Effect of Exercise Modalities on Post‐Exercise Hypotension in Normotensive Postmenopausal Women: A Randomized Controlled Trial on Vasomotor Symptoms Influence

Menopause is associated with increased blood pressure (BP) and vasomotor symptoms (VMS), both elevating cardiovascular risk. Exercise can induce postexercise hypotension (PEH), with responses varying by exercise type and population characteristics. This study aimed to (1) examine the effect of high-intensity interval exercise (HIIE) and isometric resistance exercise (IRE) compared to control session (CONT) on PEH in normotensive postmenopausal women and (2) examine the VMS effect on PEH responses. A cross-over randomized controlled trial was conducted in 29 women (15 with moderate-to-severe VMS, 14 without), aged 55 ± 3 years. HIIE included 2 sets of 12*15-s at 100% maximal aerobic power, IRE included 4*2-min at 30% maximal voluntary contraction, and CONT included a sitting period. PEH was assessed 30 min post-session and with 24-h assessment, providing data on dipping profiles and BP variability. Repeated measures ANOVA with Bonferroni post hoc tests were conducted. HIIE induced systolic PEH at +30 min postexercise compared to pre-exercise (-6.1 mmHg, p = 0.048) and CONT (-8.1 mmHg, p = 0.010). For IRE, nocturnal systolic (SBP) and diastolic (DBP) BP decreased versus CONT (SBP: -3.2 mmHg, p = 0.008; DBP: -2.0 mmHg, p = 0.003) and HIIE (SBP: -3.4 mmHg, p = 0.004; DBP: -2.2 mmHg, p < 0.001), increasing dippers proportion. In women with VMS, nocturnal SBP was lower after IRE than HIIE (-5.6 mmHg, p = 0.002). Both HIIE and IRE induced PEH in postmenopausal women, with HIIE reducing BP +30 min postexercise and IRE improving nocturnal BP and increasing dippers. In women with VMS, the nocturnal BP response varies according to exercise modality. TRIAL REGISTRATION: The study is registered on clinicaltrials.gov (n°NCT06533982).