clinical relevance. Resistance exercise training is considered an important contribution to exercise training programs for hypertensive individuals and athletes. In this context, post-exercise hypotension could be clinically relevant because it would maintain blood pressure of hypertensive individuals transiently at lower levels during day-time intervals, when blood pressure is typically at its highest levels. The aim of this study was to compare the post-exercise cardiovascular effects on Paralympic powerlifting athletes of two typical high-intensity resistance-training sessions, using either five sets of five bench press repetitions at 90% 1 repetition maximum (1RM) or five sets of three bench press repetitions at 95% 1RM. Materials and Methods: Ten national-level Paralympic weightlifting athletes (age: 26.1 ± 6.9 years; body mass: 76.8 ± 17.4 kg) completed the two resistance-training sessions, one week apart, in a random order. Results: Compared with baseline values, a reduction of 5-9% in systolic blood pressure was observed after 90% and 95% of 1RM at 20-50 min post-exercise. Furthermore, myocardial oxygen volume and double product were only significantly increased immediately after and 5 min post-exercise, while the heart rate was significantly elevated after the resistance training but decreased to baseline level by 50 min after training for both training conditions. Conclusions: A hypotensive response can be expected in elite Paralympic powerlifting athletes after typical high-intensity type resistance-training sessions.
Assuntos
Exercício Físico/fisiologia , Paratletas , Hipotensão Pós-Exercício/etiologia , Levantamento de Peso/fisiologia , Adulto , Pressão Sanguínea/fisiologia , Determinação da Pressão Arterial/métodos , Brasil , Humanos , Masculino , Hipotensão Pós-Exercício/fisiopatologia , Treinamento Resistido/efeitos adversos , Treinamento Resistido/métodos , Levantamento de Peso/lesõesRESUMO
Given the scarcity of studies with elderly and the existence of studies investigating the effect of vitamin D supplementation in PEH (post exercise hypotension), this study evaluated the effect of a single megadose of vitamin D on resting blood pressure (RBP) and post-exercise hypotension (PEH) in the elderly. 11 hypertensive elderly women (70.3 ± 1.7 years) received a single megadose of 200.000 IU of cholecalciferol or a placebo, orally, through capsules. On day 7, the subjects performed 30 minutes of aerobic exercise with blood pressure measurement before exercise and every 10 minutes after exercise during 60 minutes, besides cardiac autonomic modulation. RBP did not significantly change. Exercise promoted significant systolic PEH only in one moment post exercise in treated group and in the placebo group promoted significant systolic PEH at four moments. Significant diastolic PEH did not occur in any of the groups. Sympathovagal activity increased at post exercise balance in supplemented subjects at 20 min, 40 min, 50 min and 60 min when compared to rest; this increase was not observed in the placebo. A megadose of vitamin D did not reduce RBP, promoted partial inhibition of systolic PEH and increased sympathovagal balance.
Assuntos
Sistema Nervoso Autônomo/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Hipotensão Pós-Exercício/tratamento farmacológico , Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/administração & dosagem , Idoso , Sistema Nervoso Autônomo/fisiopatologia , Pressão Sanguínea/fisiologia , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Humanos , Masculino , Projetos Piloto , Hipotensão Pós-Exercício/fisiopatologia , Deficiência de Vitamina D/fisiopatologiaRESUMO
Tomeleri, CM, Nunes, JP, Souza, MF, Gerage, AM, Marcori, A, Iarosz, KC, Cardoso-Júnior, CG, and Cyrino, ES. Resistance exercise order does not affect the magnitude and duration of postexercise blood pressure in older women. J Strength Cond Res 34(4): 1062-1070, 2020-The aim of this study was to compare the effects of 2 resistance exercise order on postexercise blood pressure (BP) in trained nonhypertensive older women. Sixteen women (68.3 ± 3.3 years, 63.5 ± 11.6 kg, 157.5 ± 5.1 cm) performed 2 sessions with 8 exercises (3 sets of 8-12 repetitions) in distinct orders (from multi- to single-joint exercises [MS] or from single- to multijoint exercises [SM]) and a control session (CS), without exercise. Blood pressure and heart rate (HR) were obtained pre- and postsessions (60 minutes). Postexercise hypotension was observed for systolic BP (SBP) and mean BP in both the MS session (SBP: -6.9 mm Hg, mean BP: -3.3 mm Hg, p ≤ 0.05) and SM session (SBP: -4.6 mm Hg; mean BP: -1.1 mm Hg). Postexercise HR was higher than presession values until 30 minutes of recovery in both training sessions. Furthermore, SBP and mean BP, and HR were lower than the values obtained in the CS (30-60 minutes and 0 minutes, respectively; p ≤ 0.05). There were no differences between the SM and MS sessions in any variable or at any moment. In conclusion, resistance exercise order does not interfere in the magnitude and duration of postexercise hypotension in trained nonhypertensive older women.
Assuntos
Pressão Sanguínea/fisiologia , Hipotensão Pós-Exercício/fisiopatologia , Treinamento Resistido/métodos , Idoso , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
INTRODUCTION: High salt intake is a widespread cardiovascular risk factor with systemic effects. These effects include an expansion of plasma volume, which may interfere with postexercise hypotension (PEH). However, the effects of high salt intake on central and peripheral indices of PEH remain unknown. We tested the hypothesis that high salt intake would attenuate central and peripheral PEH. METHODS: Nineteen healthy adults (7 female/12 male; age, 25 ± 4 yr; body mass index, 23.3 ± 2.2 kg·m; V[Combining Dot Above]O2peak, 41.6 ± 8.7 mL·min·kg; systolic blood pressure (BP), 112 ± 9 mm Hg; diastolic BP, 65 ± 9 mm Hg) participated in this double-blind, randomized, placebo-controlled crossover study. Participants were asked to maintain a 2300 mg·d sodium diet for 10 d on two occasions separated by ≥2 wk. Total salt intake was manipulated via ingestion of capsules containing either table salt (3900 mg·d) or placebo (dextrose) during each diet. On the 10th day, participants completed 50 min of cycling at 60% V[Combining Dot Above]O2peak. A subset of participants (n = 8) completed 60 min of seated rest (sham trial). Beat-to-beat BP was measured in-laboratory for 60 min after exercise via finger photoplethysmography. Brachial and central BPs were measured for 24 h after exercise via ambulatory BP monitor. RESULTS: Ten days of high salt intake increased urinary sodium excretion (134 ± 70 (dextrose) vs 284 ± 74 mmol per 24 h (salt), P < 0.001), expanded plasma volume (7.2% ± 10.8%), and abolished PEH during in-laboratory BP monitoring (main effect of diet, P < 0.001). Ambulatory systolic BPs were higher for 12 h after exercise during the salt and sham trials compared with the dextrose trial (average change, 3.6 ± 2.1 mm Hg (dextrose), 9.9 ± 1.4 mm Hg (salt), 9.8 ± 2.5 mm Hg (sham); P = 0.01). Ambulatory central systolic BP was also higher during the salt trial compared with dextrose trial. CONCLUSION: High salt intake attenuates peripheral and central PEH, potentially reducing the beneficial cardiovascular effects of acute aerobic exercise.
Assuntos
Hipotensão Pós-Exercício/fisiopatologia , Sódio na Dieta/administração & dosagem , Adulto , Pressão Sanguínea/fisiologia , Volume Sanguíneo/fisiologia , Estudos Cross-Over , Método Duplo-Cego , Exercício Físico/fisiologia , Feminino , Humanos , Masculino , Hipotensão Pós-Exercício/urina , Sódio/urina , Adulto JovemRESUMO
OBJECTIVE: This study compared resting blood pressure (BP) using ambulatory BP monitoring (ABPM) responses in two groups of subjects trained in land exercise (LE) and aquatic exercise (AE), and assessed post-exercise hypotension (PEH) using ABPM, after land- and aquatic-based exercises. METHODS: ABPM (24 hours) was used to measure the baseline BP in elderly hypertensive women trained in LE and AE and the PEH induced by exercise. For this, 40 subjects were evaluated at rest and after a land- or aquatic-based exercise session (aerobic: 75% of reserve heart rate combined with resistance exercise). RESULTS: The daytime BP was lower for AE [systolic BP (SBP) 124 ± 1.0 mmHg, diastolic BP (DBP) 70 ± 1.5 mmHg] than for LE (SBP 134 ± 0.9 mmHg, DBP 76 ± 0.9 mmHg), but there were no differences at night-time. The aquatic exercise-induced PEH in the second hour was maintained at the 24th hour post-exercise. For land exercise-induced PEH, it was maintained at the 12th hour post-exercise. The SBP and DBP were lower at the 24th hour for AE than for LE. CONCLUSIONS: Elderly hypertensive people trained in AE had lower baseline BP during the daytime. SBP and DBP values were lower for individuals trained in AE, and their PEH was more rapid and longer lasting after AE.
Assuntos
Pressão Sanguínea , Terapia por Exercício/métodos , Hipertensão/terapia , Hipotensão Pós-Exercício/fisiopatologia , Fatores Etários , Idoso , Monitorização Ambulatorial da Pressão Arterial , Brasil , Aptidão Cardiorrespiratória , Terapia por Exercício/efeitos adversos , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Imersão , Pessoa de Meia-Idade , Hipotensão Pós-Exercício/diagnóstico , Treinamento Resistido , Fatores Sexuais , Fatores de Tempo , Resultado do Tratamento , ÁguaRESUMO
The present crossover design study investigated acute hemodynamic responses to two sets of leg press (LP) and bench press (BeP) at 10 and 20 repetition maximum (RM) in ten normotensive young men. At the end of each set, an increase in systolic blood pressure (SBP), heart rate (HR), and rate pressure product (RPP) was observed (p < .01), with no differences between intensities, but SBP was greater during the LP exercise (p < .01). Lower resting values of diastolic blood pressure (DBP) were observed in the post-BeP exercise period (p < .05), suggesting that DBP post-exercise hypotension may be more evident after upper-limb exercise.
Assuntos
Pressão Sanguínea/fisiologia , Exercício Físico/fisiologia , Extremidades , Hipotensão Pós-Exercício , Treinamento Resistido , Adulto , Estudos Cross-Over , Extremidades/irrigação sanguínea , Extremidades/fisiopatologia , Voluntários Saudáveis , Frequência Cardíaca/fisiologia , Hemodinâmica/fisiologia , Humanos , Masculino , Hipotensão Pós-Exercício/diagnóstico , Hipotensão Pós-Exercício/etiologia , Hipotensão Pós-Exercício/fisiopatologia , Treinamento Resistido/efeitos adversos , Treinamento Resistido/métodos , Descanso/fisiologiaRESUMO
We studied the effects of supramaximal interval exercise (SIE) with or without antihypertensive medication (AHM) on 21-hr blood pressure (BP) response. Twelve hypertensive patients chronically medicated with AHM, underwent three trials in a randomized order: a) control trial without exercise and substituting their AHM with a placebo (PLAC); b) placebo medicine and a morning bout of SIE (PLAC+SIE), and c) combining AHM and exercise (AHM+SIE). Acute and ambulatory blood pressure responses were measured for 21-hr after treatment. 20 min after treatment, systolic blood pressure (SBP) readings were reduced, similar to readings after PLAC+SIE (-9.7±6.0 mmHg, P<0.001) and AHM+SIE (-10.4±7.9 mmHg, P=0.001). 21 h after treatment, SBP remained reduced after PLAC+SIE (125±12 mmHg, P=0.022) and AHM+SIE (122±12 mmHg, P=0.013) compared to PLAC (132±16 mmHg). The BP reduction in PLAC+SIE faded out at 4 a.m., while in AHM+SIE it continued overnight. At night, BP reduction was larger in AHM+SIE than PLAC+SIE (-5.6±4.0 mmHg, P=0.006). Our data shows that a bout of supramaximal aerobic interval exercise in combination with ARB medication in the morning elicits a sustained blood pressure reduction lasting at least 21-h. Thus, the combination of exercise and angiotensin receptor blocker medication seems superior to exercise alone for acutely decreasing blood pressure.
Assuntos
Anti-Hipertensivos/uso terapêutico , Treinamento Intervalado de Alta Intensidade , Hipertensão/tratamento farmacológico , Hipertensão/fisiopatologia , Hipotensão Pós-Exercício/fisiopatologia , Actigrafia/métodos , Idoso , Pressão Sanguínea/fisiologia , Estudos Cross-Over , Método Duplo-Cego , Feminino , Monitores de Aptidão Física , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Postura/fisiologia , Estudos de Tempo e MovimentoRESUMO
Post-exercise hypotension (PEH) is a common physiological phenomenon leading to lower blood pressure after acute exercise, but it is not fully understood how this intriguing response occurs. This study investigated whether the nitrate-reducing activity of oral bacteria is a key mechanism to trigger PEH. Following a randomized, double blind and crossover design, twenty-three healthy individuals (15 males/8 females) completed two treadmill trials at moderate intensity. After exercise, participants rinsed their mouth with antibacterial mouthwash to inhibit the activity of oral bacteria or a placebo mouthwash. Blood pressure was measured before, 1h and 2â¯h after exercise. The microvascular response to a reactive hyperaemia test, as well as blood and salivary samples were taken before and 2â¯h after exercise to analyse nitrate and nitrite concentrations and the oral microbiome. As expected, systolic blood pressure (SBP) was lower (1â¯h: -5.2⯱â¯1.0â¯mmHg; Pâ¯<â¯0.001); 2â¯h: -3.8⯱â¯1.1â¯mmHg, Pâ¯=â¯0.005) after exercise compared to baseline in the placebo condition. This was accompanied by an increase of circulatory nitrite 2â¯h after exercise (2h: 100⯱â¯13â¯nM) compared to baseline (59⯱â¯9â¯nM; Pâ¯=â¯0.013). Additionally, an increase in the peak of the tissue oxygenation index (TOI) during the reactive hyperaemia response was observed after exercise (86.1⯱â¯0.6%) compared to baseline levels (84.8⯱â¯0.5%; Pâ¯=â¯0.010) in the placebo condition. On the other hand, the SBP-lowering effect of exercise was attenuated by 61% at 1â¯h in the recovery period, and it was fully attenuated 2â¯h after exercise with antibacterial mouthwash. This was associated with a lack of changes in circulatory nitrite (Pâ¯>â¯0.05), and impaired microvascular response (peak TOI baseline: 85.1⯱â¯3.1%; peak TOI post-exercise: 84.6⯱â¯3.2%; Pâ¯>â¯0.05). Diversity of oral bacteria did not change after exercise in any treatment. These findings show that nitrite synthesis by oral commensal bacteria is a key mechanism to induce the vascular response to exercise over the first period of recovery thereby promoting lower blood pressure and greater muscle oxygenation.
Assuntos
Bactérias/crescimento & desenvolvimento , Exercício Físico , Hiperemia/fisiopatologia , Boca/microbiologia , Músculo Esquelético/metabolismo , Nitratos/farmacologia , Hipotensão Pós-Exercício/fisiopatologia , Adulto , Bactérias/efeitos dos fármacos , Estudos Cross-Over , Método Duplo-Cego , Feminino , Humanos , Hiperemia/tratamento farmacológico , Hiperemia/metabolismo , Hiperemia/microbiologia , Masculino , Boca/efeitos dos fármacos , Antissépticos Bucais/farmacologia , Músculo Esquelético/efeitos dos fármacos , Hipotensão Pós-Exercício/tratamento farmacológico , Hipotensão Pós-Exercício/metabolismo , Hipotensão Pós-Exercício/microbiologia , Saliva/efeitos dos fármacos , Saliva/microbiologiaRESUMO
Abstract Background: Studies have persuasively demonstrated that citrulline has a key role in the arginine-nitric oxide system, increasing nitric oxide bioavailability, an important mediator of peripheral vasodilation. Objective: To analyze the inter-individual post-exercise hypotension responsiveness following acute citrulline supplementation in hypertensives. Methods: Forty hypertensives were randomly assigned to one of the four experimental groups (control-placebo, control-citrulline, exercise-placebo, and exercise-citrulline). They ingested placebo or citrulline malate [CM] (6 grams). During the exercise session, individuals performed 40 minutes of walking/running on a treadmill at 60-70% of HR reserve. For the control session, the individuals remained seated at rest for 40 minutes. Office blood pressure (BP) was taken every 10 minutes until completing 60 minutes after the experimental session. The ambulatory BP device was programmed to take the readings every 20 minutes (awake time) and every 30 minutes (sleep time) over the course of 24 hours of monitoring. Statistical significance was defined as p < 0.05. Results: Unlike the other experimental groups, there were no "non-responders" in the exercise/citrulline (EC) for "awake" (systolic and diastolic BP) and "24 hours" (diastolic BP). The effect sizes were more consistent in the EC for systolic and diastolic ambulatorial BP response. The effects were "large" (> 0.8) for "awake", "asleep", and "24 hours" only in the EC for diastolic BP. Conclusion: CM supplementation can increase the post-exercise hypotensive effects in hypertensives. In addition, the prevalence of non-responders is lower when associated with aerobic exercise and CM supplementation.
Resumo Fundamento: Estudos demonstraram de maneira persuasiva que a citrulina tem um papel fundamental no sistema arginina-óxido nítrico, aumentando a biodisponibilidade do óxido nítrico, um importante mediador da vasodilatação periférica. Objetivo: Analisar a responsividade interindividual da hipotensão pós-exercício após suplementação aguda com citrulina em hipertensos. Métodos: Quarenta hipertensos foram aleatoriamente designados para um dos quatro grupos experimentais (controle-placebo, controle-citrulina, exercício-placebo e exercício-citrulina). Eles ingeriram placebo ou citrulina malato [CM] (6 gramas). Durante a sessão de exercício, os indivíduos realizaram 40 minutos de caminhada/corrida em esteira a 60-70% da FC de reserva. Para a sessão de controle, os indivíduos permaneceram sentados em repouso por 40 minutos. A medida da pressão arterial (PA) no consultório foi realizada a cada 10 minutos até completar 60 minutos após a sessão experimental. O dispositivo ambulatorial de PA foi programado para fazer as leituras a cada 20 minutos (tempo de vigília) e a cada 30 minutos (tempo de sono) ao longo de 24 horas de monitoramento. A significância estatística foi definida como p < 0,05. Resultados: Diferentemente de outros grupos experimentais, não houve "não respondedores" no exercício/citrulina (EC) para "acordado" (PA sistólica e diastólica) e "24 horas" (PA diastólica). Os tamanhos de efeito foram mais consistentes no EC para a resposta sistólica e diastólica da PA ambulatorial. Os efeitos foram "grandes" (> 0,8) para "acordado", "dormindo", e para "24 horas" apenas no EC para a PA diastólica. Conclusão: A suplementação com CM pode aumentar os efeitos hipotensivos pós-exercício em hipertensos. Além disso, a prevalência de "não respondedores" é menor quando associada ao exercício aeróbico e à suplementação com CM.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Vasodilatadores/farmacologia , Pressão Sanguínea/efeitos dos fármacos , Exercício Físico/fisiologia , Citrulina/análogos & derivados , Hipotensão Pós-Exercício/fisiopatologia , Hipertensão/fisiopatologia , Malatos/farmacologia , Arginina/metabolismo , Valores de Referência , Fatores de Tempo , Efeito Placebo , Antropometria , Método Duplo-Cego , Análise de Variância , Resultado do Tratamento , Citrulina/farmacologia , Estatísticas não Paramétricas , Teste de Esforço , Hipertensão/terapia , Óxido Nítrico/metabolismoRESUMO
BACKGROUND: Studies have persuasively demonstrated that citrulline has a key role in the arginine-nitric oxide system, increasing nitric oxide bioavailability, an important mediator of peripheral vasodilation. OBJECTIVE: To analyze the inter-individual post-exercise hypotension responsiveness following acute citrulline supplementation in hypertensives. METHODS: Forty hypertensives were randomly assigned to one of the four experimental groups (control-placebo, control-citrulline, exercise-placebo, and exercise-citrulline). They ingested placebo or citrulline malate [CM] (6 grams). During the exercise session, individuals performed 40 minutes of walking/running on a treadmill at 60-70% of HR reserve. For the control session, the individuals remained seated at rest for 40 minutes. Office blood pressure (BP) was taken every 10 minutes until completing 60 minutes after the experimental session. The ambulatory BP device was programmed to take the readings every 20 minutes (awake time) and every 30 minutes (sleep time) over the course of 24 hours of monitoring. Statistical significance was defined as p < 0.05. RESULTS: Unlike the other experimental groups, there were no "non-responders" in the exercise/citrulline (EC) for "awake" (systolic and diastolic BP) and "24 hours" (diastolic BP). The effect sizes were more consistent in the EC for systolic and diastolic ambulatorial BP response. The effects were "large" (> 0.8) for "awake", "asleep", and "24 hours" only in the EC for diastolic BP. CONCLUSION: CM supplementation can increase the post-exercise hypotensive effects in hypertensives. In addition, the prevalence of non-responders is lower when associated with aerobic exercise and CM supplementation.
Assuntos
Pressão Sanguínea/efeitos dos fármacos , Citrulina/análogos & derivados , Exercício Físico/fisiologia , Hipertensão/fisiopatologia , Malatos/farmacologia , Hipotensão Pós-Exercício/fisiopatologia , Vasodilatadores/farmacologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Antropometria , Arginina/metabolismo , Citrulina/farmacologia , Método Duplo-Cego , Teste de Esforço , Feminino , Humanos , Hipertensão/terapia , Masculino , Pessoa de Meia-Idade , Óxido Nítrico/metabolismo , Efeito Placebo , Valores de Referência , Estatísticas não Paramétricas , Fatores de Tempo , Resultado do TratamentoRESUMO
PURPOSE: Physical exercise is associated with reduced blood pressure (BP). Moderate-intensity continuous exercise (MCE) promotes post-exercise hypotension (PEH), which is highly recommended to hypertensive patients. However, recent studies with high-intensity interval exercise (HIIE) have shown significant results in cardiovascular disease. Thus, this study aimed to analyze PEH in hypertensive subjects submitted to HIIE and compare it to post MCE hypotension. METHODS: 20 hypertensive adults (51 ± 8 years), treated with antihypertensive medications, were submitted to two different exercise protocols and a control session. The MCE was performed at 60-70% of VO2 reserve, while HIIE was composed of five bouts of 3 min at 85-95% VO2 reserve with 2 min at 50% of VO2 reserve. The following variables were evaluated during exercise, pre- and post-session: clinical BP, heart rate (HR), double product, perception of effort, body mass, height and body mass index. RESULTS: Systolic BP decreased after exercise in both sessions, showing greater decrease after HIIE (- 7 ± 10 and - 11 ± 12 mmHg, after MCE and HIIE, respectively, p ≤ 0.01). Diastolic BP also decreased after both sessions, but there were no significant differences between the two sessions (- 4 ± 8 and - 7 ± 8 mmHg, after MCE and HIIE, respectively). CONCLUSION: Both exercise sessions produced PEH, but HIIE generated a greater magnitude of hypotension. The HIIE protocol performed in this study caused a greater cardiovascular stress during exercise; however, it was safe for the studied population and efficient for reducing BP after exercise.
Assuntos
Treinamento Intervalado de Alta Intensidade/efeitos adversos , Hipotensão Pós-Exercício/etiologia , Adulto , Pressão Sanguínea , Feminino , Frequência Cardíaca , Treinamento Intervalado de Alta Intensidade/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Consumo de Oxigênio , Hipotensão Pós-Exercício/fisiopatologiaRESUMO
Paz, GA, Iglesias-Soler, E, Willardson, JM, Maia, MdF, and Miranda, H. Postexercise hypotension and heart rate variability responses subsequent to traditional, paired set, and superset resistance training methods. J Strength Cond Res 33(9): 2433-2442, 2019-The purpose of this study was to compare training volume, postexercise hypotension (PEH), and heart rate variability (HRV) responses to different strength training methods. Thirteen trained men volunteered for this study. Three training methods were completed in a randomized design, which included: Traditional Set (TS)-3 successive sets for the lying bench press (LBP), lat pulldown (LPD), incline 45° bench press (BP45), seated close-grip row (SCR), triceps extension (TE), and biceps curl (BC), with a 90-second rest interval between sets and exercises; Paired Set (PS)-3 paired sets for the LBP-LPD, BP45-SCR, and TE-BC, with a 90-second rest interval between sets and exercises; and superset (SS)-3 supersets for the LBP-LPD, BP45-SCR, and TE-BC. During the SS session, no rest was permitted between PSs, followed by 180 seconds of rest after each SS. Ten repetition-maximum (RM) loads were adopted for all exercises. Blood pressure (BP) and HRV were measured at baseline, immediately aftersession, and at 10-minute intervals until 60 minutes after session. Significantly greater training volume was noted under the SS method (8,608.6 ± 2,062.2 kg) vs. the TS method (7,527.5 ± 2,365.1 kg), respectively. Significantly greater training volume was also observed under the PS method (8,262.3 ± 2,491.2 kg) vs. the TS method (p ≤ 0.05). No main effects for HRV and PEH were noted between protocols (p > 0.05). However, similar PEH response intraprotocols were observed for the TS, PS, and SS methods (p ≤ 0.05). Considering the duration of the PEH intraprotocol, large effect sizes were noted for the SS and PS methods vs. the TS method in diastolic and mean BP. Therefore, both the PS and SS methods may be an alternative to the TS method to achieve greater total repetitions and training volume with a tendency toward a longer PEH response.
Assuntos
Pressão Sanguínea , Frequência Cardíaca , Hipotensão Pós-Exercício/fisiopatologia , Treinamento Resistido/métodos , Adulto , Estudos Cross-Over , Humanos , Masculino , Hipotensão Pós-Exercício/etiologia , Distribuição Aleatória , Treinamento Resistido/efeitos adversos , Descanso/fisiologia , Adulto JovemRESUMO
The aim of this study was to compare the hemodynamic and salivary responses after mat Pilates, aerobics, resistance exercises, and control. A total of 16 normotensive postmenopausal women performed: Pilates, 10 floor exercises; aerobics, 35 min on a treadmill (60-70% of heart rate reserve); resistance exercises, 60% of one-repetition maximum; and control, no physical exercise. Blood pressure and heart rate variability were evaluated at rest and 60 min after the intervention. Saliva samples were collected at rest, immediately after, and 30 and 60 min after exercise for analysis of nitrite concentration and total proteins. Systolic blood pressure, diastolic blood pressure, and mean blood pressure area under the curve were lower (p < .05) after both aerobic and resistance exercises sessions but not after the Pilates session when compared with the control session. Nitrite concentrations in saliva were higher 60 min after the end of all exercise sessions. Heart rate variability was higher after the resistance exercise. Aerobic and resistance exercises were capable of decreasing arterial blood pressure after acute exercise.
Assuntos
Exercício Físico/fisiologia , Frequência Cardíaca/fisiologia , Hipertensão/prevenção & controle , Nitritos/metabolismo , Hipotensão Pós-Exercício/fisiopatologia , Pós-Menopausa , Saliva/química , Salivação/fisiologia , Idoso , Pressão Sanguínea/fisiologia , Determinação da Pressão Arterial , Terapia por Exercício , Feminino , Hemodinâmica , Humanos , Pessoa de Meia-Idade , Treinamento ResistidoRESUMO
OBJECTIVE: The purpose of the study was to compare acute bouts of aquatic treadmill (ATM) and land treadmill (LTM) exercise on flow-mediated dilation, postexercise blood pressure, plasma nitrate/nitrite, and atrial natriuretic peptide in untrained, prehypertensive men. DESIGN: In a counterbalanced, crossover design, 19 untrained, prehypertensive men completed bouts of ATM and LTM on separate days. Flow-mediated dilation was measured pre-exercise and 1-hr postexercise. Blood samples were obtained pre-exercise and immediately postexercise and analyzed for plasma nitrate/nitrite and atrial natriuretic peptide. A magnitude-based inference approach to inference was used for statistical analysis. RESULTS: A possible clinically beneficial increase in flow-mediated dilation (1.2%, 90% confidence interval = -0.07% to 2.5%) was observed 1 hr after ATM. In contrast, a possible clinically harmful decrease in flow-mediated dilation (-1.3%, 90% confidence interval = -2.7% to 0.2%) was observed 1 hr after LTM. The magnitude of the postexercise systolic blood pressure reduction was greater after ATM (-4.9, SD = 2.9 mm Hg) than LTM (-2.6, SD = 2.5 mm Hg). Atrial natriuretic peptide increased 34.3 (SD = 47.0%) after ATM and decreased -9.0 (SD = 40.0%) after LTM. CONCLUSIONS: An acute bout of ATM induced a more favorable endothelial response and greater postexercise hypotensive response than LTM. These changes were associated with increased atrial natriuretic peptide levels after ATM.