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PurposeThe effectiveness of exercise to lower blood pressure may depend on the type and intensity of exercise. We study the short-term (i.e., 14-h) effects of a bout of high-intensity aerobic interval training (HIIT) on blood pressure in metabolic syndrome (MetS) patients. Methods Nineteen MetS patients (55.2 ± 7.3 years, 6 women) entered the study. Eight of them were normotensive and eleven hypertensive according to MetS threshold (≥130 mmHg for SBP and/or ≥85 mmHg for DBP). In the morning of 3 separated days, they underwent a cycling exercise bout of HIIT (>90% of maximal heart rate, ~85% VO2max), or a bout of isocaloric moderate-intensity continuous training (MICT; ~70% of maximal heart rate, ~60% VO2max), or a control no-exercise trial (REST). After exercise, ambulatory blood pressure (ABP; 14 h) was monitored, while subjects continued their habitual daily activities wearing a wrist-band activity monitor. ResultsNo ABP differences were found for normotensive subjects. In hypertensive subjects, systolic ABP was reduced by 6.1 ± 2.2 mmHg after HIIT compared to MICT and REST (130.8 ± 3.9 vs. 137.4 ± 5.1 and 136.4 ± 3.8 mmHg, respectively; p < 0.05). However, diastolic ABP was similar in all three trials (77.2 ± 2.6 vs. 78.0 ± 2.6 and 78.9 ± 2.8 mmHg, respectively). Motion analysis revealed no differences among trials during the 14-h. Conclusion This study suggests that the blood pressure reducing effect of a bout of exercise is influence by the intensity of exercise. A HIIT exercise bout is superior to an equivalent bout of continuous exercise when used as a non-pharmacological aid in the treatment of hypertension in MetS.
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Eur J Appl Physiol (2017) 117:1403–1411
DOI 10.1007/s00421-017-3631-z
ORIGINAL ARTICLE
Ambulatory blood pressure response to a bout of HIIT
in metabolic syndrome patients
M. Ramirez‑Jimenez1 · F. Morales‑Palomo1 · J. G. Pallares2 ·
Ricardo Mora‑Rodriguez1 · J. F. Ortega1
Received: 28 January 2017 / Accepted: 4 May 2017 / Published online: 10 May 2017
© Springer-Verlag Berlin Heidelberg 2017
analysis revealed no differences among trials during the
14-h.
Conclusion This study suggests that the blood pressure
reducing effect of a bout of exercise is influence by the
intensity of exercise. A HIIT exercise bout is superior to
an equivalent bout of continuous exercise when used as a
non-pharmacological aid in the treatment of hypertension
in MetS.
Keywords Hypertension · Metabolic syndrome · High
intensity interval training · Ambulatory blood pressure
Abbreviations
ABP Ambulatory blood pressure (systolic and
diastolic)
BMI Body mass index
DBP Diastolic blood pressure
GXT Graded exercise testing
HIIT High-intensity interval training
HSD Honest significant difference
MICT Moderate-intensity continuous training
MetS Metabolic syndrome
PEH Post-exercise hypotension
SBP Systolic blood pressure
VO2max Maximal oxygen consumption
Introduction
Metabolic syndrome (MetS) is cluster of conditions that
raise the risk of suffering cardiovascular diseases among
other health problems. Hypertension, one of the compo-
nents of MetS, increases the risk of developing heart fail-
ure, atrial fibrillation (Angeli et al. 2014), stroke, coronary
artery disease (Shen et al. 2013), and peripheral vascular
Abstract
Purpose The effectiveness of exercise to lower blood pres-
sure may depend on the type and intensity of exercise. We
study the short-term (i.e., 14-h) effects of a bout of high-
intensity aerobic interval training (HIIT) on blood pressure
in metabolic syndrome (MetS) patients.
Methods Nineteen MetS patients (55.2 ± 7.3 years, 6
women) entered the study. Eight of them were normoten-
sive and eleven hypertensive according to MetS threshold
(130 mmHg for SBP and/or 85 mmHg for DBP). In
the morning of 3 separated days, they underwent a cycling
exercise bout of HIIT (>90% of maximal heart rate, ~85%
VO2max), or a bout of isocaloric moderate-intensity continu-
ous training (MICT; ~70% of maximal heart rate, ~60%
VO2max), or a control no-exercise trial (REST). After exer-
cise, ambulatory blood pressure (ABP; 14 h) was moni-
tored, while subjects continued their habitual daily activi-
ties wearing a wrist-band activity monitor.
Results No ABP differences were found for normoten-
sive subjects. In hypertensive subjects, systolic ABP
was reduced by 6.1 ± 2.2 mmHg after HIIT compared
to MICT and REST (130.8 ± 3.9 vs. 137.4 ± 5.1 and
136.4 ± 3.8 mmHg, respectively; p < 0.05). However,
diastolic ABP was similar in all three trials (77.2 ± 2.6 vs.
78.0 ± 2.6 and 78.9 ± 2.8 mmHg, respectively). Motion
Communicated by Carsten Lundby.
* Ricardo Mora-Rodriguez
ricardo.mora@uclm.es
1 Exercise Physiology Lab at Toledo, University of Castilla-La
Mancha, 45071 Toledo, Spain
2 Human Performance and Sport Science Lab, University
of Murcia, Murcia, Spain
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
... This is illustrated by the following simplified example: To expend a total amount of 600 kcal, a person needs 60 min of LIT and 40 min of HIIT, resulting in a ratio of 60/40 = 1.5. Applying this ratio to quantify T iso to previous research, LIT requires a T iso of 1.0 [32], 1.1 [10], 1.26 [30], 1.33 [33], 1.6 [34], or 1.85 [31] of the HIIT time to achieve equal EE. These large discrepancies in T iso are somewhat remarkable but may partly be attributed to different methods to match the different exercise modalities (such as total work [32], heart rate (HR)-, oxygen uptake (VO 2 ) relation [10,33], indirect calorimetry [30,31]) or differences in the work:rest ratio. ...
... Applying this ratio to quantify T iso to previous research, LIT requires a T iso of 1.0 [32], 1.1 [10], 1.26 [30], 1.33 [33], 1.6 [34], or 1.85 [31] of the HIIT time to achieve equal EE. These large discrepancies in T iso are somewhat remarkable but may partly be attributed to different methods to match the different exercise modalities (such as total work [32], heart rate (HR)-, oxygen uptake (VO 2 ) relation [10,33], indirect calorimetry [30,31]) or differences in the work:rest ratio. In addition, various approaches on how to set the intensity for LIT (e.g., power output at 65 % of maximal oxygen uptake (VO 2max ) [32], 60-75 % of maximal heart rate (HR max ) [10,30,33], intensity equivalent to maximal fat oxidation [31]) and HIIT (e.g.: power output at 80-90 % of VO 2max [31][32][33], 85-95 % HR max [10,30]) have been used. ...
... These large discrepancies in T iso are somewhat remarkable but may partly be attributed to different methods to match the different exercise modalities (such as total work [32], heart rate (HR)-, oxygen uptake (VO 2 ) relation [10,33], indirect calorimetry [30,31]) or differences in the work:rest ratio. In addition, various approaches on how to set the intensity for LIT (e.g., power output at 65 % of maximal oxygen uptake (VO 2max ) [32], 60-75 % of maximal heart rate (HR max ) [10,30,33], intensity equivalent to maximal fat oxidation [31]) and HIIT (e.g.: power output at 80-90 % of VO 2max [31][32][33], 85-95 % HR max [10,30]) have been used. These methodological differences in study designs consequently complicate inter-study comparisons. ...
Article
Full-text available
Background: A sedentary lifestyle with low energy expenditure (EE) is associated with chronic diseases and mortality. Barriers such as "lack of time" or "lack of motivation" are common reasons why physical exercise is neglected in the general population. To optimize EE in the time available, time-efficient but also enjoyable types of exercise are required. We therefore used an isocaloric approach to systematically investigate the effects of six different endurance exercise modalities on metabolic, mechanical, cardiorespiratory, and subjective variables in relation to biological sex and physical fitness. Methods: Out of 104, 92 healthy participants (21 recreationally trained and 18 trained females, 25 recreationally trained and 28 trained males) were subjected to physiological exercise testing to determine the exercise intensities for six exercise modalities, i.e., three different high-intensity interval training (HIIT) protocols (5 × 4 min, 15 × 1 min, 30 × 30 sec intervals), threshold (THR), speed endurance production (SEP), and low-intensity training (LIT). One of three HIIT sessions served as the reference for the subsequent isocaloric exercise modalities which were completed in randomized order. Metabolic and mechanical variables, i.e., EE during exercise, time to isocaloric EE (Tiso), relative and absolute fat contribution, post-exercise oxygen consumption (EPOC), mechanical energy, as well as cardiorespiratory and subjective variables, i.e., heart rate, oxygen uptake response, rating of perceived exertion, and enjoyment were assessed. Data were analyzed using a 6 × 2 × 2 repeated-measures ANOVA. Results: All three versions of HIIT and THR achieved the same EE during exercise for the same training duration. We found that LIT had a 1.6-fold (p < 0.001) and SEP a 1.3-fold (p < 0.001) longer Tiso compared to HIIT with no effects of biological sex (p = 0.42, pη2 = 0.01) or physical fitness (p = 0.09, pη2 = 0.04). There was a main effect of exercise modality on EPOC (p < 0.001, pη2 = 0.76) with highest values for HIIT 30 × 30 (p = 0.032) and lowest for LIT (p < 0.001). The highest relative and absolute amounts of fatty acids were measured during LIT (p < 0.001), and the lowest values were obtained during HIIT modalities. HIIT 30 × 30 was the most enjoyable version of HIIT (p = 0.007), while THR was the least enjoyable exercise modality (p = 0.008). Conclusion: HIIT modalities are time-saving and enjoyable, regardless of sex and physical fitness. The results illustrate the relationship between exercise modality and metabolic, physiological, and subjective responses, and are thus of great interest to healthy individuals seeking time-saving and enjoyable exercise options.
... All publications included patients diagnosed with hypertension (average age 30-70 years), of which ≈54% were men, and ≈65% were taking antihypertensive medications during the study. [34][35][36][37][38][39][40]43,45,46,[48][49][50][51]58,[60][61][62][63] Some studies included participants who completed a medication washout period before entering the study, 25,32,42,52,53,55,56,59,63,64 whereas other studies included nonmedicated patients with high BP. 33,44,54,57,66,67 Three studies included both medicated and nonmedicated patients with hypertension. ...
... 41,47,65 Exercise Characteristics Exercise sessions lasted on average ≈30 to ≈50 minutes. Different modalities of exercise were analyzed, including aerobic, 25 41,48 Studies analyzing the effects of aerobic exercise applied either light-to-moderate 25,32,33,40,42,45,46,50,[52][53][54][55][56][57][58]60,66,67 or vigorous intensities. [35][36][37]41,[57][58][59]64 Three of the studies with aerobic exercise applied high-intensity interval exercise, 35,37,58 and 2 of the studies with resistance exercise applied handgrip exercise. ...
... Different modalities of exercise were analyzed, including aerobic, 25 41,48 Studies analyzing the effects of aerobic exercise applied either light-to-moderate 25,32,33,40,42,45,46,50,[52][53][54][55][56][57][58]60,66,67 or vigorous intensities. [35][36][37]41,[57][58][59]64 Three of the studies with aerobic exercise applied high-intensity interval exercise, 35,37,58 and 2 of the studies with resistance exercise applied handgrip exercise. 32,65 Exercise Safety No exercise-related adverse events (eg, excessive hypertensive or hypotensive response to exercise, dizziness, or loss of consciousness) were reported in any of the studies. ...
Article
Full-text available
Chronic exercise reduces clinic and ambulatory blood pressure (BP), but the short-term effects of an acute exercise bout on ambulatory BP have not been studied widely. We reviewed the literature regarding the short-term effects of acute exercise on ambulatory BP in patients with hypertension and considered moderating factors (medication status and exercise modality/intensity) on ambulatory BP outcomes. A systematic search was conducted (PubMed, Cochrane Library, and Scopus; since inception to January 1, 2021) for crossover randomized controlled trials assessing the short-term effects of acute exercise on ambulatory BP in hypertensive individuals versus nonexercise control conditions. A meta-analysis was conducted for 24-hour, daytime, and nighttime systolic and diastolic BP. Subanalyses also were performed attending to medication status and exercise modality/intensity. Thirty-seven studies (N=822) met the inclusion criteria. A single acute exercise bout reduces 24-hour (systolic BP, −1.6 mm Hg [95% CI, −2.4 to −0.8] for all exercise modalities combined; diastolic BP, −1.0 mm Hg [95% CI, −1.5 to −0.5]), daytime (−3.1 mm Hg [95% CI, −4.1 to −2.2]; -2.0 mm Hg [95% CI, −2.8 to −1.2]), and nighttime ambulatory BP (−1.8 mm Hg [95% CI, −3.0 to −0.6]; −1.5 mm Hg [95% CI, −2.3 to −0.6]), respectively. The magnitude of the effect appears similar in medicated and nonmedicated patients. In separate analyses for exercise modalities, aerobic exercises reduce all ambulatory BP measures ( P <0.001) yet with no significant effects for resistance or combined (aerobic and resistance) exercise for any ambulatory BP measure. Vigorous aerobic exercise tends to produce the largest effects. A single bout of acute aerobic exercise, reduces ambulatory BP over 24 hours in medicated and nonmedicated hypertensive adults.
... After screening of the full-text, 14 papers could be included in the final meta-analysis. Three studies (Angadi et al., 2015;Morales-palomo et al., 2017;Ramirez-Jimenez et al., 2017) included multiple HIIE interventions or more than one patient group (i.e., a normotensive and hypertensive group). As a result, 18 comparisons were included in the final analysis. ...
... None of the studies explicitly stated that researchers were blinded, and all studies were thus classified as unclear for the risk "blinding of outcome assessment." Seven studies reported that office BP measurements were performed by an automated device (Rossow et al., 2009;Tordi et al., 2010;Angadi et al., 2015;Costa et al., 2016;Graham et al., 2016;Morales-palomo et al., 2017;Silva et al., 2018), and all four studies measuring ambulatory BP used an automated device (Ciolac et al., 2009;de Carvalho et al., 2014;Sosner et al., 2016;Ramirez-Jimenez et al., 2017). The remaining two studies used a manual device to measure office BP (Seeger et al., 2014;Pimenta et al., 2019) and one did not specify the device (de Carvalho et al., 2014). ...
... All studies were published between 2004 and 2019 and conducted in Brazil (n = 5) (Ciolac et al., 2009;de Carvalho et al., 2014;Costa et al., 2016;Silva et al., 2018;Pimenta et al., 2019), France (n = 3) (Mourot et al., 2004;Tordi et al., 2010;Sosner et al., 2016), Spain (n = 2) (Morales-palomo et al., (Rossow et al., 2009;Angadi et al., 2015), the United Kingdom (n = 1) (Seeger et al., 2014), and New Zealand (n = 1) (Graham et al., 2016). Twelve studies used a randomized cross-over design (Mourot et al., 2004;Rossow et al., 2009;Tordi et al., 2010;de Carvalho et al., 2014;Seeger et al., 2014;Angadi et al., 2015;Costa et al., 2016;Graham et al., 2016;Morales-palomo et al., 2017;Ramirez-Jimenez et al., 2017;Silva et al., 2018;Pimenta et al., 2019) while the remaining two applied a randomized parallel design (Ciolac et al., 2009;Sosner et al., 2016) . A total sample of 276 individuals (193 males; 83 females) was included in this meta-analysis. ...
Article
Full-text available
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).
... After screening of the full-text, 14 papers could be included in the final meta-analysis. Three studies (Angadi et al., 2015;Morales-palomo et al., 2017;Ramirez-Jimenez et al., 2017) included multiple HIIE interventions or more than one patient group (i.e., a normotensive and hypertensive group). As a result, 18 comparisons were included in the final analysis. ...
... None of the studies explicitly stated that researchers were blinded, and all studies were thus classified as unclear for the risk "blinding of outcome assessment." Seven studies reported that office BP measurements were performed by an automated device (Rossow et al., 2009;Tordi et al., 2010;Angadi et al., 2015;Costa et al., 2016;Graham et al., 2016;Morales-palomo et al., 2017;Silva et al., 2018), and all four studies measuring ambulatory BP used an automated device (Ciolac et al., 2009;de Carvalho et al., 2014;Sosner et al., 2016;Ramirez-Jimenez et al., 2017). The remaining two studies used a manual device to measure office BP (Seeger et al., 2014;Pimenta et al., 2019) and one did not specify the device (de Carvalho et al., 2014). ...
... All studies were published between 2004 and 2019 and conducted in Brazil (n = 5) (Ciolac et al., 2009;de Carvalho et al., 2014;Costa et al., 2016;Silva et al., 2018;Pimenta et al., 2019), France (n = 3) (Mourot et al., 2004;Tordi et al., 2010;Sosner et al., 2016), Spain (n = 2) (Morales-palomo et al., (Rossow et al., 2009;Angadi et al., 2015), the United Kingdom (n = 1) (Seeger et al., 2014), and New Zealand (n = 1) (Graham et al., 2016). Twelve studies used a randomized cross-over design (Mourot et al., 2004;Rossow et al., 2009;Tordi et al., 2010;de Carvalho et al., 2014;Seeger et al., 2014;Angadi et al., 2015;Costa et al., 2016;Graham et al., 2016;Morales-palomo et al., 2017;Ramirez-Jimenez et al., 2017;Silva et al., 2018;Pimenta et al., 2019) while the remaining two applied a randomized parallel design (Ciolac et al., 2009;Sosner et al., 2016) . A total sample of 276 individuals (193 males; 83 females) was included in this meta-analysis. ...
Conference Paper
Objective 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). We aimed to compare the effect of HIIE vs. MICE on PEH by means of a systematic review and meta-analysis. Design and method 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-minutes post-exercise, were 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). Conclusions HIIE promoted a larger PEH than MICE on ambulatory daytime BP. However, the number of studies was small, 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.
... In addition to these traditional modalities, high-intensity interval exercise (HIIE) is now recommended for hypertensive patients (Pescatello et al., 2015b). It is becoming clear that a bout of HIIE is more effective at lowering BP than an isocaloric bout of moderate intensity and continuous exercises (Marçal et al., 2021;Pimenta et al., 2019;Ramirez-Jimenez et al., 2017;Sosner et al., 2016;Tucker et al., 2016). ...
... The results are presented as mean±SD and, for inferential statistics, as mean±standard error of the mean. Sample size was based on the ability to detect a large effect (1.45) according to a previous report by Ramirez -Jimenez et al. (2017). As a consequence, it was decided upon to require 80% power at 0.05 significance. ...
Article
Full-text available
A randomized crossover trial was carried out in prehypertensive obese men to compare postexercise hypotension and heart rate variability (HRV) following water-based and land-based high-intensity interval exercises (HIIEs). Nine prehypertensive obese participants, aged 23.6 ± 2.4 years, were randomly assigned to one of three interventions: no-exercise control, HIIE with immersion up to the chest, or HIIE on dry land. In the evenings of three separate days, participants performed either of the interventions. Matched with exercise volume, both HIIEs composed of 5 repetitions of 30-sec sprints at maximum effort followed by a 4-min rest. Ambulatory blood pressure and HRV were measured before the interventions and over the 24-hr following period. Both HIIEs resulted in significant reductions of average 24-hr mean arterial pressure (-6.7 mmHg). Notably, the water-based HIIE resulted in a significantly higher reduction of 24-hr systolic blood pressure (SBP) (-9 mmHg) than the land-based HIIE, particularly at night, in addition to a significantly longer duration of postexercise hypotension. Finally, the water-based HIIE was more effective at restoring HRV during recovery. Our findings demonstrated postexercise hypotension following the HIIEs, particularly the water-based HIIE. During recovery, the water-based HIIE was remarkably effective at restoring HRV. These findings indicate that water-based HIIE is more effective at reducing SBP and requires less recovery time than land-based HIIE in prehypertensive obese men.
... Eduardo et al. reported that HIIT was significantly associated with longer post-exercise hypotension compared to traditional aerobic exercise but did not change DBP and arterial compliance in middle-aged and older hypertensive women with increased arterial stiffness [53]. In addition, Ramirez-Jimenez et al. demonstrated that the blood pressure response to a single HIIT session is more strongly stimulated compared to isocaloric MICT [54]. Post-HIIT produces flow-mediated vasodilation due to increased shear stress by plasma viscosity status [55], which reflects central sympathetic control and endothelial dilatory mechanisms. ...
Article
Full-text available
The purpose of this study was to compare different high-intensity interval training (HIIT) protocols with different lengths of work and rest times for a single session (all three had identical work-to-rest ratios and exercise intensities) for cardiac auto-regulation using a wearable device. With a randomized counter-balanced crossover, 13 physically active young male adults (age: 19.4 years, BMI: 21.9 kg/m2) were included. The HIIT included a warm-up of at least 5 min and three protocols of 10 s/50 s (20 sets), 20 s/100 s (10 sets), and 40 s/200 s (5 sets), with intensities ranging from 115 to 130% Wattmax. Cardiac auto-regulation was measured using a non-invasive method and a wearable device, including HRV and vascular function. Immediately after the HIIT session, the 40 s/200 s protocol produced the most intense stimulation in R-R interval (Δ-33.5%), ln low-frequency domain (Δ-42.6%), ln high-frequency domain (Δ-73.4%), and ln LF/HF ratio (Δ416.7%, all p < 0.05) compared to other protocols of 10 s/50 s and 20 s/100 s. The post-exercise hypotension in the bilateral ankle area was observed in the 40 s/200 s protocol only at 5 min after HIIT (right: Δ-12.2%, left: Δ-12.6%, all p < 0.05). This study confirmed that a longer work time might be more effective in stimulating cardiac auto-regulation using a wearable device, despite identical work-to-rest ratios and exercise intensity. Additional studies with 24 h measurements of cardiac autoregulation using wearable devices in response to various HIIT protocols are warranted.
... Other pieces of evidence reported in women with obesity revealed that HIIT (4 min × 4 min at 85 %-95 % of maximum heart rate, interspersed with 3-min rest periods) and MICT alone (41 min at 65 %-75 % of maximum heart rate) decreased arterial stiffness, and interestingly, HIIT significantly reduced brachial ΔSBP (−6.3) and central ΔSBP (−6.6 mmHg) (De Oliveira et al., 2020), where comparing with the present study, our results show higher ΔSBP reduction (−10.2 mmHg) than previous evidential studies. A part of the mechanisms, by which exercise training decreases blood pressure, is explained by the angiogenesis in skeletal muscle mass (Fernandes et al., 2012), a reduction in peripheral vascular resistance (Correia et al., 2015), a reduction in arterial stiffness (Guimaraes et al., 2010), improvements in the endothelial-mediated vasodilation mechanisms (Ramirez-Jimenez et al., 2017), an increase in production and action of nitric oxide plasma levels (Izadi et al., 2018), and the health status and mode of exercise (Álvarez et al., 2018;De Oliveira et al., 2020). Additional mechanisms explaining why concurrent training decreases blood pressure could include a major baroreflex control (Somers et al., 1991), the shear stress produced by exercise in Frontiers in Physiology frontiersin.org ...
Article
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The non-responders (NRs) after exercise training have been poorly studied in populations with morbid obesity. The purpose of this study was to determine the NR prevalence after 20 weeks of concurrent training of morbidly obese women with a high or low number of metabolic syndrome (MetS) risk factors. Twenty-eight women with morbid obesity participated in an exercise training intervention and were allocated into two groups distributed based on a high (≥3, n = 11) or low number (<3, n = 17) of MetS risk factors. The main outcomes were waist circumference (WC), fasting plasma glucose (FPG), high-density lipids (HDL-c), triglycerides (Tg), and systolic (SBP) and diastolic (DBP) blood pressure, and secondary outcomes were body composition, anthropometric and physical fitness, determined before and after 20 weeks of concurrent training. NRs were defined as previously used technical error cut-off points for the MetS outcomes. Significantly different (all p < 0.05) prevalences of NRs between the H-MetS vs. L-MetS groups (respectively) in WC (NRs 18.2 % vs. 41.1 %, p < 0.0001), SBP (NRs 72.7 % vs. 47.0 %, p = 0.022), DBP (NRs 54.5 % vs. 76.4 %, p < 0.0001), FPG (NRs 100% vs. 64.8 %, p < 0.0001), and HDL-c (NRs 90.9 % vs. 64.7 %, p = 0.012) were observed. In addition, the H-MetS group evidenced significant changes on ΔSBP (−10.2 ± 11.4 mmHg), ΔFPG (−5.8 ± 8.2 mg/dl), ΔHDL-c (+4.0 ± 5.9 mg/dl), and ΔTg (−8.8 ± 33.8 mg/dl), all p < 0.05. The L-MetS group only showed significant changes in ΔWC (−3.8 ± 5.0 cm, p = 0.009). Comparing H-MetS vs. L-MetS groups, significant differences were observed in ∆FPG (−5.8 ± 8.2 vs. +0.3 ± 3.2 mg/dl, p = 0.027), but not in other MetS outcomes. In conclusion, 20 weeks of concurrent training promotes greater beneficial effects in morbidly obese patients with a high number of MetS risk factors. However, the NR prevalence for improving MetS outcomes was significantly superior in these more-diseased groups in SBP, FPG, and HDL-c, independent of their major training-induced effects.
... Thus, in the present study, NRs were considered for those participants who decreased a -1 mmHg in blood pressure. The mechanisms of how exercise decreases blood pressure could be potentially explained by 1) angiogenesis in the skeletal muscle (Fernandes et al., 2012), 2) a reduction of the peripheral vascular resistance (Correia et al., 2015), 3) a reduction of the arterial stiffness (Guimaraes et al., 2010), 4) improvements in the endothelial function (Ramirez-Jimenez et al., 2017), 5) an increase in production and action of nitric oxide levels (Izadi et al., 2018), 6) an increase in the major baroreflex control (Somers et al., 1991), and also by the 6) increased shear stress produced by exercise in the arterial wall (Hong et al., 2022), and, thus, a major arterial distensibility (Kobayashi et al., 2022). ...
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Background: Postexercise hypotension (PEH) is a common physiological phenomenon occurring immediately after endurance training (ET), resistance training (RT), and ET plus RT, also termed concurrent training (CT); however, there is little knowledge about the interindividual and magnitude response of PEH in morbidly obese patients. Aim: The aims of this study were (1) to investigate the effect of CT order (ET + RT vs. RT + ET) on the blood pressure responses; 2) characterize these responses in responders and nonresponders, and 3) identify potential baseline outcomes for predicting blood pressure decreases as responders. Methods: A quasi-experimental study developed in sedentary morbidly obese men and women (age 43.6 ± 11.3 years; body mass index [BMI] ≥40 kg/m²) was assigned to a CT group of ET plus RT (ET + RT; n = 19; BMI 47.8 ± 16.7) or RT plus ET order group (RT + ET; n = 17; BMI 43.0 ± 8.0). Subjects of both groups received eight exercise sessions over four weeks. Primary outcomes include systolic (SBP), diastolic (DBP), mean arterial pressure [MAP], heart rate at rest [HR], and pulse pressure [PP] measurements before and after 10 min post-exercise. Secondary outcomes were other anthropometric, body composition, metabolic, and physical fitness parameters. Using the delta ∆SBP reduction, quartile categorization (Q) in “high” (Rs: quartile 4), “moderate” (MRs: quartile 3), “low” (LRs: quartile 2), and “nonresponders” (NRs: quartile 1) was reported. Results: Significant pre–post changes were observed in ET + RT in session 2 for SBP (131.6 vs. 123.4 mmHg, p = 0.050) and session 4 (131.1 vs. 125.2 mmHg, p = 0.0002), while the RT + ET group showed significant reductions in session 4 (134.2 vs. 125.3 mmHg, p < 0.001). No significant differences were detected in the sum of the eight sessions for SBP (∑∆SBP) between ET + RT vs. RT + ET (−5.7 vs. −4.3 mmHg, p = 0.552). Interindividual analyses revealed significant differences among frequencies comparing Q1 “NRs” (n = 8; 22.2%), Q2 “LRs” (n = 8; 22.2%), Q3 “MRs” (n = 9; 25.0%), and Q4 “HRs” (n = 11; 30.5%), p < 0.0001. Quartile comparisons showed significant differences in SBP changes (p = 0.035). Linear regression analyses revealed significant association between ∑∆SBP with body fat % (β –3.826, R ² 0.211 [21.1%], p = 0.031), skeletal muscle mass [β –2.150, R ² 0.125 (12.5%), p = 0.023], fasting glucose [β 1.273, R ² 0.078 (7.8%), p = 0.003], triglycerides [β 0.210, R ² 0.014 (1.4%), p = 0.008], and the 6-min walking test [β 0.183, R ² 0.038 (3.8%), p = 0.044]. Conclusion: The CT order of ET + RT and RT + ET promote a similar ‘magnitude’ in the postexercise hypotensive effects during the eight sessions of both CT orders in 4 weeks of training duration, revealing “nonresponders” and ‘high’ responders that can be predicted from body composition, metabolic, and physical fitness outcomes.
... The blunted BP response observed in our study could be related to the attenuation of BP benefits described during long-term non-pharmacological programs by Hinderliter et al. [21]. Our findings, potentially, could also be due to a lower threshold of BP response, where it cannot be decreased further below a given level in order to prevent hypotension [22]. Interestingly, HIIE still maintained its capability to also induce SBP lowering in the trained state. ...
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This study investigated which exercise mode (continuous or sprint interval) is more effective for improving insulin sensitivity. Ten young, healthy men underwent a non-exercise trial (CON) and 3 exercise trials in a cross-over, randomized design that included 1 sprint interval exercise trial (SIE; 4 all-out 30-s sprints) and 2 continuous exercise trials at 46% VO2peak (CELOW) and 77% VO2peak (CEHIGH). Insulin sensitivity was assessed using intravenous glucose tolerance test (IVGTT) 30 min, 24 h and 48 h post-exercise. Energy expenditure was measured during exercise. Glycogen in vastus lateralis was measured once in a resting condition (CON) and immediately post-exercise in all trials. Plasma lipids were measured before each IVGTT. Only after CEHIGH did muscle glycogen concentration fall below CON (P<0.01). All exercise treatments improved insulin sensitivity compared with CON, and this effect persisted for 48-h. However, 30-min post-exercise, insulin sensitivity was higher in SIE than in CELOW and CEHIGH (11.5±4.6, 8.6±5.4, and 8.1±2.9 respectively; P<0.05). Insulin sensitivity did not correlate with energy expenditure, glycogen content, or plasma fatty acids concentration (P>0.05). After a single exercise bout, SIE acutely improves insulin sensitivity above continuous exercise. The higher post-exercise hyperinsulinemia and the inhibition of lipolysis could be behind the marked insulin sensitivity improvement after SIE.