Different Types Of Exercise Training To Attenuate Exaggerated Blood Pressure Response To Exercise In Hypertension

Purpose: An exaggerated blood pressure response (EBPR) to exercise is associated with the future development of hypertension and cardiovascular disease. While aerobic exercise (AE) and inspiratory muscle strength training (IMST) are known to manage resting blood pressure in hypertension, their effects on attenuating EBPR during exercise are unclear. This study aimed to investigate the effects of AE and IMST on EBPR in hypertensive individuals during a graded exercise test. Methods: Twenty-three hypertensive patients were randomly assigned to AE (n = 11, age 58.2 ± 3.9 years, 4 men, 40 ~ 70% of heart rate reserve, 30 minutes) or IMST (n = 12, age 59.8 ± 4.8 years, 4 men, 55 ~ 75% of maximal inspiratory pressure, 30 repetitions). Each group performed their assigned exercise 5 days per week for 8 weeks. Brachial blood pressure was measured at rest, every 2 minutes during a graded maximal cycling exercise test, and every 1 minute during a recovery phase, both pre- and post-intervention. The ramp protocol was used with a 20-watt warm-up, and intensity increased by 15 watts for men and 10 watts for women every minute. EBPR was defined as a maximal exercise systolic blood pressure (SBP) of ≥210 mmHg for men and ≥ 190 mmHg for women. Results: After the exercise training, both groups demonstrated significant reductions in SBP during sub-maximal exercise, the recovery phase, and at rest (p < 0.05 for all). Additionally, there was a 17.4% decrease in the prevalence of EBPR, from 60.9% pre-intervention to 43.5% post-intervention. In a subgroup analysis, the AE group showed significant SBP reductions during stage 3 of the exercise test, while the IMST group exhibited significant decreases in SBP during stage 5. Conclusion: Both AE and IMST effectively attenuate EBPR in hypertensive individuals during a graded exercise test, demonstrating the potential of exercise training to manage exercise-induced hypertension. However, the varying impacts of each type of exercise underscore the potential benefits of tailored exercise programs in managing exercise-induced hypertension. The research was conducted with funding from The Korean Society of Hypertension.