Effects of exercise modalities on decreased blood pressure in patients with hypertension

Thiago Rozales Ramis; Franccesco Pinto Boeno; Rodrigo Leal-Menezes; Samuel Vargas Munhoz; Juliano Boufleur Farinha; Jerri Luiz Ribeiro; Alvaro Reischak-Oliveira

doi:10.3389/fphys.2022.993258

Effects of exercise modalities on decreased blood pressure in patients with hypertension

Front Physiol. 2022 Oct 14:13:993258. doi: 10.3389/fphys.2022.993258. eCollection 2022.

Authors

Thiago Rozales Ramis¹, Franccesco Pinto Boeno^{1

2}, Rodrigo Leal-Menezes¹, Samuel Vargas Munhoz¹, Juliano Boufleur Farinha¹, Jerri Luiz Ribeiro¹, Alvaro Reischak-Oliveira¹

Affiliations

¹ Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
² Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States.

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.

Keywords: ambulatory blood pressure monitoring; cross-sectional studies; endothelin-1; hemodynamics; nitric oxide; physical activity.

Associated data

ClinicalTrials.gov/NCT03282942