Abstract
Reports suggest that the blood pressure (BP) response to an acute bout of exercise is associated with the BP response to aerobic training in participants with elevated BP. These associations have not been tested among patients with resistant hypertension. This study aimed to determine whether the BP response to acute exercise predicts the 24-h ambulatory BP response to a 12-week exercise training program in patients with resistant hypertension (n = 26, aged 59.3 ± 8.2 years, 24-h ambulatory BP 127.4 ± 12.2/75.6 ± 7.8 mm Hg) who completed the exercise arm of the EnRicH trial. Ambulatory BP measurements were obtained before and after the exercise program to assess the chronic BP response. To assess acute BP changes, resting BP was measured before and 10 min after three exercise sessions in the third week of training and averaged. The resting systolic (9.4 ± 6.7, p < 0.001) and diastolic BP (1.9 ± 3.2, p = 0.005) were reduced after acute exercise. The 24-h systolic (6.2 ± 12.2, p = 0.015) and diastolic BP (4.4 ± 6.1, p = 0.001) were decreased after exercise training. The reductions in systolic BP after acute exercise were associated with the reductions in 24-h systolic BP after exercise training (ß = 0.538, adjusted r2 = 0.260, P = 0.005). The reductions in diastolic BP after acute exercise (ß = 0.453, adjusted r2 = 0.187) and baseline 24-h diastolic BP (ß = −0.459, adjusted r2 = 0. 199) accounted for 38.6% (p = 0.008) of the 24-h diastolic BP response to exercise training. In conclusion, the magnitude of the BP response to acute exercise appears to predict the ambulatory BP response to exercise training among patients with resistant hypertension.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on SpringerLink
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1038%2Fs41440-022-00945-w/MediaObjects/41440_2022_945_Fig1_HTML.png)
References
Agasthi P, Shipman J, Arsanjani R, Ashukem M, Girardo ME, Yerasi C, et al. Renal denervation for resistant hypertension in the contemporary era: a systematic review and meta-analysis. Sci Rep. 2019;9:6200. https://doi.org/10.1038/s41598-019-42695-9.
Carey RM, Calhoun DA, Bakris GL, Brook RD, Daugherty SL, Dennison-Himmelfarb CR, et al. Resistant hypertension: detection, evaluation, and management: a scientific statement from the American Heart Association. Hypertension. 2018;72:e53–e90. https://doi.org/10.1161/HYP.0000000000000084.
Lopes S, Mesquita-Bastos J, Garcia C, Bertoquini S, Ribau V, Teixeira M, et al. Effect of exercise training on ambulatory blood pressure among patients with resistant hypertension. JAMA Cardiol. 2021;6:1317–23. https://doi.org/10.1001/jamacardio.2021.2735.
Blumenthal JA, Hinderliter AL, Smith PJ, Mabe S, Watkins LL, Craighead L, et al. Effects of lifestyle modification on patients with resistant hypertension: results of the TRIUMPH randomized clinical trial. Circulation. 2021;144:1212–26. https://doi.org/10.1161/CIRCULATIONAHA.121.055329.
Dimeo F, Pagonas N, Seibert F, Arndt R, Zidek W, Westhoff TH. Aerobic exercise reduces blood pressure in resistant hypertension. Hypertension. 2012;60:653–8. https://doi.org/10.1161/HYPERTENSIONAHA.112.197780.
Guimaraes GV, De Barros Cruz LG, Fernandes-Silva MM, Dorea EL, Bocchi EA. Heated water-based exercise training reduces 24-hour ambulatory blood pressure levels in resistant hypertensive patients: a randomized controlled trial (HEx trial). Int J Cardiol. 2014;172:434–41. https://doi.org/10.1016/j.ijcard.2014.01.100.
Liu S, Goodman J, Nolan R, Lacombe S, Thomas SG. Blood pressure responses to acute and chronic exercise are related in prehypertension. Med Sci Sports Exerc. 2012;44:1644–52. https://doi.org/10.1249/MSS.0b013e31825408fb.
Moreira SR, Cucato GG, Terra DF, Ritti-Dias RM. Acute blood pressure changes are related to chronic effects of resistance exercise in medicated hypertensives elderly women. Clin Physiol Funct Imaging. 2016;36:242–8. https://doi.org/10.1111/cpf.12221.
Calhoun JDW, Textor SC, Goff DC, Murphy TP, Toto RD, et al. Resistant hypertension: diagnosis, evaluation, and treatment. A scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Hypertension. 2008;51:1403–19. https://doi.org/10.1161/HYPERTENSIONAHA.108.189141.
Hecksteden A, Grütters T, Meyer T. Association between postexercise hypotension and long-term training-induced blood pressure reduction: a pilot study. Clin J Sport Med. 2013;23:58–63. https://doi.org/10.1097/JSM.0b013e31825b6974.
Dos Santos ES, Asano RY, Filho IG, Lopes NL, Panelli P, Da C, Nascimento D, et al. Acute and chronic cardiovascular response to 16 weeks of combined eccentric or traditional resistance and aerobic training in elderly hypertensive women: a randomized controlled trial. J Strength Cond Res. 2014;28:3073–84. https://doi.org/10.1519/JSC.0000000000000537.
Tibana RA, De Sousa NMF, Da Cunha Nascimento D, Pereira GB, Thomas SG, Balsamo S, et al. Correlation between acute and chronic 24-hour blood pressure response to resistance training in adult women. Int J Sports Med. 2015;36:82–89. https://doi.org/10.1055/s-0034-1382017.
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH guidelines for the management of arterial hypertension. Eur Heart J. 2018;39:3021–104. https://doi.org/10.1093/eurheartj/ehy339.
Matias LAS, Mariano IM, Batista JP, De Souza TCF, Amaral AL, Dechichi JGAC, et al. Acute and chronic effects of combined exercise on ambulatory blood pressure and its variability in hypertensive postmenopausal women. Chin J Physiol. 2020;63:227–34. https://doi.org/10.4103/CJP.CJP_61_20.
Santos LP, Moraes RS, Vieira PJ, Ash GI, Waclawovsky G, Pescatello LS, et al. Effects of aerobic exercise intensity on ambulatory blood pressure and vascular responses in resistant hypertension: a crossover trial. J Hypertens. 2016;34:1317–24. https://doi.org/10.1097/HJH.0000000000000961.
Acknowledgements
The Institute of Biomedicine (iBiMED; reference no. UID/BIM/04501/2020), Research Centre in Physical Activity, Health and Leisure (CIAFEL; reference no. UID/DTP/00617/2020), and Research Center in Sports Sciences, Health and Human Development (CIDESD; reference no. UID/DTP/04045/2020) are research units supported by the Portuguese Foundation for Science and Technology.
Funding
This work was financed by FEDER Funds through the Operational Competitiveness Factors Program - COMPETE and by National Funds through FCT - Foundation for Science and Technology, Portugal, within the project ‘PTDC/DTP-DES/1725/2014’. SL received a Ph.D. grant from FCT (SFRH/BD/129454/2017).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no competing interests.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Lopes, S., Mesquita-Bastos, J., Garcia, C. et al. The blood pressure response to acute exercise predicts the ambulatory blood pressure response to exercise training in patients with resistant hypertension: results from the EnRicH trial. Hypertens Res 45, 1392–1397 (2022). https://doi.org/10.1038/s41440-022-00945-w
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41440-022-00945-w