The additive blood pressure lowering effects of exercise intensity on post-exercise hypotension

doi:10.1016/j.ahj.2010.06.005

American Heart Journal

Volume 160, Issue 3, September 2010, Pages 513-520

https://doi.org/10.1016/j.ahj.2010.06.005 Get rights and content

Background

Evidence contends lower levels of physical exertion reduce blood pressure (BP) as effectively as more rigorous levels. We compared the effects of low (40% peak oxygen consumption, Vo₂peak), moderate (60% Vo₂peak), and vigorous (100% Vo₂peak) exercise intensity on the BP response immediately following aerobic exercise. We also examined clinical correlates of the BP response.

Methods

Subjects were 45 men (mean ± SEM, 43.9 ± 1.4 years) with elevated awake ambulatory BP (ABP, 144.5 ± 1.5/85.4 ± 1.2 mm Hg). Men completed four randomly assigned experiments: non-exercise control and three exercise bouts at low, moderate, and vigorous intensity. All experiments began with a baseline period of seated rest. Subjects left the laboratory wearing an ABP monitor.

Results

Systolic ABP increased 2.8 ± 1.6 mm Hg less after low, 5.4 ± 1.4 mm Hg less after moderate, and 11.7 ± 1.5 mm Hg less after vigorous than control over 9 h (P < .001). Diastolic ABP decreased 1.5 ± 1.2 mm Hg more after low, 2.0 ± 1.0 mm Hg more after moderate, and 4.9 ± 1.3 mm Hg more after vigorous versus control over 9 h (P < .010). Baseline correlates of the systolic ABP post-exercise response to vigorous were fasting glucose (r = -0.415), C-reactive protein (r = -0.362), renin (r = −0.348), fasting insulin (r = 0.310), and fasting low density lipoprotein (r = −0.298) (R² = 0.400, P = .002). Baseline correlates of the diastolic ABP post-exercise response to vigorous were Vo₂peak (r = −0.431), fasting low density lipoprotein (r = -0.431), renin (r = -0.411), fibrinogen (r = 0.369), and fasting glucose (r = −0.326) (R² = 0.429, P < .001).

Conclusions

The antihypertensive effects of exercise intensity occurred in dose response fashion. Clinicians should weigh the benefits and risks of prescribing vigorous exercise intensity for those with hypertension on an individual basis.

Section snippets

Subjects

Subjects in this investigation were from the same cohort of our previous publications.11, 12, 20, 21, 22, 23, 24, 25, 26 They were 45 white, nonsmoking men 18-55 years old. Volunteers were apparently healthy other than having pre- to stage 1 HTN [systolic BP (SBP) 130 ≤ 160 mm Hg and/or diastolic BP (DBP) 85 ≤ 100 mm Hg]. Subjects were excluded if they had CVD, diabetes mellitus, asthma, thyroid dysfunction, pancreatitis, acute illness and/or were on antidepressant medication. Any subject

Subjects

Subjects were 45 white, middle-aged men with pre-to Stage 1 HTN (Table I). The participants were overweight to obese and had borderline dyslipidemia²⁸ and below-average physical fitness.²⁹ The SBP, DBP, and HR responses before, at peak exercise, and >9 h following VIGOROUS are shown in Table II. No subject exhibited a hypertensive response to the graded exercise test as defined by the American College of Sports Medicine as SBP >250 mm Hg and/or DBP >115 mm Hg.²⁹

Systolic blood pressure

Over the course of 9 h, SBP

Discussion

The primary purpose of this investigation was to examine the influence of a range of levels of physical exertion on PEH. Our new and unexpected findings were VIGOROUS (SBP/DBP, 11.7/4.9 mm Hg) elicited the largest BP reductions followed by MODERATE (5.4/2.0 mm Hg) and then LOW (2.8/1.5 mm Hg) compared to nonexercise control over the course of 9 h among men with pre- to stage 1 HTN. The influence of exercise intensity on PEH occurred in dose response fashion such that for each 10% increase in

Disclosures

Conflict of Interest: None.

Acknowledgements

We thank the subjects who volunteered their time, corporate and municipal agencies who enabled subject recruitment, and the University of Connecticut graduate students who assisted with data collection.

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: Sources of Support: Supported by American Heart Association Grant-in-Aid#0150507N.

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Clinical InvestigationHypertensionThe additive blood pressure lowering effects of exercise intensity on post-exercise hypotension

Background

Methods

Results

Conclusions

Section snippets

Subjects

Subjects

Systolic blood pressure

Discussion

Disclosures

Acknowledgements

Am J Cardiol

2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension

J Hypertens

World Health Report 2002: reducing risks, promoting healthy life. Geneva, Switzerland

Educ Health

Heart disease and stroke statistics-2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee

Circulation

Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. JNC 7—Complete Version

Hypertension

2007 ESH-ESC practice guidelines for the management of arterial hypertension

J Hypertens

Effects of endurance training on blood pressure, blood pressure-regulating mechanisms, and cardiovascular risk factors

Hypertension

American College of Sports Medicine position stand. Exercise and hypertension

Med Sci Sports Exerc

The acute versus the chronic response to exercise

Med Sci Sports Exerc

Influence of endurance exercise training status and gender on postexercise hypotension

J Appl Physiol

Effects of aerobic training intensity of resting, exercise and post-exercise blood pressure, heart rate and heart-rate variability

J Hum Hypertens

Short-term effect of dynamic exercise on arterial blood pressure

Circulation

Exercise intensity alters post-exercise hypotension

J Hypertens

Influence of exercise at lower and higher intensity on blood pressure and cardiovascular risk factors at older age

J Hypertens

Post-exercise changes in blood pressure, heart rate and rate pressure product at different exercise intensities in normotensive humans

Braz J Med Biol Res

The role of exercise training in the treatment of hypertension: An update

Sports Med

The effects of exercise intensity on post exercise hypotension

J Hum Hypertens

Twenty-four hour ambulatory BP responses following acute exercise: impact of exercise intensity

J Hum Hypertens

Clinical Investigation
Hypertension
The additive blood pressure lowering effects of exercise intensity on post-exercise hypotension