Resistance exercise with combined Valsalva manoeuvre acutely increases carotid-femoral pulse wave velocity in healthy untrained individuals

PURPOSE: The Valsalva manoeuvre (VM) may contribute to the observed increase in pulse wave velocity (PWV) following resistance exercise (RE). However, VM use during RE is rarely reported or discussed in the literature. We compared the acute carotid-femoral PWV response before and following RE with paced breathing, RE with a VM (REVM) and the VM alone. METHODS: 15 healthy RE-untrained participants (female = 8) (mean ± SD: age, 24 ± 5 years; height, 171.7 ± 10.9 cm; body mass 69.6 ± 14.5 kg) completed in a randomised order (1) RE: 3 sets of 10 repetitions of 4 RE exercises at 60% of 1RM with paced breathing (2) REVM: repetition of the RE requirements with a VM during each of the last 6 repetitions of each set (3) VM: 12 sets of 6, 3 s VMs at a mouth pressure of 40 mm Hg. PWV was measured pre- and post-condition, with mean middle cerebral artery blood velocity, mean arterial blood pressure (MAP), heart rate, and partial pressure of end-tidal carbon dioxide measured during each visit. RESULTS: An interaction effect for PWV (P = 0.024) was observed, with post hoc tests revealing increased PWV post REVM (P = 0.006, pre 5.4 ± 0.3 vs. post 6.1 ± 0.9 cm/s) and VM (P = 0.031, 5.7 ± 0.8 vs. 6.0 ± 1.0 cm/s), but not RE (P = 0.957, 5.7 ± 0.6 vs. 5.7 ± 0.8). REVM produced the greatest MAP increase from baseline (Δ37 ± 15 mm Hg, P < 0.05 vs. both RE and VM). CONCLUSION: These findings indicate that the VM contributes to the acute rise in post RE PWV when performed during RE and acutely increases PWV when performed repeatedly in isolation (Trial registration number ACTRN12624000876594, Date of registration 18/07/2024). TRIAL REGISTRATION NUMBER: ACTRN12624000876594.