title: Effects of aerobic exercise intensity on ambulatory blood pressure and vascular responses in resistant hypertension: a crossover trial.
abstract: Resistant hypertension often exposes patients to poor blood pressure (BP) control, resulting in clinical vulnerability, possible need for device-based procedures (denervation) and increased therapy costs. Regular exercise markedly benefits patients with hypertension, including resistant patients. However, little is known about short-term exercise effects in resistant hypertension.
  
  
  
  To evaluate acute hemodynamic effects of exercise in resistant hypertension.
  
  
  
  After maximal exercise testing, 20 patients (54.0 ± 5.7 years, 30.2 ± 4.9 kg/m) with resistant hypertension participated in three crossover interventions, in random order, and on separate days: control (45' of rest), and light intensity and moderate intensity (45' of aerobic exercise at 50 and 75% of maximum heart rate, respectively). Ambulatory BP, forearm blood flow (with subsequent calculation of vascular resistance), and reactive hyperemia were measured before and after interventions trough venous occlusion plethysmography.
  
  
  
  Compared with control, both exercise intensities reduced ambulatory systolic pressure over 5 h (light: -7.7 ± 2.4 mmHg and moderate: -9.4 ± 2.8 mmHg, P < 0.01), whereas only light intensity reduced diastolic pressure (-5.7 ± 2.2 mmHg, P < 0.01). Light intensity also lowered systolic and diastolic pressures over 10-h daytime (-3.8 ± 1.3 and -4.0 ± 1.3 mmHg, respectively, P < 0.02), night-time (-6.0 ± 2.4 and -6.1 ± 1.6 mmHg, respectively, P < 0.05), and diastolic pressure over 19 h (-4.8 ± 1.2 mmHg, P < 0.01). Forearm blood flow changed (decreased) compared with baseline only at 50 min after light intensity (P < 0.05). After the control and light intensity sessions, vascular resistance increased at the end of 1 h, and after moderate intensity, it decreased only at the moment (∼2 min) immediately after intervention (P < 0.05).
  
  
  
  A single session of light or moderate aerobic exercise acutely reduces ambulatory BP in resistant hypertension, although benefits persist longer following light intensity.
authors.affiliation: aExercise Pathophysiology Research Laboratory, Hospital de Clínicas de Porto Alegre bGraduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Federal University of Rio Grande do Sul cCardiology Division, Hospital de Clínicas de Porto Alegre dFederal University of Rio Grande do Sul's Medical School, Porto Alegre, Rio Grande do Sul, Brazil eDepartment of Kinesiology, University of Connecticut, Storrs, Connecticut, USA.
authors.forename: Lucas P
authors.initials: LP
authors.lastname: Santos
authors.forename: Ruy S
authors.initials: RS
authors.lastname: Moraes
authors.forename: Paulo J C
authors.initials: PJ
authors.lastname: Vieira
authors.forename: Garrett I
authors.initials: GI
authors.lastname: Ash
authors.forename: Gustavo
authors.initials: G
authors.lastname: Waclawovsky
authors.forename: Linda S
authors.initials: LS
authors.lastname: Pescatello
authors.forename: Daniel
authors.initials: D
authors.lastname: Umpierre
mesh_terms: D001794:Blood Pressure; D003329:Coronary Vasospasm / Q000503:physiopathology* / Q000628:therapy*; D018592:Cross-Over Studies; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy; D005260:Female; D005542:Forearm / Q000098:blood supply; D006801:Humans; D006940:Hyperemia / Q000209:etiology; D006973:Hypertension / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion / Q000502:physiology*; D012039:Regional Blood Flow; D014655:Vascular Resistance