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European Journal of Applied Physiology

, Volume 119, Issue 5, pp 1235–1243 | Cite as

High-intensity interval exercise promotes post-exercise hypotension of greater magnitude compared to moderate-intensity continuous exercise

  • Flávia C. Pimenta
  • Fábio Tanil Montrezol
  • Victor Zuniga Dourado
  • Luís Fernando Marcelino da Silva
  • Gabriela Alves Borba
  • Wesley de Oliveira Vieira
  • Alessandra MedeirosEmail author
Original Article

Abstract

Purpose

Physical exercise is associated with reduced blood pressure (BP). Moderate-intensity continuous exercise (MCE) promotes post-exercise hypotension (PEH), which is highly recommended to hypertensive patients. However, recent studies with high-intensity interval exercise (HIIE) have shown significant results in cardiovascular disease. Thus, this study aimed to analyze PEH in hypertensive subjects submitted to HIIE and compare it to post MCE hypotension.

Methods

20 hypertensive adults (51 ± 8 years), treated with antihypertensive medications, were submitted to two different exercise protocols and a control session. The MCE was performed at 60–70% of VO2 reserve, while HIIE was composed of five bouts of 3 min at 85–95% VO2 reserve with 2 min at 50% of VO2 reserve. The following variables were evaluated during exercise, pre- and post-session: clinical BP, heart rate (HR), double product, perception of effort, body mass, height and body mass index.

Results

Systolic BP decreased after exercise in both sessions, showing greater decrease after HIIE (− 7 ± 10 and − 11 ± 12 mmHg, after MCE and HIIE, respectively, p ≤ 0.01). Diastolic BP also decreased after both sessions, but there were no significant differences between the two sessions (− 4 ± 8 and − 7 ± 8 mmHg, after MCE and HIIE, respectively).

Conclusion

Both exercise sessions produced PEH, but HIIE generated a greater magnitude of hypotension. The HIIE protocol performed in this study caused a greater cardiovascular stress during exercise; however, it was safe for the studied population and efficient for reducing BP after exercise.

Keywords

Hypertension Post-exercise hypotension Aerobic exercise Moderate-intensity continuous exercise High-intensity interval exercise 

Abbreviations

ANOVA

Analysis of variance

BMI

Body mass index

BP

Blood pressure

CVD

Cardiovascular disease

DBP

Diastolic blood pressure

DP

Double product

EPIMOV

Epidemiology and human movement

HIIE

High-intensity interval exercise

HR

Heart rate

MAP

Mean arterial pressure

MCE

Moderated-intensity continuous exercise

PHE

Post-exercise hypotension

PSE

Perception-subjective effort

SBP

Systolic blood pressure

SD

Standard deviation

SEM

Standard error of the mean

VO2peak

Maximal oxygen uptake

Notes

Acknowledgements

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001.

Author contributions

AM, FCP and VZD conceived and designed research. FCP, LFMS, GAB and WOV conducted experiments. AM, FCP and FTM analyzed data. AM, FCP, FTM and VZD wrote the manuscript. All authors read and approved the manuscript.

Compliance with ethical standards

Conflict of interest

The authors report no relationships that could be construed as a conflict of interest.

References

  1. Angadi SS, Bhammar DM, Gaesser GA (2015) Postexercise hypotension after continuous, aerobic interval, and sprint interval exercise. J Strength Cond Res 29:2888–2893CrossRefGoogle Scholar
  2. Blair SN, Kampert JB, Kohl HW, Barlow CE, Macera CA, Paffenbarger RS, Gibbons LW (1996) Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA 276:205–210CrossRefGoogle Scholar
  3. Borg GA, Noble BJ (1974) Perceived exertion. Exerc Sport Sci Rev 2:131–154CrossRefGoogle Scholar
  4. Brook RD et al (2013) Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the American heart association. Hypertension 61:1360–1383.  https://doi.org/10.1161/HYP.0b013e318293645f CrossRefGoogle Scholar
  5. Buchheit M, Laursen PB (2013) High-intensity interval training solutions to the programming puzzle. Sports Med 43:313–338CrossRefGoogle Scholar
  6. Burgomaster KA, Howarth KR, Phillips SM, Rakobowchuk M, MacDonald MJ, McGee SL, Gibala MJ (2008) Similar metabolic adaptations during exercise after low volume sprint interval and traditional endurance training in humans. J Physiol 586:151–160CrossRefGoogle Scholar
  7. Cardiologia. SBd (2016) 7° Diretriz Brasileira de Hipertensão ArterialGoogle Scholar
  8. Carlson RV, Boyd KM, Webb DJ (2004) The revision of the Declaration of Helsinki: past, present and future. Br J Clin Pharmacol 57:695–713CrossRefGoogle Scholar
  9. Crozier J et al (2018) High-intensity interval training after stroke: an opportunity to promote functional recovery. Cardiovasc Health Neuroplast Neurorehabil Neural Repair 32:543–556.  https://doi.org/10.1177/1545968318766663 CrossRefGoogle Scholar
  10. Cunha GA, Rios ACS, Moreno JR, Braga PL, Campbell CSG, Simões HG, Denadai MLDR (2006) Hipotensão pós-exercício em hipertensos submetidos ao exercício aeróbio de intensidades variadas e exercício de intensidade constante. Revista Brasileira de Medicina do Esporte 12:313–317CrossRefGoogle Scholar
  11. Eckel RH et al (2014) 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on. Pract Guidel Circ 129:S76–S99.  https://doi.org/10.1161/01.cir.0000437740.48606.d1 Google Scholar
  12. Forjaz CL, Cardoso CG Jr, Rezk CC, Santaella DF, Tinucci T (2004) Postexercise hypotension and hemodynamics: the role of exercise intensity. J Sports Med Phys Fit 44:54–62Google Scholar
  13. Fu T-c et al (2013) Aerobic interval training improves oxygen uptake efficiency by enhancing cerebral and muscular hemodynamics in patients with heart failure. Int J Cardiol 167:41–50CrossRefGoogle Scholar
  14. Gibala MJ (2007) High-intensity interval training: a time-efficient strategy for health promotion? Curr Sports Med Rep 6:211–213Google Scholar
  15. Gibala MJ, McGee SL (2008) Metabolic adaptations to short-term high-intensity interval training: a little pain for a lot of gain? Exerc Sport Sci Rev 36:58–63CrossRefGoogle Scholar
  16. Gibala MJ, Little JP, MacDonald MJ, Hawley JA (2012) Physiological adaptations to low-volume, high-intensity interval training in health and disease. J Physiol 590:1077–1084CrossRefGoogle Scholar
  17. Hagberg JM, Montain SJ, Martin Wr (1987) Blood pressure and hemodynamic responses after exercise in older hypertensives. J Appl Physiol 63:270–276CrossRefGoogle Scholar
  18. Halliwill JR, Buck TM, Lacewell AN, Romero SA (2013) Postexercise hypotension and sustained postexercise vasodilatation: what happens after we exercise? Exp Physiol 98:7–18CrossRefGoogle Scholar
  19. Hansen JE, Sue DY, Wasserman K (1984) Predicted values for clinical exercise testing. Am Rev Respir Dis 129:S49–S55.  https://doi.org/10.1164/arrd.1984.129.2P2.S49 CrossRefGoogle Scholar
  20. Harber MP, Kaminsky LA, Arena R, Blair SN, Franklin BA, Myers J, Ross R (2017) Impact of cardiorespiratory fitness on all-cause and disease-specific mortality: advances since 2009. Prog Cardiovasc Dis 60:11–20  https://doi.org/10.1016/j.pcad.2017.03.001 CrossRefGoogle Scholar
  21. Headley SA, Claiborne JM, Lottes CR, Korba CG (1996) Hemodynamic responses associated with post-exercise hypotension in normotensive black males. Ethn Dis 6(1–2):190–201Google Scholar
  22. Helgerud J et al (2007) Aerobic high-intensity intervals improve VO2max more than moderate training. Med Sci Sports Exerc 39:665–671CrossRefGoogle Scholar
  23. James PA et al (2014) 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 311:507–520CrossRefGoogle Scholar
  24. Jung ME, Bourne JE, Little JP (2014) Where does HIT fit? An examination of the affective response to high-intensity intervals in comparison to continuous moderate-and continuous vigorous-intensity exercise in the exercise intensity-affect continuum. PLoS One 9:e114541CrossRefGoogle Scholar
  25. Kannel WB (1996) Blood pressure as a cardiovascular risk factor: prevention and treatment. JAMA 275:1571–1576CrossRefGoogle Scholar
  26. Kelley G (1997) Dynamic resistance exercise and resting blood pressure in adults: a meta-analysis. J Appl Physiol 82:1559–1565CrossRefGoogle Scholar
  27. Kemi OJ, Wisløff U (2010) High-Intensity aerobic exercise training improves the heart in health and disease. J Cardiopulm Rehabil Prev 30:2–11CrossRefGoogle Scholar
  28. Kenney MJ, Seals DR (1993) Postexercise hypotension. Key features, mechanisms and clinical significance. Hypertension 22:653–664CrossRefGoogle Scholar
  29. Khan NA et al (2009) The 2009 Canadian hypertension education program recommendations for the management of hypertension: part 2—therapy. Can J Cardiol 25:287–298CrossRefGoogle Scholar
  30. Lacombe SP, Goodman JM, Spragg CM, Liu S, Thomas SG (2011) Interval and continuous exercise elicit equivalent postexercise hypotension in prehypertensive men, despite differences in regulation. Appl Physiol Nutr Metab 36:881–891CrossRefGoogle Scholar
  31. Laukkanen JA, Zaccardi F, Khan H, Kurl S, Jae SY, Rauramaa R (2016) Long-term change in cardiorespiratory fitness and all-cause mortality: a population-based follow-up study. Mayo Clinic Proc 91:1183–1188.  https://doi.org/10.1016/j.mayocp.2016.05.014 CrossRefGoogle Scholar
  32. Law M, Morris J, Wald N (2009) Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ 338:b1665CrossRefGoogle Scholar
  33. Liu S, Goodman J, Nolan R, Lacombe S, Thomas SG (2012) Blood pressure responses to acute and chronic exercise are related in prehypertension. Med Sci Sports Exerc 44:1644–1652CrossRefGoogle Scholar
  34. MacDonald JR (2002) Potential causes, mechanisms, and implications of post exercise hypotension. J Hum Hypertens 16:225CrossRefGoogle Scholar
  35. MacDonald JR, Hogben CD, Tarnopolsky MA, MacDougall JD (2001) Post exercise hypotension is sustained during subsequent bouts of mild exercise and simulated activities of daily living. J Hum Hypertens 15:567–571.  https://doi.org/10.1038/sj.jhh.1001223 CrossRefGoogle Scholar
  36. Medicine ACoS (2013) ACSM’s guidelines for exercise testing and prescription. Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar
  37. Milanović Z, Sporiš G, Weston M (2015) Effectiveness of high-intensity interval training (HIT) 3 and continuous endurance training for VO2max improvements: 4 a systematic review and meta-analysis of controlled trials. Sports Med.  https://doi.org/10.1007/s40279-015-0365-0 Google Scholar
  38. Moholdt T et al (2012) Aerobic interval training increases peak oxygen uptake more than usual care exercise training in myocardial infarction patients: a randomized controlled study. Clin Rehabil 26:33–44.  https://doi.org/10.1177/0269215511405229 CrossRefGoogle Scholar
  39. Molmen-Hansen HE et al (2012) Aerobic interval training reduces blood pressure and improves myocardial function in hypertensive patients. Eur J Prev Cardiol 19:151–160CrossRefGoogle Scholar
  40. WHO (2013) A global brief on hypertension: silent killer, global public health crisis. https://www.who.int/cardiovascular_diseases/publications/global_brief_hypertension/en/
  41. Pescatello LS, Fargo AE, Leach CN, Scherzer HH (1991) Short-term effect of dynamic exercise on arterial blood pressure. Circulation 83:1557–1561CrossRefGoogle Scholar
  42. Pescatello LS, Franklin BA, Fagard R, Farquhar WB, Kelley GA, Ray CA (2004) American College of Sports Medicine position stand. Med Sci Sports Exerc 36:533–553CrossRefGoogle Scholar
  43. Pescatello LS, MacDonald HV, Lamberti L, Johnson BT (2015) Exercise for hypertension: a prescription update integrating existing recommendations with emerging research. Curr Hypertens Rep 17:87CrossRefGoogle Scholar
  44. Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, Cooney MT, Corrà U, Cosyns B, Deaton C, Graham I, Hall MS, Hobbs FDR, Løchen ML, Löllgen H, Marques-Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders Y, Tiberi M, Bart van der Worp H, van Dis I, Verschuren WMM (2016) 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Atherosclerosis 252:207–274.  https://doi.org/10.1016/j.atherosclerosis.2016.05.037 CrossRefGoogle Scholar
  45. Quinn TJ (2000) Twenty-four hour, ambulatory blood pressure responses following acute exercise: impact of exercise intensity. J Hum Hypertens 14:547–553CrossRefGoogle Scholar
  46. Rocco EA et al (2012) Effect of continuous and interval exercise training on the PETCO2 response during a graded exercise test in patients with coronary artery disease. Clinics 67:623–628CrossRefGoogle Scholar
  47. Taylor-Tolbert NS, Dengel DR, Brown MD, McCole SD, Pratley RE, Ferrell RE, Hagberg JM (2000) Ambulatory blood pressure after acute exercise in older men with essential hypertension. Am J Hypertens 13:44–51CrossRefGoogle Scholar
  48. Team RC (2016) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna. 2015. http://www.R-project.org. Accessed 25 Jan 2017
  49. Tjønna AE et al (2008) Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome. Circulation 118:346–354CrossRefGoogle Scholar
  50. Wallace JP, Bogle PG, King BA, Krasnoff JB, Jastremski CA (1999) The magnitude and duration of ambulatory blood pressure reduction following acute exercise. J Hum Hypertens 13:361–366CrossRefGoogle Scholar
  51. Wasserman K, Whipp BJ (1975) Excercise physiology in health and disease. Am Rev Resp Dis 112:219–249.  https://doi.org/10.1164/arrd.1975.112.2.219 Google Scholar
  52. Wen H, Wang L (2017) Reducing effect of aerobic exercise on blood pressure of essential hypertensive patients: a meta-analysis. Medicine 96:e6150.  https://doi.org/10.1097/md.0000000000006150 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Flávia C. Pimenta
    • 1
  • Fábio Tanil Montrezol
    • 1
  • Victor Zuniga Dourado
    • 2
  • Luís Fernando Marcelino da Silva
    • 1
  • Gabriela Alves Borba
    • 1
  • Wesley de Oliveira Vieira
    • 2
  • Alessandra Medeiros
    • 1
    Email author
  1. 1.Department of BiosciencesFederal University of São PauloSantosBrazil
  2. 2.Department of Human Movement SciencesFederal University of São PauloSantosBrazil

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