The Immediate Aftereffects of Endurance Exercise on Blood Pressure Among Adults with Hypertension pp. 147-165
Authors: Linda S. Pescatello
Abstract: The purpose of this chapter is to overview the current state of knowledge regarding the immediate aftereffects of endurance exercise on blood pressure (BP) or postexercise hypotension (PEH). The chapter begins with a discussion of the possible interactions between the acute (immediate, PEH) and chronic (exercise training) effects of exercise on BP. The chronic effects of exercise on BP among people with hypertension (HTN) are summarized and include the recommended exercise prescription of: Frequency: on most, preferably all, days of the week Intensity:moderate intensity (40-<60% of maximum oxygen uptake reserve). Time:>30 min of continuous or accumulated physical activity per day Type:primarily endurance physical activity supplemented by resistance exercise achieving a goal of caloric energy expenditure of 1000->2000 kcal per week.
Acute exercise BP effects are presented via the evidence based approach of the American College of Sports Medicine (A highest rating to D expert opinion) and include: • Dynamic exercise acutely reduces BP among people with HTN for a major portion of the daytime hours. (B) • Limited evidence suggests PEH occurs in older adults. (C) • Limited evidence suggests acute endurance exercise reduces BP similarly in white men and women. (C) • Currently no convincing evidence exists to support the notion that ethnic differences exist in the BP response to acute exercise. (C) • For persons with high BP, an exercise program that is primarily aerobic-based is recommended. (A) • The evidence is limited regarding frequency, intensity, time, and type recommendations. (C) • Limited evidence exists regarding special considerations for those with HTN. (D) • Both neural and vascular changes contribute to the decreases in BP that result from acute and chronic endurance exercise. (C) • Emerging data suggest possible genetic links to acute and chronic exercise BP reductions. (D)
Since the publication of the position stand, the additional evidence based statements are made: • The decrease in BP after acute aerobic exercise is a function of initial values, being more pronounced in those with HTN. (B) • Lower intensity exercise is a sufficient stimulus to reduce BP after acute endurance exercise. (B) • Acute exercise BP effects contribute to the exercise training BP effects. (C)
The acute BP lowering effects of exercise are immediate and do not require people to become physically fit. Consequently, public health benefits could be achieved if people with HTN habitually engaged in lower levels of endurance exercise equivalent to a casual to brisk paced walk.