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Acute antihypertensive effect of self-selected exercise intensity in older women with hypertension: a crossover trial.

ABSTRACT: Purpose:Acute reduction in blood pressure (BP) following an exercise session is evidenced in controlled settings with formal supervision in hypertensive older populations. This study investigated the effect of a self-selected exercise (SSE)-intensity session on ambulatory BP in hypertensive older women in a "real-world" setting. Methods:Twenty inactive older women with hypertension (64.9±4.5 years) were included in this randomized, controlled, crossover trial. After baseline assessments, participants performed 30 minutes of an SSE-intensity session on an outdoor track and a control session, separated by 7-10 days. Heart rate (HR), rating of perceived exertion (RPE), and affective response were assessed. Ambulatory BP was monitored for 20 hours following both sessions. Paired t-tests and generalized estimation were used for data analysis. Results:Participants exercised at 5.1±1.1 km/h, spent ~90% of the exercise time at moderate-vigorous intensity (≥40% of heart rate reserve). SSE-intensity session was reported as light (RPE 11.0±1.5) and pleasant (affect 3.4±1.2). SSE-intensity session elicited reductions in systolic BP in the first 6 hours postexercise (6.0 mmHg, CI 2.7-9.3 mmHg; P<0.001). Average systolic BP in the 20-hour (-3.4 mmHg, CI -5.9 to -0.9 mmHg; P=0.010) and awake (-4.0 mmHg, CI -6.4 to -1.6 mmHg; P=0.003) periods were lower following SSE-intensity session compared to control session. No differences were observed in average systolic BP during asleep period and diastolic BP during the 20-hour awake and asleep periods between the SSE-intensity session and control session (P>0.05). Conclusion:An SSE-intensity session elicited a reduction in ambulatory systolic BP in inactive older women with hypertension during awake and 20-hour periods. Also, the SSE-intensity session was reported as light and pleasant.

SUBMITTER: Costa IBB

PROVIDER: S-EPMC6689089 | biostudies-other | 2019

REPOSITORIES: biostudies-other

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Acute antihypertensive effect of self-selected exercise intensity in older women with hypertension: a crossover trial.

Costa Ingrid Bezerra Barbosa IBB Schwade Daniel D Macêdo Geovani Araújo Dantas GAD Macêdo Geovani Araújo Dantas GAD Browne Rodrigo Alberto Vieira RAV Farias-Junior Luiz Fernando LF Freire Yuri Alberto YA Sócrates Júlio J Boreskie Kevin F KF Duhamel Todd A TA Caldas Costa Eduardo E

Clinical interventions in aging 20190805

<h4>Purpose</h4>Acute reduction in blood pressure (BP) following an exercise session is evidenced in controlled settings with formal supervision in hypertensive older populations. This study investigated the effect of a self-selected exercise (SSE)-intensity session on ambulatory BP in hypertensive older women in a "real-world" setting.<h4>Methods</h4>Twenty inactive older women with hypertension (64.9±4.5 years) were included in this randomized, controlled, crossover trial. After baseline asses ...[more]

PMID: 31496668

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Project description:BackgroundPhysical inactivity has been consistently linked to increased risk of cognitive decline; however, studies examining the impact of exercise interventions on cognition have produced inconsistent findings. Some observational studies suggest exercise intensity may be important for inducing cognitive improvements; however, this has yet to be thoroughly examined in older adult cohorts. The objective of the current study was to evaluate the effect of systematically manipulated high-intensity and moderate-intensity exercise interventions on cognition.MethodsThis multi-arm pilot randomised clinical trial investigated the effects of 6 months of high-intensity exercise and moderate-intensity exercise, compared with an inactive control, on cognition. Outcome measures were assessed at pre- (baseline), post- (6?months), and 12 months post-intervention. Ninety-nine cognitively normal men and women (aged 60-80?years) were enrolled from October 2016 to November 2017. Participants that were allocated to an exercise group (i.e. high-intensity or moderate-intensity) engaged in cycle-based exercise two times per week for 6?months. Cognition was assessed using a comprehensive neuropsychological test battery. Cardiorespiratory fitness was evaluated by a graded exercise test.ResultsThere was a dose-dependent effect of exercise intensity on cardiorespiratory fitness, whereby the high-intensity group experienced greater increases in fitness than the moderate-intensity and control groups. However, there was no direct effect of exercise on cognition.ConclusionsWe did not observe a direct effect of exercise on cognition. Future work in this field should be appropriately designed and powered to examine factors that may contribute to individual variability in response to intervention.Trial registrationThis study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12617000643370). Registered on 3 May 2017-retrospectively registered. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372780.

Project description:Question addressed by the studyTo investigate exercise performance and hypoxia-related health effects in patients with pulmonary hypertension (PH) during a high-altitude sojourn.Patients and methodsIn a randomised crossover trial in stable (same therapy for >4 weeks) patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) with resting arterial oxygen tension (P aO2 ) ≥7.3 kPa, we compared symptom-limited constant work-rate exercise test (CWRET) cycling time during a day-trip to 2500 m versus 470 m. Further outcomes were symptoms, oxygenation and echocardiography. For safety, patients with sustained hypoxaemia at altitude (peripheral oxygen saturation <80% for >30 min or <75% for >15 min) received oxygen therapy.Results28 PAH/CTEPH patients (n=15/n=13); 13 females; mean±sd age 63±15 years were included. After >3 h at 2500 m versus 470 m, CWRET-time was reduced to 17±11 versus 24±9 min (mean difference -6, 95% CI -10 to -3), corresponding to -27.6% (-41.1 to -14.1; p<0.001), but similar Borg dyspnoea scale. At altitude, P aO2 was significantly lower (7.3±0.8 versus 10.4±1.5 kPa; mean difference -3.2 kPa, 95% CI -3.6 to -2.8 kPa), whereas heart rate and tricuspid regurgitation pressure gradient (TRPG) were higher (86±18 versus 71±16 beats·min-1, mean difference 15 beats·min-1, 95% CI 7 to 23 beats·min-1) and 56±25 versus 40±15 mmHg (mean difference 17 mmHg, 95% CI 9 to 24 mmHg), respectively, and remained so until end-exercise (all p<0.001). The TRPG/cardiac output slope during exercise was similar at both altitudes. Overall, three (11%) out of 28 patients received oxygen at 2500 m due to hypoxaemia.ConclusionThis randomised crossover study showed that the majority of PH patients tolerate a day-trip to 2500 m well. At high versus low altitude, the mean exercise time was reduced, albeit with a high interindividual variability, and pulmonary artery pressure at rest and during exercise increased, but pressure-flow slope and dyspnoea were unchanged.

Dataset Information

Acute antihypertensive effect of self-selected exercise intensity in older women with hypertension: a crossover trial.

Publications

Acute antihypertensive effect of self-selected exercise intensity in older women with hypertension: a crossover trial.

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