Postexercise blood pressure reduction in elderly hypertensive patients

• Published in: Journal of the American College of Cardiology 2002-02, Vol.39 (4), p.676-682
• Main Authors: Brandão Rondon, Maria Urbana P, Alves, Maria Janieire N.N, Braga, Ana Maria F.W, Teixeira, Odila Tomoko U.N, Barretto, Antonio Carlos P, Krieger, Eduardo M, Negrão, Carlos Eduardo
• Format: Article
• Language: English
• Subjects: Aged; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood pressure; Blood Pressure - physiology; Blood Pressure Monitoring, Ambulatory; Body mass index; Carbon dioxide; Cardiac Output - physiology; Cardiology; Cardiology. Vascular system; Cardiovascular disease; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Colleges & universities; Echocardiography, Doppler; Equilibrium; Exercise; Exercise - physiology; Exercise Therapy; Female; Heart; Heart attacks; Heart rate; Hemodynamics - physiology; Humans; Hypertension; Hypertension - diagnostic imaging; Hypertension - physiopathology; Hypertension - therapy; Hypotheses; Male; Medical sciences; Metabolic disorders; Older people; Time Factors; Ventricular Function, Left - physiology
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/S0735-1097(01)01789-2

We sought to study: 1) the impact of hemodynamic and left ventricular function on short-term postexercise blood pressure reduction in elderly hypertensive patients; and 2) the 22-h postexercise effects on ambulatory blood pressure in elderly hypertensive patients. Although early exercise provokes postexercise blood pressure reduction, the mechanisms underlying this response are not completely understood. Besides, it is unclear whether the reduction in blood pressure after exercise lasts long enough to have clinical relevance in elderly hypertensive patients. We studied 24 elderly hypertensive patients (age 68.9 ± 1.5 years) and 18 age-matched normotensive control subjects (age 68.1 ± 1.2 years). Cardiac output (carbon dioxide rebreathing) and blood pressure (auscultatory) were measured at rest and after a 45-min period of low-intensity bicycle exercise (50% maximal oxygen uptake) and at 15, 30, 60 and 90 min after exercise. Left ventricular function (by Doppler echocardiography) was also evaluated. Ambulatory blood pressure monitoring was evaluated after 45 min of exercise or 45 min of rest, in a randomized order. In the hypertensive patients, exercise provoked a significant reduction in blood pressure, cardiac output, stroke volume and left ventricular end-diastolic volume. It also provoked a significant reduction in systolic, mean and diastolic blood pressure during a 22-h period, at daytime and nighttime. The short-term reduction in blood pressure after exercise in elderly hypertensive patients is associated with a decrease in stroke volume and left ventricular end-diastolic volume. The 22-h postexercise reduction in blood pressure demonstrates the clinical relevance of low-intensity exercise in elderly hypertensive patients.