Effects of aerobic exercise intensity on ambulatory blood pressure and vascular responses in resistant hypertension: a crossover trial. Issue 7 (July 2016)

• Record Type: Journal Article
• Authors: Santos, Lucas P.; Moraes, Ruy S.; Vieira, Paulo J.C.; Ash, Garrett I.; Waclawovsky, Gustavo; Pescatello, Linda S.; Umpierre, Daniel
• Is Part Of: Journal of hypertension. Volume 34:Issue 7(2016:Jul.)
• Publication Date: 2016-07
• Subjects: arterial pressure -- crossover studies -- hemodynamics -- hypertension -- physical activity; Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/HJH.0000000000000961
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Background: Resistant hypertension often exposes patients to poor blood pressure (BP) control, resulting in clinical vulnerability, possible need for device-based procedures (denervation) and increased therapy costs. Regular exercise markedly benefits patients with hypertension, including resistant patients. However, little is known about short-term exercise effects in resistant hypertension. Objective: To evaluate acute hemodynamic effects of exercise in resistant hypertension. Method: After maximal exercise testing, 20 patients (54.0 ± 5.7 years, 30.2 ± 4.9 kg/m 2 ) with resistant hypertension participated in three crossover interventions, in random order, and on separate days: control (45′ of rest), and light intensity and moderate intensity (45′ of aerobic exercise at 50 and 75% of maximum heart rate, respectively). Ambulatory BP, forearm blood flow (with subsequent calculation of vascular resistance), and reactive hyperemia were measured before and after interventions trough venous occlusion plethysmography. Results: Compared with control, both exercise intensities reduced ambulatory systolic pressure over 5 h (light: −7.7 ± 2.4 mmHg and moderate: −9.4 ± 2.8 mmHg, P < 0.01), whereas only light intensity reduced diastolic pressure (−5.7 ± 2.2 mmHg, P < 0.01). Light intensity also lowered systolic and diastolic pressures over 10-h daytime (−3.8 ± 1.3 and −4.0 ± 1.3 mmHg, respectively, P < 0.02), night-time (−6.0 ± 2.4 and −6.1 ± 1.6 mmHg, respectively, P < 0.05), and diastolic pressure over 19 h (−4.8 ± 1.2 mmHg, P < 0.01). Forearm blood flow changed (decreased) compared with baseline only at 50 min after light intensity ( P < 0.05). After the control and light intensity sessions, vascular resistance increased at the end of 1 h, and after moderate intensity, it decreased only at the moment (∼2 min) immediately after intervention ( P < 0.05). Conclusion: A single session of light or moderate aerobic exercise acutely reduces ambulatory BP in resistant hypertension, although benefits persist longer following light intensity.