Hemodynamic responses associated with post-exercise hypotension in hypertensive patients with ischemic heart disease: concurrent circuit exercise versus high intensity interval exercise

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background. Concurrent aerobic plus resistance exercise (RAE) and high intensive interval exercise (HIIE) are both effective on inducing post-exercise hypotension (PEH) in patients with hypertension. However central hemodynamic changes asssociated to PEH in hypertensive subjects with underlying ischemic heart disease (IHD) have been poorly investigated. Aim: to compare the acute effects produced by these two exercise modalities on left ventricular diastolic function and left atrial function . Methods. Twenty untrained male patients with history of hypertension and IHD under stable pharmacological therapy were enrolled. Each patient underwent 3 exercise sessions: RAE, HIIE and a control session without exercise each lasting 45 minutes. Echocardiography examination was performed before and between 30 minutes and 40 minutes from the end of the exercise sessions. Results. In the first hour post exercise BP values decreased in a similar way in RAE and HIIE and were unchanged after control. Compared to pre-session, E/E1 ratio increased after HIIE and remained unchanged after both RAE snd control sessions (between-sessions p 0.002). PALS increased sligthly after RAE (+1.4 ± 1.1%), decreased after HIIE (-4.6 ± 2.4%) . and was unchanged after control. (between-sessions p 0.03). PACS was mildly increased after RAE, was reduced after HIIE. and was unchanged after control. Atrial volume was unchanged after both sessions. Left ventricular and left atrial stiffness increased significantly after HIEE while remained unchanged after RAE and control. Stroke volume and cardiac output increased after RAE, decreased after HIIE, anùd were unchanged after control. Conclusion. Single sessions of RAE and HIIE determined similar PEHs in hypertensive subjects with IHD, while they evoked different central hemodinamyc adjustements. Given its neutral effects of on diastolic and atrial functions, RAE seems more suitable for reducing blood pressure in hypertensive patients with IHD .