Post-exercise central blood pressure and haemodynamics among a treated hypertensive population

Chin-Hung Lin

doi:10.25918/thesis.198

To date, there has been limited understanding of the effects of exercise on central blood pressure (BP) and haemodynamics among people with diagnosed hypertension; particularly those treated with antihypertensive medications. Thus, this research aimed to further contribute to an improved understanding of the post- exercise effects on central BP and haemodynamics in people pharmacologically treated for hypertension. An experimental, crossover, within-subjects study was conducted with a sample of individuals pharmacologically treated for hypertension (n = 20). The participants completed initial baseline recording, exercise testing, and then four exercise sessions. The initial baseline recording comprised the 'no-exercise' control condition (CC). This was followed by the exercise testing where submaximal aerobic capacity and 10-repetition maximum test were conducted to determine individualised, moderate intensity for the exercise conditions. Then, each participant completed four exercise sessions, seven days apart, during which they completed each of the following exercise conditions, in random order: 1) aerobic exercise (AC), 2) resistance exercise (RC), 3) aerobic followed by resistance exercise (AR), and 4) resistance followed by aerobic exercise (RA); the latter two conditions are referred to as concurrent exercise. Measures were collected prior to each condition (i.e., pre-condition/exercise) and 10-, 30- and 60 minutes post-condition/exercise. The measures included peripheral measures (systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP) and augmentation index (PAIx)), central measures (central systolic blood pressure (CSBP), central diastolic blood pressure (CDBP), central pulse pressure (CPP), central augmentation pressure (CAP) and augmentation index (CAIx)) and indices of the autonomic nervous system (heart rate (HR) and pulse rate variability (PRV)). A linear mixed-effects model was used to assess the effects of exercise on the measures. When compared with CC, there were no significant differences in SBP, DBP, CSBP, CDBP, PP, CPP and PRV after exercise; however, the decreases in SBP and DBP were considered to be of minimum clinical importance. HR was significantly increased after the experimental exercise conditions, with significantly greater increases after the aerobic and concurrent exercise conditions. CAIx was significantly decreased after the experimental exercise conditions (CC: 26.10%, 95% CI [22.45, 29.75]; AC: 17.82%, 95% CI [14.14, 21.49]; RA: 19.98%, 95% CI [16.29, 23.68]; AR: 17.42%, 95% CI [13.69, 21.14]; RA: 16.98%, 95% CI [13.28, 20.68]); however, these differences were no longer statistically significant after adjusting for HR. Moreover, CAIx, PAIx, and CAP were significantly decreased after the experimental exercise conditions. These decreases were significantly greater for the aerobic and concurrent exercise conditions when compared with resistance. In conclusion, these results indicate that a single bout of a standardised exercise modality, particularly aerobic exercise, does not induce any abnormal BP responses and may actually have beneficial effects on haemodynamics. However, the post-exercise responses measured reported could differ from the chronic effects. Further research is required to investigate the longer-term effects of exercise training on central BP and haemodynamics and therefore the sustaining of positive health outcomes for those being treated for hypertension.

Post-exercise central blood pressure and haemodynamics among a treated hypertensive population

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Post-exercise central blood pressure and haemodynamics among a treated hypertensive population

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