Accumulation of physical activity: blood
pressure reduction between 10-min
S Park1, LD Rink2and JP Wallace3
1Division of Sports Science, Korea Institute of Sport Science, Seoul, Korea;2Department of Medicine, Indiana
University Medical Center, Bloomington, IN, USA and3Clinical Exercise Physiology Laboratory, Department
of Kinesiology, Indiana University, Bloomington, IN, USA
The accumulation of intermittent bouts of physical
activity (PA) has been found to reduce blood pressure
(BP) in prehypertension and hypertension. Yet, the BP
response among several short sessions within the
accumulation of PA in a single day has not been
examined. The purpose of the study was (1) to
investigate the BP reduction during the rest periods
following three successive 10-min walking sessions
accumulated over a 3-h period in prehypertensive adults
and (2) to observe the role of autonomic modulation
during the rest periods following each short PA
session. Adults with prehypertension (131.9±4.7/82.5±
6.4mmHg) participated in the study. BP using ambula-
tory monitoring and autonomic modulation through
heart rate variability (HRV) using Holter monitoring were
measured at baseline and during the rest periods
following three short sessions (three 10-min treadmill
walks at 50% of peak oxygen uptake (VO2peak); at least
50min apart) over a 3-h period. Variables of BP and
autonomic modulation were averaged for the baseline
and for the rest periods following each 10-min walk.
One-way analysis of variance with repeated measures
was used to test the differences over time in BP and HRV
(Po0.05). A significant main effect was found in systolic
BP (P¼0.039), whereas none was found in diastolic BP
(P¼0.630). Systolic BP was decreased following the
third short session (?4.0±7.4mmHg) compared to
baseline. No significance was found in any of the
autonomic modulation variables. In conclusion, accu-
mulating intermittent bouts of PA, as short as 10min,
total 30-min walk sessions may reduce systolic BP in
Journal of Human Hypertension (2008) 22, 475–482;
doi:10.1038/jhh.2008.29; published online 8 May 2008
Keywords: ambulatory blood pressure; post-exercise hypotension; fractionization of exercise; heart rate variability;
A public health strategy to prevent hypertension
is warranted as the lifetime risk of developing
hypertension is about 90%.1The primary preven-
tion of hypertension has been promoted to the
population, particularly in adults with prehyperten-
sion (defined as systolic blood pressure (BP) of
120–139mmHg and/or diastolic BP of 80–89mmHg),1
which is associated with an increase in cardio-
modifications, including regular physical activity
(PA), are the only recommended treatment for
prehypertension.1,5The PA recommendation for
the treatment of both prehypertension and hyper-
tension includes the accumulation of 30min or
more of moderately intense PA in most, preferably
all, days of the week.1,6Yet, the scientific evidence
has neglected the accumulation aspects of PA in the
treatment of hypertension and prehypertension.1,6,7
The American College of Sports Medicine Position
Stand on exercise and hypertension stated that
there is limited evidence regarding the accumula-
tion of several short sessions of PA on BP reduction6.
This limited scientific evidence led to our work
in the accumulation of PA as a treatment for
We have investigated the effects of the accumula-
tion of PA in prehypertension and hypertension8,9
First, we8examined the effects of the accumulation
of lifestyle PA in prehypertension and hypertension.
The accumulation of lifestyle PA over a 12-h period
significantly reduced systolic BP in adults with
prehypertension (?6.6±2.3mmHg for 6h) and
hypertension (?12.9±4.3mmHg for 8h). For the
second study,9we took this field study8into the
laboratory for a more controlled investigation. We
Received 28 September 2007; revised 7 February 2008; accepted
23 February 2008; published online 8 May 2008
Correspondence: Dr S Park, Division of Sports Science, Korea
Institute of Sport Science, 223-19 Kongneung-Dong, Nowon-Gu,
Seoul 139-242, Korea.
Journal of Human Hypertension (2008) 22, 475–482
& 2008 Nature Publishing Group All rights reserved 0950-9240/08 $30.00
pressure reduction following acute exercise. J Hum
Hypertens 1999; 13: 361–366.
15 Task Force of The European Society of Cardiology and
The North American Society of Pacing and Electro-
physiology. Heart rate variability: standards of mea-
surement, physiological interpretation, and clinical
use. Eur Heart J 1996; 17: 354–381.
16 Keppel G. Design and Analysis: A Researcher’s Hand-
book, 3rd edn. A Simon & Schuster Company: Upper
Saddle River, NJ.
17 Williams B, Poulter NR, Brown MJ, Davis M, McInnes
GT, Potter JF et al. Guidelines for management of
hypertension: report of the fourth working party of the
British Hypertension Society, 2004-BHS IV. J Hum
Hypertens 2004; 18: 139–185.
18 Taylor R, Chidley K, Goodwin J, Broeders M, Kirby B.
Accutracker II (version 30/23) ambulatory blood
pressure monitor: clinical validation using the British
hypertension society and association for the advence-
ment of medical Instrumentation standards. J Hyper-
tens 1993; 1993: 1275–1282.
19 Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN,
Franklin BA et al. Physical activity and public health:
updated recommendation for adults from the Amer-
ican college of sports medicine and the American heart
association. Circulation 2007; 116: 1081–1093.
20 Almuzaini KS, Potteiger JA, Green SB. Effects of split
exercise sessions on excess postexercise oxygen con-
sumption and resting metabolic rate. Can J Appl
Physiol 1998; 23: 433–443.
21 Kaminsky LA, Padjen S, LaHam-Saeger J. Effect of split
exercise sessions on excess post-exercise oxygen
consumption. Br J Sports Med 1990; 24: 95–98.
22 Park S, Scherzinger JR, Bollinger LC, Nuseibeh LO,
Rink LD, Wallace JP. Blood pressure reduction in
prehypertension: accumulation of physical activity vs
a single continuous session. Med Sci Sports Exerc
2006; 38(5 Supplement): S536.
23 Park S, Jastremski CA, Wallace JP. Time of day for
exercise on blood pressure reduction in dipping and
nondipping hypertension. J Hum Hypertens 2005; 19:
24 LegramanteJM, Galante
Attanasio A, Raimondi G, Pigozzi F et al. Hemody-
hypotension in patients with mild hypertension.
Am J Physiol Regul Integr Comp Physiol 2002; 282:
25 Pober DM, Braun B, Freedson PS. Effects of a single
bout of exercise on resting heart rate variability. Med
Sci Sports Exerc 2004; 36: 1140–1148.
26 Bernardi L, Passino C, Robergs R, Appenzenller O.
Acute and persistent effects of a 46-kilometre wild-
erness trail run at altitude: cardiovascular autonomic
modulation and baroreflexes. Cardiovasc Res 1997; 34:
27 Piepoli M, Coats AJS, Adamopoulos S, Bernardi L,
Feng YH, Conway J et al. Persistent peripheral
vasodilation and sympathetic activity in hypotension
after maximal exercise. J Appl Physiol 1993; 75:
28 World Health Organization, International Society of
Hypertension Writing Group. 2003 World Health
Organization (WHO)/International Society of Hyper-
tension (ISH) statement on management of hyperten-
sion. J Hypertens 2003; 21: 1983–1992.
Accumulating 10-min brisk walking sessions on blood pressure reduction
S Park et al
Journal of Human Hypertension