Post-exercise Hypotension Following a Single Bout of High Intensity Interval Exercise vs. a Single Bout of Moderate Intensity Continuous Exercise in Adults With or Without Hypertension: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Abstract

Background: Post-exercise hypotension (PEH) is an important tool in the daily management of patients with hypertension. Varying the exercise parameters is likely to change the blood pressure (BP) response following a bout of exercise. In recent years, high-intensity interval exercise (HIIE) has gained significant popularity in exercise-based prevention and rehabilitation of clinical populations. Yet, to date, it is not known whether a single session of HIIE maximizes PEH more than a bout of moderate-intensity continuous exercise (MICE).Objective: To compare the effect of HIIE vs. MICE on PEH by means of a systematic review and meta-analysis.Methods: A systematic search in the electronic databases MEDLINE, Embase, and SPORTDiscus was conducted from the earliest date available until February 24, 2020. Randomized clinical trials comparing the transient effect of a single bout of HIIE to MICE on office and/or ambulatory BP in humans (≥18 years) were included. Data were pooled using random effects models with summary data reported as weighted means and 95% confidence interval (CIs).Results: Data from 14 trials were included, involving 18 comparisons between HIIE and MICE and 276 (193 males) participants. The immediate effects, measured as office BP at 30- and 60-min post-exercise, was similar for a bout of HIIE and MICE (p > 0.05 for systolic and diastolic BP). However, HIIE elicited a more pronounced BP reduction than MICE [(−5.3 mmHg (−7.3 to −3.3)/ −1.63 mmHg (−3.00 to −0.26)] during the subsequent hours of ambulatory daytime monitoring. No differences were observed for ambulatory nighttime BP (p > 0.05).Conclusion: HIIE promoted a larger PEH than MICE on ambulatory daytime BP. However, the number of studies was low, patients were mostly young to middle-aged individuals, and only a few studies included patients with hypertension. Therefore, there is a need for studies that involve older individuals with hypertension and use ambulatory BP monitoring to confirm HIIE's superiority as a safe BP lowering intervention in today's clinical practice.Systematic Review Registration: PROSPERO (registration number: CRD42020171640).

Postexercise Hypotension Is Delayed in Men With Obesity and Hypertension

“…Most studies of PEH have reported measurements only for the initial hour after exercise ( Marcal et al, 2021 ). Thus it is difficult to compare our subjects’ PEH responses over longer postexercise periods with published data.…”

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

“…Three studies included in this metaanalysis used a combination of aerobic and resistance exercise in water or land; one used only aerobic exercise, and the last used High Intensive Interval Exercise (HIIE). A recent metaanalysis showed that land HIIE promoted a larger PEH than moderate-intensity continuous exercise on ambulatory daytime blood pressure (Marçal et al, 2021). Another meta-analysis showed that several types of regular AE as swimming, deep water, circuits, resistance, and others, significantly reduce the blood pressure in hypertensive subjects.…”

Stair walking effects on feelings of energy and fatigue: Is 4-min enough for benefits?

“…For example, our sample was normotensive and we assessed blood pressure a few minutes after exercise while a review of the literature on post-exercise hypotension found larger effects for hypertensive samples and the magnitude of the reduction in blood pressure was larger 2-h post-exercise compared to 1-h post-exercise ( Casonatto et al, 2016 ). Additionally, the lack of effects for blood pressure for a single short bout of stair walking are not necessarily indicative of the known improvements in hypertension for longer bout duration or sustained behavior change ( Marçal et al, 2021 ).…”