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Can blood pressure decrease after maximal exercise test predict the blood pressure lowering effect of aerobic training in treated hypertensive men?

Abstract

The acute decrease in blood pressure (BP) observed after a session of exercise (called post-exercise hypotension) has been proposed as a tool to predict the chronic reduction in BP induced by aerobic training. Therefore, this study investigated whether post-exercise hypotension observed after a maximal exercise test is associated to the BP-lowering effect of aerobic training in treated hypertensives. Thirty hypertensive men (50 ± 8 years) who were under consistent anti-hypertensive treatment underwent a maximal exercise test (15 watts/min until exhaustion), and post-exercise hypotension was determined by the difference between BP measured before and at 30 min after the test. Subsequently, the patients underwent 10 weeks of aerobic training (3 times/week, 45 min/session at moderate intensity), and the BP-lowering effect of training was assessed by the difference in BP measured before and after the training period. Pearson correlations were employed to evaluate the associations. Post-maximal exercise test hypotension was observed for systolic and mean BPs (−8 ± 6 and −2 ± 4 mmHg, all P < 0.05). Aerobic training reduced clinic systolic/diastolic BPs (−5 ± 6/−2 ± 3 mmHg, both P < 0.05) as well as awake and 24 h mean BPs (−2 ± 6 and −2 ± 5 mmHg, all P < 0.05). No significant correlation was detected between post-exercise hypotension and the BP-lowering effect of training either for clinic or ambulatory BPs (r values ranging from 0.00 to 0.32, all p > 0.05). Post-exercise hypotension assessed 30 min after a maximal exercise test cannot be used to predict the BP-lowering effect of aerobic training in treated hypertensive men.

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Acknowledgements

The authors thank the volunteers for participating and Dr. Sean M. Rice from the Oregon Health & Science University for statistical assistance.

Funding

This study was supported by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP 2014/216676-6), Programa de Excelência Acadêmica (PROEX 88882.327719/2019-01), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq 304436/2018-6), and Coordenação de Aperfeiçoamento Pessoal de Nível Superior–Brasil (CAPES, financial code 0001).

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LMA and LCB collaborate to the study design, collected data, carried out the statistical analysis, contributed to the interpretation of results, and drafted the initial manuscript; TP, RYF, RAR collected data, and revised the manuscript; GVS, APA, DMJ were responsible for patients clinical evaluation and follow-up, and revised the manuscript; JRH contributed to the interpretation of results and revised the manuscript; CLMF designed the study, get grants for the study, supervised data collection, contributed to the interpretation of results and revised the manuscript. All authors gave final approval of the manuscript version submitted for publication.

Corresponding author

Correspondence to Cláudia Lúcia de Moraes Forjaz.

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The authors declare no competing interests.

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All patients signed a written consent form. The study from which data of the present investigation was derived was approved by the Research Ethical Committee of the School of Physical Education and Sport (no. 966.072) and registered in the Brazilian Clinical Trials platform (RBR-7q7pz7), and its procedures followed the standards proposed by the Helsinki Declaration.

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Azevêdo, L.M., Brito, L.C.d., Peçanha, T. et al. Can blood pressure decrease after maximal exercise test predict the blood pressure lowering effect of aerobic training in treated hypertensive men?. J Hum Hypertens 37, 1070–1075 (2023). https://doi.org/10.1038/s41371-023-00853-7

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