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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.
... 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. ...
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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).
... 9,10 Specifically, hypertension is a risk factor with high responsiveness to aerobic exercise. 11,12 Therefore, American and European therapeutic guidelines for the management of arterial hypertension recommend exercise as an optimal non-pharmacological intervention to reduce blood pressure. 7,8 Within aerobic exercise programs, high-intensity aerobic interval training (ie, HIIT) is more effective on lowering blood pressure in comparison with the traditionally recommended low-to-moderate intensity continuous training. ...
... 7,8 Within aerobic exercise programs, high-intensity aerobic interval training (ie, HIIT) is more effective on lowering blood pressure in comparison with the traditionally recommended low-to-moderate intensity continuous training. 12,13 Sprint exercise involving several 1-min bouts 14 and graded exercise to exhaustion 15 also elicit remarkable reductions in blood pressure in hypertensive individuals with metabolic syndrome. The benefits of HIIT are not limited to reductions in blood pressure but extend to other metabolic and cardiovascular benefits in these patients. ...
... This type of training was chosen because it results in larger blood pressure reductions when compared to lower intensity training. 12,13 Training consisted on pedaling for 10 min as warm up at 70% HR MAX followed by 4 × 4-min intervals at 90% of HR MAX interspersed with 3-min active recovery at 70% HR MAX and a 5-min cooldown period for a total of 43 min. After 6 weeks of training, one more interval was added (ie, 5 × 4 min) to result in 48min workouts. ...
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Full-text available
Pharmacological and non‐pharmacological therapies are simultaneously prescribed when treating hypertensive individuals with elevated cardiovascular risk (i.e., metabolic syndrome individuals). However, it is unknown if the interactions between antihypertensive medication (AHM) and lifestyle interventions (i.e., exercise training) may result in a better ambulatory blood pressure (ABP) control. To test this hypothesis, thirty‐six hypertensive individuals with metabolic syndrome (MetS) under long‐term prescription with AHM targeting the renin‐angiotensin‐aldosterone system (RAAS) were recruited. Before and after 4‐months of high‐intensity interval training (HIIT), participants completed two trials in a double‐blind, randomized order: a) placebo trial consisting of AHM withdrawal for 3‐days and b) AHM trial where individuals held their habitual dose of AHM. 24‐h mean arterial pressure (MAP) was monitored in each trial and considered the primary study outcome. Secondary outcomes included plasma renin activity (PRA) and aldosterone concentration to confirm withdrawal effects on RAAS, along with the analysis of urine albumin‐to‐creatinine ratio (UACR) to assess kidney function. The results showed main effects from AHM and HIIT reducing 24‐h MAP (‐5.7 mmHg, P<0.001 and ‐2.3 mmHg, P=0.007, respectively). However, there was not interaction between AHM and HIIT on 24‐h MAP (P=0.240). There was a main effect of AHM increasing PRA (P<0.001) but no effect on plasma aldosterone concentration (P=0.423). HIIT did not significantly improve RAAS hormones or the UACR. In conclusion, AHM and HIIT have independent and additive effects in lowering ABP. These findings support the combination of habitual AHM with exercise training with the goal to reduce ABP in hypertensive MetS individuals.
... A few previous studies have investigated the effect of different bouts of isocaloric endurance exercise on the PEH response: Comparing moderate and intensive endurance exercise, Ramirez-Jimenez et al. (2017) observed that the ambulatory blood pressure 14 hours post exercise was lower following intensive exercise. Their conclusion was that the magnitude of PEH responses was determined by the exercise intensity (39), while others have concluded that the total volume (energy expenditure) seems to be a major determinant of the PEH response in pre-hypertensive men (14). However, there are marked differences between the two latter studies, as Ramirez-Jiminez et al. (39) included both hypertensive and normotensive persons with metabolic syndrome, while Fonseca et al. (14) included pre-hypertensive men without metabolic syndrome. ...
... Their conclusion was that the magnitude of PEH responses was determined by the exercise intensity (39), while others have concluded that the total volume (energy expenditure) seems to be a major determinant of the PEH response in pre-hypertensive men (14). However, there are marked differences between the two latter studies, as Ramirez-Jiminez et al. (39) included both hypertensive and normotensive persons with metabolic syndrome, while Fonseca et al. (14) included pre-hypertensive men without metabolic syndrome. ...
... Hence, differences in participant baseline characteristics may affect the BP response following exercise. This argument is supported by the fact that Ramirez-Jiminez et al. observed no differences in ambulatory post-exercise BP in the normal-weight, normotensive participants in the above study (39). Taken together, the results of Jones et al., (22) and Ramirez-Jiminez et al., (39) suggest that the PEH response is independent of exercise intensity in healthy, normotensive adults, and this seems to be the case also for adults with elevated blood pressure/stage 1 hypertension without metabolic syndrome (present study). ...
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International Journal of Exercise Science 13(3): X-Y, 2020. This study investigated the acute post-exercise hypotension (PEH) response in persons with elevated blood pressure or stage 1 hypertension following moderate and high-intensity isoenergetic endurance exercise. Twelve middle-aged persons (six females), with resting systolic and diastolic BP of 130±6 and 84±7 mmHg, participated in three bicycle ergometer bouts: 1) Testing of peak aerobic capacity (VO2peak), 2) Moderate intensity exercise (MOD) at 66% of VO2peak, 3) High-intensity exercise (INT) at 80% of VO2peak. All variables were recorded pre-exercise, during exercise and 0, 5, 10, and 30 minutes post-exercise. The total duration of exercise was 26% longer during MOD than INT (p <0.001), while total energy expenditure (TEE) was similar between exercise conditions (359 ± 69 kcal). Oxygen consumption, heart rate, power output and ratings of perceived exertion was 21, 13, 21 and 26% higher during INT than MOD exercise, respectively (0.05 ≤ p ≤ 0.001). Compared to pre-exercise, systolic BP was significantly lower at 30 min post-exercise following both INT (p < 0.05) and MOD (p < 0.01) exercise, and there was no difference between INT and MOD conditions. Other variables were similar to pre-exercise values at 30 min post-exercise. Linear regression shows that the largest post-exercise reductions in systolic BP was found for the persons with the highest pre-exercise systolic BP (r = 0.58 r 2 = 0.33, p < 0.003). In conclusion, this study shows that endurance exercise with different intensities and durations, but similar TEE is equally effective in eliciting reductions in the post-exercise systolic BP. Furthermore, the magnitude of PEH response is partly dependent on the individuals' resting blood pressure.
... 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. ...
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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.
... In addition to the prolonged intervention duration (8 weeks longer), the increased magnitude of BP reduction observed in their study may be linked to the cohort recruited being Stage 2 hypertensive (>140/ 90 mmHg), as similar antihypertensive interventions have reported greater reductions in groups with higher baseline BP values [27,28]. This is potentially due to a lower threshold of BP response, where it cannot be decreased further below its homeostatic clinical level without producing a mechanistic response to prevent hypotension [29]. ...
... Although the optimal HIIT protocol is yet to be established, these separate findings provide support for HIIT as a flexible training modality, which can be successfully applied through various effective protocols. Regardless of these methodological differences, the limited number of studies investigating the effects of HIIT on ambulatory BP have reported similar results to ours, thus reinforcing the role of HIIT in the management of BP [29][30][31][32]. ...
Article
Abstract Objective: Hypertension remains the leading cause of cardiovascular disease and premature mortality globally. Although high-intensity interval training (HIIT) is an effective nonpharmacological intervention for the reduction of clinic blood pressure (BP), very little research exists regarding its effects on ambulatory BP. The aim of this study was to measure alterations in ambulatory and clinic BP following HIIT in physically inactive adults. Methods: Forty-one participants (22.8 ± 2.7 years) were randomly assigned to a 4-week HIIT intervention or control group. The HIIT protocol was performed on a cycle ergometer set against a resistance of 7.5% bodyweight and consisted of 3 × 30-s maximal sprints separated with 2-min active recovery. Clinic and ambulatory BP was recorded pre and post the control period and HIIT intervention. Results: Following the HIIT intervention, 24-h ambulatory BP significantly decreased by 5.1 mmHg in sBP and 2.3 mmHg in dBP (P = 0.011 and 0.012, respectively), compared with the control group. In addition, clinic sBP significantly decreased by 6.6 mmHg compared with the control group (P = 0.021), with no significant changes in dBP and mean BP (mBP). Finally, 24-h ambulatory diastolic, daytime sBP, mBP and dBP, and night-time sBP and mBP variability significantly decreased post-HIIT compared with the control group. Conclusion: HIIT remains an effective intervention for the management of BP. Our findings support enduring BP reduction and improved BP variability, which are important independent risk factors for cardiovascular disease.
... 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 ...
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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.
... 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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Full-text available
Background: In this study, we aimed at comparing the effects of three different exercise modalities on post-exercise hypotension (PEH) in elderly hypertensive patients and at investigating whether PEH responses to the same exercises are affected by their training status. Methods: Thirty-six male sedentary hypertensive patients over 60 years old, were included. They were divided into three groups each one corresponding to a different exercise modality, i.e., aerobic continuous exercise (ACE), high-intensive interval exercise (HIIE), and combined (aerobic and resistance) exercise (CE). PEH was assessed in each group by ambulatory blood pressure monitoring (ABPM) in two different conditions as follows: (1) sedentary status and (2) trained status, at the end of a 12 week of ACE training program. A cardiopulmonary test was performed before and at the end of the training program. Results: In the sedentary status, 24-h and nocturnal systolic and diastolic blood pressure (BP) decreased in all groups as compared with top pre-exercise, with a greater but not significant reduction in the ACE and CE groups as compared with HIIE. ACE and HIIE groups presented a more sustained PEH than CE. In the trained status, 24-h and nighttime systolic and diastolic BP decreased significantly only after HIIE, but were unchanged as compared with pre-exercise in the ACE and CE groups. Conclusions: ACE and CE produced greater PEH than HIIE in sedentary elderly hypertensive patients. However, after training, HIIE produced the greater and more sustained PEH. The training status appears to exert significant effects on PEH produced by different exercise modalities.
... Among the current trends in syndrome management, training programs composed of high intensity and short duration exercises have gained prominence. Indeed, several studies using the so-called HIIT (high-intensity interval training) with different intensities have shown promising results in reducing MetS and its components [202][203][204][205]. The beneficial impacts of moderate-intensity PA have been demonstrated by Lee et al. even in the absence of weight loss with significant reductions in total and abdominal fat in adult men regardless of previous body weight and physical activity levels [206]. ...
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... Among the potential effects of exercise on hypertensive patients, post-exercise hypotension is of clinical relevance because it indicates a reduction in the progression of cardiovascular disease, and low resting BP values are associated with reduced risk of death [28]. Interestingly, hypertensive individuals have more significant reductions in blood pressure when compared to non-hypertensive individuals, both acutely and chronically [29,30]. Besides, it has recently been proposed that acute response may be able to predict the responsiveness of hypertensive individuals to chronic exercise [31]. ...
Article
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We examined the effects of three exercise bouts, differing markedly in intensity, on postexercise hypotension (PEH). Eleven young adults (24.6 ± 3.7yr) completed four randomly assigned experimental conditions: 1) Control; 2) 30-minute Steady-State Exercise (SSE) at 75-80% maximum heart rate (HRmax); 3) Aerobic Interval Exercise (AIE): four, 4-minute bouts at 90-95% HRmax, separated by three minutes of active recovery, and 4) Sprint Interval Exercise (SIE): six, 30-second Wingate sprints, separated by 4 minutes of active recovery. Exercise was performed on a cycle ergometer. Blood pressure (BP) was measured prior to exercise and every 15 minutes postexercise for 3-hours. Linear mixed models were used to compare BP between trials. During the 3-hours postexercise, systolic BP (SBP) was lower (P < 0.001) after AIE (118 ± 10 mm Hg), SSE (121 ± 10 mm Hg), and SIE (121 ± 11 mm Hg) compared to control (124 ± 8 mm Hg). Diastolic BP (DBP) was also lower (P < 0.001) after AIE (66 ± 7 mm Hg), SSE (69 ± 6 mm Hg), and SIE (68 ± 8 mm Hg) compared to control (71 ± 7 mm Hg). Only AIE resulted in sustained (>2 hours) PEH, with SBP (120 ± 9 mm Hg) and DBP (68 ± 7 mm Hg) during the third hour postexercise being lower (P < .05) than control (124 ± 8 mm Hg and 70 ± 7 mm Hg). Although all exercise bouts produced similar reductions in BP at 1-hour postexercise, the duration of PEH was greatest after AIE.
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Vascular dysfunction is a precursor to the atherosclerotic cascade, significantly increasing susceptibility to cardiovascular events such as myocardial infarction or stroke. Previous studies have revealed a strong relationship between vascular function and cardiorespiratory fitness (CRF). Thus, since high-intensity interval training (HIIT) is a potent method of improving CRF, several small randomized trials have investigated the impact on vascular function of HIIT relative to moderate-intensity continuous training (MICT). The aim of this study was to systematically review the evidence and quantify the impact on vascular function of HIIT compared with MICT. Three electronic databases (PubMed, Embase, and MEDLINE) were searched (until May 2014) for randomized trials comparing the effect of at least 2 weeks of HIIT and MICT on vascular function. HIIT protocols involved predominantly aerobic exercise at a high intensity, interspersed with active or passive recovery periods. We performed a meta-analysis to compare the mean difference in the change in vascular function assessed via brachial artery flow-mediated dilation (FMD) from baseline to post-intervention between HIIT and MICT. The impact of HIIT versus MICT on CRF, traditional cardiovascular disease (CVD) risk factors, and biomarkers associated with vascular function (oxidative stress, inflammation, and insulin resistance) was also reviewed across included studies. Seven randomized trials, including 182 patients, met the eligibility criteria and were included in the meta-analysis. A commonly used HIIT prescription was four intervals of 4 min (4 × 4 HIIT) at 85-95 % of maximum or peak heart rate (HRmax/peak), interspersed with 3 min of active recovery at 60-70 % HRmax/peak, three times per week for 12-16 weeks. Brachial artery FMD improved by 4.31 and 2.15 % following HIIT and MICT, respectively. This resulted in a significant (p < 0.05) mean difference of 2.26 %. HIIT also had a greater tendency than MICT to induce positive effects on secondary outcome measures, including CRF, traditional CVD risk factors, oxidative stress, inflammation, and insulin sensitivity. HIIT is more effective at improving brachial artery vascular function than MICT, perhaps due to its tendency to positively influence CRF, traditional CVD risk factors, oxidative stress, inflammation, and insulin sensitivity. However, the variability in the secondary outcome measures, coupled with the small sample sizes in these studies, limits this finding. Nonetheless, this review suggests that 4 × 4 HIIT, three times per week for at least 12 weeks, is a powerful form of exercise to enhance vascular function.
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Purpose: The health benefits of a training program are largely influenced by the exercise dose and intensity. We sought to determine if during a training bout of continuous vs. interval exercise the workload needs to be reduced to maintain the prescribed target heart rate. Methods: Fourteen obese (31±4 kg·m) middle-age (57±8 y) individuals with metabolic syndrome, underwent two exercise training bouts matched by energy expenditure (i.e., 70±5 min of continuous exercise; CE or 45 min of interval exercise; HIIT). All subjects completed both trials in a randomized order. Heart rate (HR), power output (W), percent dehydration, intestinal and skin temperature (TINT and TSK), mean blood pressure (MAP), cardiac output (CO), stroke volume (SV) and blood lactate concentration (La) were measured at the initial and latter stages of each trial to assess time-dependent drift. Results: During the HIIT trial power output was lowered by 30±16 W to maintain the target HR while a 10±11 W reduction was needed in the CE trial (P<0.05). Energy expenditure, cardiac output and stroke volume declined with exercise time only in the HIIT trial (15%, 10% and 13%, respectively). During HIIT, percent dehydration, TINT and TSK increased more than during the CE trial (all P=0.001). MAP and La were higher in HIIT without time drift in any trial. Conclusion: Our findings suggests that while CE results in mild power output reductions to maintain target HR, the increasingly popular HIIT results in significant reductions in power output, energy expenditure and cardiac output (21%; 15% and 10%, respectively). HIIT based on target HR may result in lower than expected training adaptations due to workload adjustments to avoid HR drift.
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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.