Abstract
Introduction: Despite growing evidence regarding the benefits of resistance training in hypertension, the large and abrupt rise of systolic blood pressure (SBP) observed during resistance exercise execution has resulted in concern about its safety. However, the manipulation of the resistance training protocol (RTP) organization, maintaining the work to rest ratio equated between protocols (W:R-equated), may reduce the SBP increase.Purpose: To compare cardiovascular responses during two W:R-equated RTPs (3 × 15:88 s vs. 9 × 5:22 s – sets × reps: rest between sets) performed in exercises for the lower and upper limbs.Methods: Twelve medicated hypertensives (48 ± 8 years) randomly performed two RTPs in the bilateral leg extension (BLE) and unilateral elbow flexion (UEF) exercises at 50% 1RM. Increases (Δ) of SBP, heart rate (HR) and rate pressure product (RPP) during the exercises were measured by photoplethysmography.Results: In both BLE and UEF exercises, Δ SBP was significantly greater during 3 × 15:88 s than 9 × 5:22 s (peak values: BLE = + 84 ± 39 vs. + 67 ± 20 mm Hg, and UEF = + 46 ± 25 vs. + 37 ± 18 mm Hg, respectively, both p < 0.05). ΔHR and ΔRPP were significantly higher in the 3 × 15:88 s than 9 × 5:22 s in BLE (peak values + 45 ± 17 vs. + 30 ± 8 bpm, and + 15,559 ± 5570 vs. + 10,483 ± 2614 mm Hg. bpm).Conclusion: In medicated hypertensives, a RTP combining more sets with less repetitions per set and shorter rest intervals between sets (i.e., 9 × 5:22 s) produced a smaller increase in cardiovascular load (ΔSBP, ΔHR and ΔRPP) during its execution than a protocol with fewer longer sets (i.e., 3 × 15:88 s).
Highlights
Despite growing evidence regarding the benefits of resistance training in hypertension, the large and abrupt rise of systolic blood pressure (SBP) observed during resistance exercise execution has resulted in concern about its safety
The effects of this type of training on hypertensives’ BP is controversial (Cornelissen et al, 2011), resistance training increases muscle strength (Williams et al, 2007), which is strongly associated with reduced mortality (Williams et al, 2007), and ameliorates comorbidities usually associated with hypertension (Colberg et al, 2010)
Recommendations of resistance training protocols (RTP) for hypertensives include moderate intensity (40–60% 1 repetition maximum (1RM)), high number of repetitions per set (10–15 repetitions), long rest intervals between sets (>60 s), and one to three sets per exercise (Williams et al, 2007; Malachias et al, 2016). These recommendations aim to attenuate the acute BP increase observed during the resistance exercise execution that is greater in hypertensives than normotensives (Nery et al, 2010)
Summary
Despite growing evidence regarding the benefits of resistance training in hypertension, the large and abrupt rise of systolic blood pressure (SBP) observed during resistance exercise execution has resulted in concern about its safety. Systemic arterial hypertension is characterized by sustained elevation of systolic (SBP > 140 mm Hg) and/or diastolic (DBP > 90 mm Hg) blood pressures (Lenfant et al, 2003; Mancia et al, 2013; Malachias et al, 2016) It affects about 37% of adults worldwide, and is one of the major modifiable risk factors for cardiovascular disease, morbidity, and mortality (MartínezRueda et al, 2019). Recommendations of resistance training protocols (RTP) for hypertensives include moderate intensity (40–60% 1RM), high number of repetitions per set (10–15 repetitions), long rest intervals between sets (>60 s), and one to three sets per exercise (Williams et al, 2007; Malachias et al, 2016) These recommendations aim to attenuate the acute BP increase observed during the resistance exercise execution that is greater in hypertensives than normotensives (Nery et al, 2010). The risk of an undesired cardiovascular event during resistance exercise is low (Williams et al, 2007), cases of subarachnoid hemorrhage (Haykowsky et al, 1996) and aortic dissection (Hatzaras et al, 2007) have been reported in the literature
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