Recreational beach tennis reduces 24-h blood pressure in adults with hypertension: a randomized crossover trial



To evaluate the effect of a beach tennis session on 24-h ambulatory blood pressure in adults with hypertension.


In this randomized crossover trial, 24 participants (12 men and 12 women) randomly performed two experimental sessions: a beach tennis session and a non-exercise control session. The beach tennis session started with a standardized 5-min warm-up consisting of basic techniques, followed by three 12-min beach tennis matches with 2-min intervals between them. Heart rate was continuously recorded and rating of perceived exertion was assessed in the middle and at the end of each set during the beach tennis session. Enjoyment was also assessed after the beach tennis session. The control session was performed in seated rest. Both experimental sessions lasted 45 min. Ambulatory blood pressure was measured continuously for 24 h after sessions.


Systolic blood pressure (24-h: 6 mmHg, P = 0.008; daytime: 6 mmHg, P = 0.031; nighttime: 6 mmHg, P = 0.042) and diastolic blood pressure (24-h: 3 mmHg, P = 0.021; daytime: 3 mmHg, P = 0.036; nighttime: 4 mmHg, P = 0.076) decreased after beach tennis when compared with control. The participants presented a reserve heart rate of 59–68%, and a rating of perceived exertion score of 3.4–4.7 using Borg’s CR10 Scale. The enjoyment scores after beach tennis session were higher than 90%.


A single session of recreational beach tennis reduces 24-h ambulatory blood pressure in adults with hypertension. Additionally, the participants can achieve a high physiological stress but perceive less effort during the practice.

Trial registration

Date: April 10, 2019; identifier number NCT03909308 (

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.



Blood pressure


Heart rate


Post-exercise hypotension


Rating of perceived exertion


  1. Andersen LJ, Randers MB, Westh K et al (2010) Football as a treatment for hypertension in untrained 30–55-year-old men: a prospective randomized study. Scand J Med Sci Sports 20(Suppl 1):98–102.

    Article  PubMed  Google Scholar 

  2. Arney BE, Glover R, Fusco A et al (2019) Comparison of rating of perceived exertion scales during incremental and interval exercise. Kinesiology 51:150–157

    Article  Google Scholar 

  3. Bartlett JD, Close GL, MacLaren DPM et al (2011) High-intensity interval running is perceived to be more enjoyable than moderate-intensity continuous exercise: implications for exercise adherence. J Sports Sci 29:547–553.

    Article  PubMed  Google Scholar 

  4. Bellissimo MP, Galaviz KI, Paskert MC, Lobelo F (2018) Cardiometabolic risk reduction through recreational group sport interventions in adults: a systematic review and meta-analysis. Mayo Clin Proc 93:1375–1396.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Berardi M, Lenabat P, Fabre T, Ballas R (2020) Beach tennis injuries: a cross-sectional survey of 206 elite and recreational players. Phys Sportsmed 48:173–178.

    Article  PubMed  Google Scholar 

  6. Bocalini DS, Bergamin M, Evangelista AL et al (2017) Post-exercise hypotension and heart rate variability response after water- and land-ergometry exercise in hypertensive patients. PLoS ONE 12:e0180216.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  7. Borg G (1990) Psychophysical scaling with applications in physical work and the perception of exertion. Scand J Work Environ Health 16(Suppl 1):55–58.

    Article  PubMed  Google Scholar 

  8. Borg G (1998) Borg’s perceived exertion and pain scales. Human Kinetics, Champaign

    Google Scholar 

  9. Boutron I, Altman DG, Moher D et al (2017) CONSORT statement for randomized trials of nonpharmacologic Treatments: a 2017 update and a CONSORT extension for nonpharmacologic trial abstracts. Ann Intern Med 167:40–47.

    Article  PubMed  Google Scholar 

  10. Carpio-Rivera E, Moncada-Jiménez J, Salazar-Rojas W et al (2016) Acute effects of exercise on blood pressure: a meta-analytic investigation. Arq Bras Cardiol 106:422–433.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Casonatto J, Goessler KF, Cornelissen VA et al (2016) The blood pressure-lowering effect of a single bout of resistance exercise: a systematic review and meta-analysis of randomised controlled trials. Eur J Prev Cardiol 23:1700–1714.

    Article  PubMed  Google Scholar 

  12. Cordeiro R, Monteiro W, Cunha F et al (2018) Influence of acute concurrent exercise performed in public fitness facilities on ambulatory blood pressure among older adults in Rio de Janeiro City. J Strength Cond Res 32:2962–2970.

    Article  PubMed  Google Scholar 

  13. Cornelissen VA, Smart NA (2013) Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc 2:e004473.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Cuspidi C, Tadic M, Grassi G, Mancia G (2018) Treatment of hypertension: the ESH/ESC guidelines recommendations. Pharmacol Res 128:315–321.

    Article  PubMed  Google Scholar 

  15. da Rissardi GGL, Cipullo JP, Moreira GC et al (2018) Prevalence of physical inactivity and its effects on blood pressure and metabolic parameters in a Brazilian urban population. Int J Cardiovasc Sci 31:594–602.

    Article  Google Scholar 

  16. Domingues LB, Cadore EL, Ferrari R (2021) Hemodynamic responses of resistance exercise performed with repetitions to failure and not to failure in adults with hypertension. Blood Press Monit 26(1):46–52.

    Article  PubMed  Google Scholar 

  17. Eston R (2012) Use of ratings of perceived exertion in sports. Int J Sports Physiol Perform 7:175–182.

    Article  PubMed  Google Scholar 

  18. Ferrari R, Umpierre D, Vogel G et al (2017) Effects of concurrent and aerobic exercises on postexercise hypotension in elderly hypertensive men. Exp Gerontol 98:1–7.

    Article  PubMed  Google Scholar 

  19. Ferrari R, Cadore EL, Périco B, Kothe GB (2021) Acute effects of body-weight resistance exercises on blood pressure and glycemia in middle-aged adults with hypertension. Clin Exp Hypertens 43(1):63–68.

    Article  PubMed  Google Scholar 

  20. Grossman E (2013) Ambulatory blood pressure monitoring in the diagnosis and management of hypertension. Diabetes Care 36:S307–S311.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Hunt K, Wyke S, Gray CM et al (2014) A gender-sensitised weight loss and healthy living programme for overweight and obese men delivered by Scottish Premier League football clubs (FFIT): a pragmatic randomised controlled trial. Lancet 383:1211–1221.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Kendzierski D, DeCarlo KJ (1991) Physical activity enjoyment scale: two validation studies. J Sport Exerc Psychol 13:50–64

    Article  Google Scholar 

  23. Kenney MJ (1979) Seals DR (1993) Postexercise hypotension. Key features, mechanisms, and clinical significance. Hypertens 22:653–664.

    Article  Google Scholar 

  24. Kiens B, Beyer N, Brage S et al (2007) Physical inactivity–consequences and correlations. Ugeskr Laeger 169:2442–2445

    PubMed  Google Scholar 

  25. Krustrup P, Dvorak J, Junge A, Bangsbo J (2010a) Executive summary: the health and fitness benefits of regular participation in small-sided football games. Scand J Med Sci Sports 20(Suppl 1):132–135.

    Article  PubMed  Google Scholar 

  26. Krustrup P, Hansen PR, Andersen LJ et al (2010b) Long-term musculoskeletal and cardiac health effects of recreational football and running for premenopausal women. Scand J Med Sci Sports 20(Suppl 1):58–71.

    Article  PubMed  Google Scholar 

  27. Kujala UM, Taimela S, Antti-Poika I et al (1995) Acute injuries in soccer, ice hockey, volleyball, basketball, judo, and karate: analysis of national registry data. BMJ 311:1465–1468

    CAS  Article  Google Scholar 

  28. Liu L, Zhang Y, Liu G et al (2005) The Felodipine Event Reduction (FEVER) Study: a randomized long-term placebo-controlled trial in Chinese hypertensive patients. J Hypertens 23:2157–2172.

    CAS  Article  PubMed  Google Scholar 

  29. Liu S, Goodman J, Nolan R et al (2012) Blood pressure responses to acute and chronic exercise are related in prehypertension. Med Sci Sports Exerc 44:1644–1652.

    Article  PubMed  Google Scholar 

  30. Los Arcos A, Vázquez JS, Martín J et al (2015) Effects of small-sided games vs. interval training in aerobic fitness and physical enjoyment in young elite soccer players. PLoS ONE.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Machado Filho J, Machado CLF, Tanaka H, Ferrari R (2020) Postexercise hypotension after muscle power training session in older adults with hypertension. J Aging Phys Act 28(4):652–657.

    Article  Google Scholar 

  32. Malachias M, Plavnik FL, Machado CA et al (2016) Brazilian guideline of arterial hypertension: chapter I—concept, epidemiology and primary prevention. Arq Bras Cardiol 107:1–6.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Miranda JJ, Carrillo-Larco RM, Ferreccio C et al (2020) Trends in cardiometabolic risk factors in the Americas between 1980 and 2014: a pooled analysis of population-based surveys. Lancet 8:e123–e133.

    Article  Google Scholar 

  34. NCD Risk Factor Collaboration (NCD-RisC) (2017) Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants. Lancet 389:37–55.

    Article  Google Scholar 

  35. Nielsen G, Wikman JM, Jensen CJ et al (2014) Health promotion: the impact of beliefs of health benefits, social relations and enjoyment on exercise continuation. Scand J Med Sci Sports 24(Suppl 1):66–75.

    Article  PubMed  Google Scholar 

  36. O’Brien E, Parati G, Stergiou G et al (2013) European society of hypertension position paper on ambulatory blood pressure monitoring. J Hypertens 31:1731–1768.

    CAS  Article  Google Scholar 

  37. Pescatello LS, Kulikowich JM (2001) The aftereffects of dynamic exercise on ambulatory blood pressure. Med Sci Sports Exerc 33:1855–1861.

    CAS  Article  PubMed  Google Scholar 

  38. Queiroz ACC, Sousa JCS, Cavalli A, a. P, et al (2015) Post-resistance exercise hemodynamic and autonomic responses: comparison between normotensive and hypertensive men. Scand J Med Sci Sports 25:486–494.

    CAS  Article  PubMed  Google Scholar 

  39. Raedeke TD (2007) The relationship between enjoyment and affective responses to exercise. J Appl Sport Psychol 19:105–115.

    Article  Google Scholar 

  40. Sakamoto S (2020) Prescription of exercise training for hypertensives. Hypertens Res 43:155–161.

    CAS  Article  PubMed  Google Scholar 

  41. Schimitt RP, Carpes LO, Domingues LB et al (2020) Effects of a single bout of power exercise training on ambulatory blood pressure in older adults with hypertension: a randomized controlled crossover study. Complement Ther Med 54:102554.

    Article  PubMed  Google Scholar 

  42. Sosner P, Guiraud T, Gremeaux V et al (2017) The ambulatory hypotensive effect of aerobic training: a reappraisal through a meta-analysis of selected moderators. Scand J Med Sci Sports 27:327–341.

    CAS  Article  PubMed  Google Scholar 

  43. Trajković N, Sporiš G, Krističević T, Bogataj Š (2020) Effects of small-sided recreational volleyball on health markers and physical fitness in middle-aged men. Int J Environ Res Public Health 17:3021.

    Article  PubMed Central  Google Scholar 

  44. Wegmann M, Hecksteden A, Poppendieck W et al (2018) Postexercise hypotension as a predictor for long-term training-induced blood pressure reduction: a large-scale randomized controlled trial. Clin J Sport Med 28:509–515.

    Article  PubMed  Google Scholar 

  45. Wilder J (1962) Basimetric approach (law of Initial Value) to biological rhythms. Ann N Y Acad Sci 98:1211–1220.

    CAS  Article  PubMed  Google Scholar 

Download references


We would like to thank Mr Tiago Antunes, Professor Joarez Santini, It’s Esportes e Eventos multisports club and Compass company for their support related to the structure to conduct the experimental sessions (beach tennis courts, rackets, and balls, among others). We also thank Dr. Sandra Fuchs and Guilhermo Sessim for their support related to data analysis and ambulatory blood pressure assessment equipment.


This study was partially funded by the Research and Education Fund of the Hospital de Clínicas de Porto Alegre (FIPE/HCPA, Grant number 18-0642). L.C and L.D received a scholarship from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)—finance code 001. R.F received a fellowship from the National Council for Scientific and Technological Development (CNPq).

Author information




Conceptualization, R.F; methodology, R.F, L.C, L.D, A.J and N.J.; formal analysis, R.F and L.C.; investigation, R.F, L.C and L.D.; resources, R.F.; data curation, R.F and L.C.; writing-original draft preparation, R.F and L.C.; writing-review and editing, R.F, L.C, L.D, A.J and N.J.; supervision, R.F.; project administration, R.F.; funding acquisition, R.F.

Corresponding author

Correspondence to Rodrigo Ferrari.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

The study protocol was approved by the Institutional Review Board of Hospital de Clínicas de Porto Alegre, Brazil (approval number 20180642), and registered on (identifier number NCT03909308).

Consent to participate

Written informed consent was obtained by all participants prior to data collection.

Consent for publication

All co-authors approved the final version of this manuscript.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Communicated by Kirsty Elliott sale.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Carpes, L., Jacobsen, A., Domingues, L. et al. Recreational beach tennis reduces 24-h blood pressure in adults with hypertension: a randomized crossover trial. Eur J Appl Physiol (2021).

Download citation


  • Post-exercise hypotension
  • Exercise
  • Cardiovascular system
  • Sand sports
  • Racket sports