<p>Acute antihypertensive effect of self-selected exercise intensity in older women with hypertension: a crossover trial</p>

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.

Self-selected exercise intensity for inactive hypertensive older women: a pilot study

“…All participants were recruited from a previous study conducted by our research group, which was designed to investigate the acute effect of a single SSEsession on ambulatory BP in inactive hypertensive older women (n = 20) 16 . After the end of this previous study 16 , all participants were invited to perform one additional SSEsession in order to assess the reproducibility of HR, RPE, and affective response. Seven of them declined to participate of this present study.…”

“…A single session of aerobic exercise at moderate-vigorous intensity elicit reduction of BP up to 24hour post-exercise without any clinical symptomatic hypotension, which is called post-exercise hypotension (PEH) 15 . Recently, we have demonstrated that a SSEsession reduced 4.0 and 3.4 mmHg in ambulatory systolic BP in the awake and 20-hour periods, respectively, in inactive hypertensive older women 16 . In order to establish the clinical utility of the SSEfor hypertensive older women, it is important to determine its reproducibility, especially regarding the exercise intensity recommended to this population.…”

<p>Short-Term Effect of Self-Selected Training Intensity on Ambulatory Blood Pressure in Hypertensive Older Women: A Randomized Controlled Trial</p>

“…The BP was measured every 2 minutes during and immediately following the end of the maximal graded exercise test by the auscultatory method. RPE was recorded every minute using Borg's RPE scale (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). 22 The graded exercise test was considered maximal when the participant reached an RPE > 17 and HR within ± 10 bpm of age-predicted HR max (220age).…”

“…They were allowed to exercise if their BP was lower than 160/105 mmHg. 23 Participants were instructed to regulate their own pace before the SSTI sessions using the following statement and following the same procedures of previous studies 15,16 from our group: We would like that you exercise for [30, 35, 40, 45, or 50 minutes] at a pace of your own choosing. You can freely change the pace at any time during the exercise.…”

“…7 Two previous studies from our group showed that hypertensive older women self-select an exercise intensity between 50% and 60% of HR reserve and report the exercise sessions as "light" and "pleasant". 15,16 In addition, Costa et al 16 showed that a single 30-minute self-selected exercise intensity session elicited a reduction in ambulatory systolic (BP) in inactive hypertensive older women. The systolic postexercise hypotension (PEH) of ~6 mmHg lasted up to a sixhour period and contributed to a reduction in the mean values of systolic BP in the 20-hour and awake periods.…”