title: Postexercise Hypotension after Heart Transplant: Water- versus Land-Based Exercise.
abstract: OBJECTIVE
  Heart transplant recipients (HTx) have a high prevalence of hypertension. Although exercise training promotes blood pressure (BP) reduction in HTx, the effects of a single exercise bout are unknown. Thus, we analyzed the acute effects of heated water-based exercise (HEx) versus land-based exercise (LEx) on ambulatory BP (ABP) in HTx.
  
  
  METHODS
  Eighteen (six females) clinically stable HTx (time since surgery = 5.0 ± 0.7 yr) age 45.7 ± 2.7 yr underwent 30 min of HEx (walking inside the pool), LEx (walking on a treadmill), and nonexercise control (CON) intervention in random order (2-5 d between interventions). HEx and LEx intensity was set at 11-13 in the 6-20 RPE scale. Twenty-four-hour (24-h) ABP monitoring was performed after each intervention.
  
  
  RESULTS
  No significant differences between interventions were found in 24-h and nighttime BP. However, daytime diastolic BP was significantly lower after HEx than CON (-4 ± 1.6 mm Hg, P = 0.03), and daytime diastolic BP tended to be lower after LEx than CON (-2.3 ± 1.1 mm Hg, P = 0.052). Hourly analysis showed that systolic and diastolic BP values were lower after HEx (average reductions of 6.6 to 12.3 mm Hg, P < 0.01) and LEx (average reductions of 5 to 8.3 mm Hg, P < 0.05) than after CON in several hours. No significant differences between HEx and LEx were found in any ABP data.
  
  
  CONCLUSIONS
  HEx and LEx promoted similar reductions in ABP of heart transplant recipients, which suggests that they may be a tool to counteract hypertension in this high-risk population.
authors.affiliation: 1Exercise and Chronic Disease Research Laboratory, Physical Education Department, School of Sciences, São Paulo State University-UNESP, Bauru, BRAZIL; 2Heart Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, BRAZIL.
authors.forename: Rafael Ertner
authors.initials: RE
authors.lastname: Castro
authors.forename: Guilherme Veiga
authors.initials: GV
authors.lastname: Guimarães
authors.forename: José Messias Rodrigues
authors.initials: JM
authors.lastname: Da Silva
authors.forename: Edimar Alcides
authors.initials: EA
authors.lastname: Bocchi
authors.forename: Emmanuel Gomes
authors.initials: EG
authors.lastname: Ciolac
mesh_terms: D000328:Adult; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D018592:Cross-Over Studies; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D057774:Post-Exercise Hypotension / Q000517:prevention & control*; D013551:Swimming Pools; D066027:Transplant Recipients; D016138:Walking / Q000502:physiology*; D055815:Young Adult