Acute effects of low intensity dynamic exercise on Heart rate variability and blood pressure of Normotensive and mild hypertensive individuals
Keywords:
hypertension, heart are variability, motor activity, physical therapyAbstract
Objective
To provide information to better understand the immediate effect (acute hypotensive effect) of low-intensity aerobic dynamic physical activity on the blood pressure of normotensive and mild essential hypertensive patients and the probable cardiac autonomic contribution to this process.
Methods
Ten normotensive and 7 mild essential hypertensive patients with a mean age of 21.7 ± 2.9 and 26.4 ± 8.1 years, respectively, were studied. The dynamic physical activity proposed for the study was light aerobic, at reference values of 60% of submax heart rate, understood as HRsubmax = [(195 - age) x 60%) carried out for 40 minutes. Heart Rate Variability was the tool used to analyze cardiac autonomic function in the phases of initial rest and post-exertion recovery (0 to 10 minutes after dynamic physical activity).
Results
There was a reduction in blood pressure after dynamic physical activity; however, it was found that in the normotensive group this fact was significantly linked to diastolic blood pressure values, while in the mild hypertensive group the most important hypotensive effect occurred with systolic blood pressure. However, with the analysis of Heart Rate Variability, in the time elapsed between 0 and 10 minutes of the recovery phase after dynamic physical activity, it was not possible to document a significant cardiac autonomic participation as responsible for the reduction in blood pressure levels obtained; Despite this, there was a tendency towards an increase in the values of variables that reflect parasympathetic activity and a reduction in those that show cardiac sympathetic activity.
Conclusion
The study demonstrated that appropriately prescribed dynamic physical activity can transiently reduce blood pressure in normotensive and mild essential hypertensive patients, as documented in the O to 1 O phase minutes after exertion, and that there are indications that frequent exposure to dynamic physical activity could promote beneficial adaptations to control mild hypertension. Furthermore, based on the results obtained, it can be inferred that if a larger number of individuals were studied, the analysis of Heart Rate Variability could, together with peripheral adjustments, demonstrate a more significant cardiac autonomic contribution to the process of post-exercise arterial hypotension.
Downloads
References
Somers VK, Conway J, Coats A, lsea J, Sleight P. Postexercise hypotension is not sustained in normal and hypertensive humans. Hypertension 1991; 18:211-5.
Pescatello LS, Fargo AE, Leach CN, Scherger HH. Short term effect of dynamic exercise on blood pressure. Circulation 1991; 83:1557-61.
Kenney MJ, Seals, DR. Postexercise hypotension. Hypertension 1993; 22:653-64.
Forjaz CLM, Rezk CC, Santaella DF, et ai. Hipotensão pós-exercício: características, determinantes e mecanismos. Rev Soe Cardiol Estado de São Paulo 2000; 3 supl A: 16-24.
Wilcox RG, Bennett T, Brown AM, MacDonald IA. Is exercise good for high blood pressure? Br Med J 1982; 285:767-9.
Hagberg JM, Montain SJ, Martin WH. Blood pressure and hemodynamic responses after exercise in older hypertensives. J Appl Physiol 1987; 63:270-276.
Hara K, Floras JS. lnfluence of naloxone on muscle sympathetic nerve activity, systemic and calf haemodynamics and ambulatory blood pressure after exercise in mild essential hypertension. J Hypertens 1994; 13:447-61.
Halliwill Jr, Taylor JA, Hartwig TD, Eckberg DL. Augment baroreflex heart rate gain after moderate intensity dynamic exercise. Am J Physiol 1996; 270:420-6.
Piepoli M, lsea JE, Pannarale G, Adamopoulos S, Sleight P, Coats AJS. Load dependence of changes in forearm and peripheral vascular resistance after acute leg exercise in man. J Appl Physiol 1994; 478:357-62.
Bennett T, Wilcox R, MacDonald JA. Post-exercise reduction of blood pressure in hypertensive men is not due to acute impairment of baroreflex function. Clin Sei 1984; 67:97-103.
Forjaz CLM, Santaella DF, Rezende LO, Barreto ACP, Negrão CE. A duração de exercício determina a magnitude da duração da hipotensão pós-exercício. Arq Bras Cardiol 1998; 70:99-104.
Forjaz CLM, Ramires PR, Tinucci T, Ortega KC, Salomão HEH, lgnês EC. Postexercise response of muscle symphatetic nerve activity and blood flow to hyperinsulinemia in humans. J Appl Physiol 1999; 87:824-9.
Patil RD, DiCarlo SE, Collins HL. Acute exercise enhances nitric oxide modulation of vascular response to phenylephrine. Am J Physiol 1993; 265:H 1184-8.
Paschoal MA. Variabilidade da freqüência cardíaca: estudo das influências autonômicas sobre suas características temporal e espectral em halterofilistas e sedentários [doutorado]. Campinas: Faculdade de Educação Física, Universidade Estadual de Campinas; 1999.
Paschoal MA, Gonçalves NVO, Petrelluzzi KFS, MACHADO RV. Controle autonômico cardíaco durante a execução de atividade física dinâmica de baixa intensidade. Rev Soe Cardiol Estado de São Paulo 2003; 5(supl A): 1-11.
Yamamoto K, Miyachi M, Saitoh T, Yoshioka A, Onodera S. Effects of endurance training on resting and post-exercise cardiac autonomic contrai. Med Sei Sports Exerc 2001; 33(9): 1496-502.
Guzzetti S, Piccaluga E, Casati R, et ai. Symphatetic predominance in essential hypertension: a study employing spectral analysis of heart rate variability. J Hypertens 1988; 6:711-7.
Kulics MJ, Heidi LC, DiCarlo SE. Postexercise hypotension is mediated by reductions in sympathetic nerve activity. Am J Physiol 1999; 276:H27-32.
Task Force of the European Society of Cardiology and North American Society of Pacing and Electrophysiology - Heart rate variability - standards od measurement, physiological interpretation, and clinicai use. Circulation 1996; 93:1043-65.
American College of Sports Medicine - Position Stand - Physical activity, physical fitness, and hypertension. Med Sei Sports Exerc 1993; 25(1 0):i-x.
Urata H, Tanabe Y, Kiyonaga A, et ai. Antihypertensive and volume-depleting effects of mild exercise on essential hypertension. Hypertension 1987; 9:245-52.
Kiyonaga A, Arakawa K, Tanaka H, Shindo M. Blood pressure and hormonal responses to aerobic exercise. Hypertension 1985; 7: 125-31.
Hagberg JM, Montain SJ, Martin WH, Ehsani AA. Effect of exercise training on 60-69 year old persons with essential hypertension. Am J Cardiol 1989; 64:348-53.
Baglivo H, Fabregues G, Burrieza H, Esper RC, Talarico M, Esper RJ. Effect of moderate physical training on left ventricular mass in mild hypertensive persons. Hypertension 1990; 15 Suppl 1:1153-116.
Martin JE, Dubbert PM, Cushman WC. Controlled triai of aerobic exercise in hypertension. Circulation 1990; 81:1560-7.
Jensen-Urstad K, Storck N, Bouvier F, Ericson M, Lindblad LE, Jensen-Urstad M. Heart rate variability in health subjects is related to age and gender. Acta Physiol Scand 1997; 160:235-41.
Tasaki H, Serita T, lrita A, Hano O, lliev 1, Ueyamac C, et ai. A 15-year longitudinal follow-up study of heart rate and heart rate variability in healthy elderly persons. J Gerontol A Biol Sei Med Sei 2000; 55(12):M744-9.
Arrol B, Beaglehole R. Does physical activity lower blood pressure: a criticai review of the clinicai triais. J Clin Epidemiol 1992; 41:439-47.
Wilmore JH, Costill DL. Fisiologia do esporte e do exercício. 2.ed. São Paulo: Manole; 2003.
Shoji VM, Forjaz CLM. Treinamento físico na hipertensão arterial. Rev Soe Cardiol Estado de São Paulo 2000; 10(6 supl A):7-14.