Persistent peripheral vasodilation and sympathetic activity in hypotension after maximal exercise.
Hemodynamics (by aortic Doppler), autonomic factors (power spectrum analysis of heart rate and blood pressure variabilities and baroreceptor sensitivity), and plasma renin activity during the hypotension after maximal exercise were studied in 10 normal subjects on two separate days: a nonexercise (control) day (30 min of upright rest followed by 60 min of supine rest) and an exercise day (maximal upright bicycle exercise followed by 60 min supine) in random order. After exercise, diastolic pressure was reduced for the entire hour, cardiac output increased (+33.8%, P < 0.05), stroke volume was unchanged, and systemic vascular resistance fell (-28.6%, P < 0.01). Indexes of vagal activity were reduced for 60 min, whereas the sympathetic indexes were elevated. Baroreflex sensitivity was also reduced for the first 10 min after exercise. Renin activity increased threefold after exercise. The postexercise hypotension results from a persisting peripheral vasodilation despite an increase in renin activity: the persistent sympathetic activity and reduced vagal tone are probably reflex responses to this vasodilatation.
Piepoli
M
M
Department of Cardiovascular Medicine, John Radcliffe Hospital, Headington, Oxford, United Kingdom.
Coats
A J
AJ
Adamopoulos
S
S
Bernardi
L
L
Feng
Y H
YH
Conway
J
J
Sleight
P
P
D000328:Adult; D017704:Baroreflex / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology; D015444:Exercise / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007022:Hypotension / Q000503:physiopathology*; D008297:Male; D010656:Phenylephrine; D012039:Regional Blood Flow / Q000502:physiology; D012083:Renin / Q000097:blood; D015656:Respiratory Mechanics / Q000502:physiology; D013564:Sympathetic Nervous System / Q000502:physiology*; D014655:Vascular Resistance / Q000502:physiology; D014664:Vasodilation / Q000502:physiology*
D010656:Phenylephrine; D012083:Renin