Increased Blood Pressure Levels Relative to Subjective Feelings of Intensity of Exercise Determined with the Borg Scale in Male Patients with Hypertension

Abstract

We examined the hemodynamic responses to exercise and symptoms in 37 male patients with untreated essential hypertension, and compared the findings with those in 32 age-matched healthy male volunteers by performing a graded symptom-limited exercise test using a bicycle ergometer. The subjective feeling of intensity of exercise was determined using the Borg scale. In the relationship between Borg scores and blood pressure (BP), patients with hypertension showed higher systolic BP and diastolic BP relative to the Borg scores than the controls. Consequently, patients with hypertension showed significantly higher systolic BP with Borg scores < or = 3 (subjective symptoms < or = moderately hard) than the controls (177.8 +/- 27.0 vs. 143.7 +/- 17.9 mmHg, p < 0.0001). Similarly, significantly higher diastolic BP with Borg scores < or = 3 was observed in patients with hypertension than in the controls (101.6 +/- 12.0 vs. 82.6 +/- 11.6 mmHg, p < 0.0001). The pulse pressure with Borg scores < or = 3 was also significantly higher in patients with hypertension than in the controls (76.2 +/- 20.6 vs. 61.0 +/- 13.6 mmHg, p < 0.0001). Hypertensive patients showed a decrease in the high-frequency power of heart rate variability at initial low-load exercise. In conclusion, the present study revealed that there was a greater BP response relative to the Borg score in patients with hypertension than in the controls. Autonomic nerve activity may contribute to some extent to these different relations. A determination of the relationship between the subjective feeling of intensity of the exercise and BP levels caused by a given intensity of load is essential before exercise training in patients, at least in males, with hypertension to avoid increasing the risk of cardiovascular events in association with excessive exercise training.

Can Reactivity of Heart Rate Variability Be a Potential Biomarker and Monitoring Tool to Promote Healthy Aging? A Systematic Review With Meta-Analyses

“…Additional studies were excluded on study report characteristics ( k = 190), study type ( k = 13), outcome measures ( k = 53), or comparison ( k = 9). The remaining 43 studies (Piepoli et al, 1996 ; Cacioppo et al, 2000 ; Perini et al, 2000 ; Steptoe et al, 2002 , 2005 ; Wood et al, 2002 ; Bartels Matthew et al, 2003 ; Kunz-Ebrecht et al, 2003 ; Takahashi et al, 2003 ; Steptoe and Marmot, 2005 , 2006 ; Davrath Linda et al, 2006 ; Hamer and Steptoe, 2007 ; Virtanen et al, 2007 ; Mayumi et al, 2008 ; Karavirta et al, 2009 ; Petrofsky et al, 2009 ; Dourado et al, 2010 ; Alves Naiane Ferraz et al, 2011 ; Millar et al, 2011 ; Sales et al, 2011 ; Wang Norman et al, 2011 ; Capuana et al, 2012 ; Archiza et al, 2013 ; Corrêa et al, 2013 ; Christensen Stephanie and Wright Heather, 2014 ; Collste et al, 2014 ; Lin et al, 2014 , 2017a ; Machado-Vidotti et al, 2014 ; Ahmadian and Dabidi Roshan, 2015 ; Crowley Olga et al, 2016 ; Norcliffe-Kaufmann et al, 2016 ; Wawrzyniak Andrew et al, 2016 ; Beer et al, 2017 ; Beer Noa et al, 2017 ; Betz Linda et al, 2017 ; Junior Adalberto et al, 2019 ; Kuraoka et al, 2019 ; Perpetuini et al, 2019 ; Rodrigues Jhennyfer et al, 2019 ; Wittstein et al, 2019 ; Kaltsatou et al, 2020 ) were included for the qualitative synthesis and—in case of sufficient quality and data reporting—considered for the meta-analyses ( k = 18). Consider Figure 1 for a detailed overview of the study selection.…”

“…In contrast, two studies showed no between-group differences in vagally-mediated HRV [i.e., HFnu (Wood et al, (Kaltsatou et al, 2020). Higher intensities of exercise and higher heart rate were related to larger reductions of mRR (Virtanen et al, 2007), HF (Mayumi et al, 2008;Archiza et al, 2013), LFnu (Perini et al, 2000), LF/HF (Perini et al, 2000), and DFA-α1 (Karavirta et al, 2009) as well as larger increases in HFnu (Perini et al, 2000) during exercise. The addition of gait synchronization elevated DFA-α during walking (Wittstein et al, 2019).…”

“…The reported study interventions consisted of cognitive exercises (k = 21) (Cacioppo et al, 2000;Steptoe et al, 2002Wood et al, 2002;Kunz-Ebrecht et al, 2003;Marmot, 2005, 2006;Hamer and Steptoe, 2007;Capuana et al, 2012;Christensen Stephanie and Wright Heather, 2014;Collste et al, 2014;Lin et al, 2014Lin et al, , 2017aCrowley Olga et al, 2016;Norcliffe-Kaufmann et al, 2016;Wawrzyniak Andrew et al, 2016;Beer Noa et al, 2017;Betz Linda et al, 2017;Kuraoka et al, 2019;Perpetuini et al, 2019), cardiorespiratory exercises (k = 18) (Perini et al, 2000;Bartels Matthew et al, 2003;Takahashi et al, 2003;Davrath Linda et al, 2006;Virtanen et al, 2007;Mayumi et al, 2008;Karavirta et al, 2009;Dourado et al, 2010;Alves Naiane Ferraz et al, 2011;Sales et al, 2011;Wang Norman et al, 2011;Corrêa et al, 2013;Ahmadian and Dabidi Roshan, 2015;Junior Adalberto et al, 2019;Rodrigues Jhennyfer et al, 2019;Wittstein et al, 2019;Kaltsatou et al, 2020), resistance exercises (k = 6) (Piepoli et al, 1996;Petrofsky et al, 2009;Millar et al, 2011;<...>…”

“…With 67% of studies rated "moderate" to "strong" (Table 1), the average methodological quality of the selected studies was reasonable. Twenty studies exhibited a possible selection bias caused by a lack of reporting of the selection process (Piepoli et al, 1996;Steptoe et al, 2002;Wood et al, 2002;Kunz-Ebrecht et al, 2003;Takahashi et al, 2003;Mayumi et al, 2008;Petrofsky et al, 2009;Dourado et al, 2010;Alves Naiane Ferraz et al, 2011;Sales et al, 2011;Wang Norman et al, 2011;Archiza et al, 2013;Corrêa et al, 2013;Machado-Vidotti et al, 2014;Ahmadian and Dabidi Roshan, 2015;Norcliffe-Kaufmann et al, 2016;Beer Noa et al, 2017;Junior Adalberto et al, 2019;Kuraoka et al, 2019;Kaltsatou et al, 2020). Strong study designs included randomized controlled trials (k = 2) (Karavirta et al, 2009;Junior Adalberto et al, 2019) and controlled clinical trials (k = 2) (Millar et al, 2011;Rodrigues Jhennyfer et al, 2019), while observational studies were assigned to "moderate" study designs (Piepoli et al, 1996;Cacioppo et al, 2000;Perini et al, 2000;Steptoe et al, 2002Wood et al, 2002;Bartels Matthew et al, 2003;Kunz-Ebrecht et al, 2003;Takahashi et al, 2003;Marmot, 2005, 2006;Davrath Linda et al, 2006;…”

“…Bartels Matthew et al, 2003;Alves Naiane Ferraz et al, 2011;Kaltsatou et al, 2020 Alves Naiane Ferraz et al, 2011;Ahmadian and Dabidi Roshan, 2015;Rodrigues Jhennyfer et al, 2019;Kaltsatou et al, 2020 Takahashi et al, 2003;Davrath Linda et al, 2006;Virtanen et al, 2007;Mayumi et al, 2008;Karavirta et al, 2009;Wang Norman et al, 2011;Corrêa et al, 2013;Ahmadian and Dabidi Roshan, 2015;Beer et al, 2017 (Continued) Frontiers in Physiology | www.frontiersin.org Piepoli et al, 1996;Petrofsky et al, 2009;Millar et al, 2011;Beer Noa et al, 2017 ց 1 Beer Noa et al, 2017 Millar et al, 2011;Machado-Vidotti et al, 2014;Beer Noa et al, 2017 ↑ n = significant (p < 0.05) increase from resting HRV, ր n = increasing trend (not significant or not statistically tested) → n = no significant change from resting HRV, ց n = decreasing trend (not significant or not statistically tested), ↓ n = significant (p < 0.05) decrease from resting HRV, n = number of studies reporting this effect, NR = not reported.…”