Effects of Aquatic Exercise in Post-exercise Hypotension: A Systematic Review and Meta-Analysis

Abstract

BackgroundPost-exercise hypotension (PEH) can be an important non-pharmacological strategy in the treatment of arterial hypertension. Both aerobic and resistance exercises produce PEH, but it is not clear if the exercise environment can lead to a higher PEH.ObjectiveThis meta-analysis investigated whether a session of aquatic exercise (AE) induces PEH in comparison with control conditions such as land exercise (LE) or rest in hypertensive subjects.MethodsThe present systematic review and meta-analysis was conducted using the following electronic databases: PubMed, Google Scholar, and EMBASE. Ambulatory blood pressure measurements made in randomized clinical trials were pooled to compare PEH induced by AE with LE and rest conditions in hypertensive subjects.ResultsData from four trials were included, which comprised 127 participants (94 women and 33 men). A 24-h analysis did not detect significant differences between AE and LE or rest for either systolic blood pressure (SBP) or diastolic blood pressure (DBP). Monitoring during the night showed that AE induced significant PEH in comparison with LE for SBP [−8.6 (−15.0 to −1.5) mmHg (p = 0.01)]. For DBP, the AE had pronounced PEH during the night in comparison with LE [−3.7 (−4.7 to −2.8) mmHg, p = 0.000] and rest [−1.7 (−1.9 to −0.8) mmHg, p = 0.000]. There were no differences in daytime values.ConclusionAE showed a higher PEH effect than LE sessions and rest conditions. PEH was observed in both SBP and DBP during the night. The number of studies was low, but all studies included in this meta-analysis used 24-h monitoring. The understanding of clinical relevance of AE, inducing a higher PEH, depends on a standardization of exercise protocols plus a rigorous monitoring of blood pressure.Systematic Review RegistrationPROSPERO registration: CRD42021271928.

Effects of post-aquatic exercise hypotension in older adults: a systematic review with meta-analysis

“…A recent meta-analysis 17 , which was conducted with hypertensive individuals, compared the hypotensive effects of an aquatic exercise session with a control session and found similar results. The study indicated that exercise in the aquatic environment reduced SBP by -6,0 mmHg and DBP by -1,9 mmHg but without signi cant effects over 24 hours 17 . Acute BP responses are of great clinical relevance as they provide essential data on chronic BP adaptations in addition to reducing acute cardiovascular risk 8 .…”

“…A meta-analysis evaluated BP responses in hypertensive individuals (> 18 years) after aquatic exercise compared to a control condition (land-based exercise or rest) and found no differences in 24-hour responses between the sessions. However, SBP and DBP decreased during the night period (8,6 mmHg and 3,7 mmHg, respectively) compared to land-based exercise, and DBP showed a signi cant reduction (1.7 mmHg) after aquatic exercise versus rest 17 . It is known that methodological differences can in uence these results, such as the studied population, the exercise session protocol, and the comparison between land and water exercise sessions.…”

Efeitos Da Hidrocinesioterapia Na Hipertensão Arterial Sistêmica: Uma Revisão Integrativa

“…Visto o grande impacto causado pela HAS, uma das terapias não farmacológicas recomendadas é o treinamento de 90-150 min de atividade aeróbica com intensidade moderada a vigorosa por semana, onde observa-se redução de cerca de -3/-3,5 mmHg na PA, pois a atividade gera adaptações cardiovasculares e respiratórias a fim de suprir as necessidades musculares, após as primeiras alterações ocorre a hipotensão-pós-exercício (HPE), considerado um fator positivo no tratamento da HAS (GOMES et al, 2019;TRINDADE et al, 2022).…”