title: Reversal of exertional hypotension by prolonged exercise training in selected patients with ischemic heart disease.
abstract: The effect of prolonged intense endurance exercise training on exertional hypotension was investigated in 16 patients with coronary artery disease who had a 10 mm Hg or greater fall in systolic blood pressure (SBP) during progressive exercise testing. Training consisted of walking, running, or cycling at 50% to 60% of peak oxygen uptake (peak VO2) for 30 min 3 days per week for an initial 3 months and was followed by an additional 9 months of similar exercise performed at 70% to 90% of peak VO2 for 50 to 60 min 5 days per week. The 1 year program resulted in a 41% increase in peak VO2 and lower heart rate and blood pressure responses to submaximal work. Before conditioning, SBP attained a maximal value of 162 +/- 5 mm Hg but fell 21 +/- 3 mm Hg, to 141 +/- 7 mm Hg, at peak effort (p less than .01). After training, maximal SBP was achieved at a faster heart rate (157 +/- 5 vs 132 +/- 6 beats/min; p less than .001) and was 7.4% higher (174 +/- 6 vs 162 +/- 5 mm Hg; p less than .005), while SBP at peak exercise had increased by 21% (171 +/- 6 vs 141 +/- 7 mm Hg; p less than .001) and ST segment depression was slightly reduced. Left ventricular ejection fraction (LVEF) before training declined from 56 +/- 4% at rest to 52 +/- 3% at peak exercise (p less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)
mesh_terms: D000328:Adult; D001794:Blood Pressure; D002302:Cardiac Output; D003327:Coronary Disease / Q000503:physiopathology*; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D010806:Physical Education and Training; D005082:Physical Exertion; D011187:Posture; D013318:Stroke Volume