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Int J Sports Med 2015; 36(13): 1046-1051
DOI: 10.1055/s-0035-1555853
Training & Testing
© Georg Thieme Verlag KG Stuttgart · New York

Vascular Mechanisms of Post-exercise Blood Pressure Responses in Peripheral Artery Disease

M. A. Correia
1   School of Physical Education, University of Pernambuco, Recife, Brazil
,
A. H. G. Soares
1   School of Physical Education, University of Pernambuco, Recife, Brazil
,
G. G. Cucato
2   Albert Einstein Hospital, Israel Institute of Education and Research Albert Einstein, São Paulo, Brazil
,
A. H. R. Lima
3   School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
,
A. P. F. Gomes
1   School of Physical Education, University of Pernambuco, Recife, Brazil
,
T. M. P. Prazeres
1   School of Physical Education, University of Pernambuco, Recife, Brazil
,
S. C. Rodrigues
1   School of Physical Education, University of Pernambuco, Recife, Brazil
,
D. Sobral-Filho
4   University of Pernambuco, Hospital Universitário Procape, Recife, Brazil
,
A. C. Santos
5   Department of Physical Education, University Federal of Paraíba, João Pessoa, Brazil
,
M. S. Brasileiro-Santos
5   Department of Physical Education, University Federal of Paraíba, João Pessoa, Brazil
,
R. M. Ritti-Dias
1   School of Physical Education, University of Pernambuco, Recife, Brazil
2   Albert Einstein Hospital, Israel Institute of Education and Research Albert Einstein, São Paulo, Brazil
› Author Affiliations
Further Information

Publication History



accepted after revision 04 June 2015

Publication Date:
07 August 2015 (online)

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Abstract

This study aimed to analyze the vascular mechanisms involved in post-resistance decreases in blood pressure in patients with peripheral artery disease. 17 patients underwent 2 experimental sessions conducted in random order: resistance exercise (REx–3×10 reps in 8 exercises with intensity of ~ 60% of 1 RM) and control (C- resting on the exercise machines for 50 min). Before and after each experimental session, blood pressure, reflected wave indicators, pulse wave velocity, blood flow, blood flow post-reactive hyperemia and peripheral vascular resistance responses were obtained. Both sessions increased brachial systolic, diastolic and mean blood pressure (greatest increase REx: 11 mmHg; greatest increase C: 19 mmHg; P<0.01); however, the increases were greater after the C session (P<0.01). Reflected wave indicators increased only after the C session (P<0.06), while pulse wave velocity increased similarly after both sessions (P=0.66). Individual analyses indicated a large variability between patients in vascular variables responses. A single bout of REx decreased blood pressure in peripheral artery disease patients, and these responses were followed by changes in reflected wave indicators. The other factors presented high individual variability, and thus it was not possible to identify specific factors associated with blood pressure reduction in peripheral artery disease patients.

Key words

peripheral artery disease - resistance exercise - blood pressure
 

  • References

  • 1 The Reference Values for Arterial Stiffness’ Collaboration. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘establishing normal and reference values’. Eur Heart J 2010; 31: 2338-2350
    CrossrefPubMedGoogle Scholar
  • 2 Andrade Lima AHR, Farah BQ, Rodrigues LBCC, Miranda AS, Rodrigues SLC, de Correia AM, Sobral Filho DC, Forjaz CLM, Prado WL, Wolosker N, Ritti-Dias RM. Low-intensity resistance exercise does not affect cardiac autonomic modulation in patients with peripheral artery disease. Clinics 2013; 68: 632-637
    CrossrefPubMedGoogle Scholar
  • 3 Augustine J, Tarzia B, Kasprowicz A, Heffernan KS. Effect of a single bout of resistance exercise on arterial stiffness following a high-fat meal. Int J Sports Med 2014; 35: 894-899
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Beck TW. The importance of a priori sample size estimation in strength and conditioning research. J Strength Cond Res 2013; 27: 2323-2337
    CrossrefPubMedGoogle Scholar
  • 5 Brevetti G, Silvestro A, Schiano V, Chiariello M. Endothelial dysfunction and cardiovascular risk prediction in peripheral arterial disease: additive value of flow-mediated dilation to ankle-brachial pressure index. Circulation 2003; 108: 2093-2098
    CrossrefPubMedGoogle Scholar
  • 6 Brito Ade F, de Oliveira CV, Brasileiro-Santos Mdo S, Santos Ada C. Resistance exercise with different volumes: blood pressure response and forearm blood flow in the hypertensive elderly. Clin Interv Aging 2014; 9: 2151-2158
    PubMedGoogle Scholar
  • 7 Casonatto J, Tinucci T, Dourado AC, Polito M. Cardiovascular and autonomic responses after exercise sessions with different intensities and durations. Clinics 2011; 66: 453-458
    CrossrefPubMedGoogle Scholar
  • 8 Collier SR, Diggle MD, Heffernan KS, Kelly EE, Tobin MM, Fernhall B. Changes in arterial distensibility and flow-mediated dilation after acute resistance vs. aerobic exercise. J Strength Cond Res 2010; 24: 2846-2852
    CrossrefPubMedGoogle Scholar
  • 9 Costa JBY, Gerage AM, Gonçalves CGS, Pina FLC, Polito MD. Influência do estado de treinamento sobre o comportamento da pressão arterial após uma sessão de exercícios com pesos em idosas hipertensas. Rev Bras Med Esporte 2010; 16: 103-106
    PubMedGoogle Scholar
  • 10 Cucato GG, da Rocha Chehuen M, Ritti-Dias RM, Carvalho CR, Wolosker N, Saxton JM, de Moraes Forjaz CL. Post-Walking Exercise Hypotension in Patients with Intermittent Claudication. Med Sci Sports Exerc 2014; Epub ahead of print
    PubMedGoogle Scholar
  • 11 Cucato GG, Ritti-Dias RM, Wolosker N, Santarem JM, Jacob Filho W, Forjaz CL. Post-resistance exercise hypotension in patients with intermittent claudication. Clinics 2011; 66: 221-226
    CrossrefPubMedGoogle Scholar
  • 12 DeVan AE, Anton MM, Cook JN, Neidre DB, Cortez-Cooper MY, Tanaka H. Acute effects of resistance exercise on arterial compliance. J Appl Physiol 1985 2005; 98: 2287-2291
    CrossrefPubMedGoogle Scholar
  • 13 Fahs CA, Rossow LM, Seo DI, Loenneke JP, Sherk VD, Kim E, Bemben DA, Bemben MG. Effect of different types of resistance exercise on arterial compliance and calf blood flow. Eur J Appl Physiol 2011; 111: 2969-2975
    CrossrefPubMedGoogle Scholar
  • 14 Gearhart RE, Goss FL, Lagally KM, Jakicic JM, Gallagher J, Robertson RJ. Standardized scaling procedures for rating perceived exertion during resistance exercise. J Strength Cond Res 2001; 15: 320-325
    PubMedGoogle Scholar
  • 15 Goernig M, Schroeder R, Roth T, Truebner S, Palutke I, Figulla HR, Leder U, Voss A. Peripheral arterial disease alters heart rate variability in cardiovascular patients. Pacing Clin Electrophysiol 2008; 31: 858-862
    CrossrefPubMedGoogle Scholar
  • 16 Gonzales JU, Thompson BC, Thistlethwaite JR, Scheuermann BW. Association between exercise hemodynamics and changes in local vascular function following acute exercise. Appl Physiol Nutr Metab 2011; 36: 137-144
    CrossrefPubMedGoogle Scholar
  • 17 Harriss DJ, Atkinson G. Ethical standards in sport and exercise science research: 2014 update. Int J Sports Med 2013; 34: 1025-1028
    Article in Thieme ConnectPubMedGoogle Scholar
  • 18 Heffernan KS, Collier SR, Kelly EE, Jae SY, Fernhall B. Arterial stiffness and baroreflex sensitivity following bouts of aerobic and resistance exercise. Int J Sports Med 2007; 28: 197-203
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Imai Y, Abe K, Munakata M, Sakuma H, Hashimoto J, Imai K, Sekino H, Yoshinaga K. Circadian blood pressure variations under different pathophysiological conditions. J Hypertens Suppl 1990; 8: S125-S132
    PubMedGoogle Scholar
  • 20 Jannig PR, Cardoso AC, Fleischmann E, Coelho CW, Carvalho Td. Influência da ordem de execução de exercícios resistidos na hipotensão pós-exercício em idosos hipertensos. Rev Bras Med Esporte 2009; 15: 338-341
    CrossrefPubMedGoogle Scholar
  • 21 Lefferts WK, Augustine JA, Heffernan KS. Effect of acute resistance exercise on carotid artery stiffness and cerebral blood flow pulsatility. Front Physiol 2014; 5 Article 101
    PubMedGoogle Scholar
  • 22 Lima A, Ritti-Dias R, Forjaz CL, Correia M, Miranda A, Brasileiro-Santos M, Santos A, Sobral Filho D, Silva A. A session of resistance exercise increases vasodilation in intermittent claudication patients. Appl Physiol Nutr Metab 2014; 1-6
    PubMedGoogle Scholar
  • 23 Lydakis C, Momen A, Blaha C, Gugoff S, Gray K, Herr M, Leuenberger UA, Sinoway LI. Changes of central haemodynamic parameters during mental stress and acute bouts of static and dynamic exercise. J Hum Hypertens 2008; 22: 320-328
    CrossrefPubMedGoogle Scholar
  • 24 McDermott MM, Ades P, Guralnik JM, Dyer A, Ferrucci L, Liu K, Nelson M, Lloyd-Jones D, Van Horn L, Garside D, Kibbe M, Domanchuk K, Stein JH, Liao Y, Tao H, Green D, Pearce WH, Schneider JR, McPherson D, Laing ST, McCarthy WJ, Shroff A, Criqui MH. Treadmill exercise and resistance training in patients with peripheral arterial disease with and without intermittent claudication: a randomized controlled trial. Jama 2009; 301: 165-174
    CrossrefPubMedGoogle Scholar
  • 25 Mediano MFF, Paravidino V, Simão R, Pontes FL, Polito MD. Comportamento subagudo da pressão arterial após o treinamento de força em hipertensos controlados. Rev Bras Med Esporte 2005; 11: 337-340
    PubMedGoogle Scholar
  • 26 Meijer WT, Hoes AW, Rutgers D, Bots ML, Hofman A, Grobbee DE. Peripheral arterial disease in the elderly: The Rotterdam Study. Arterioscler Thromb Vasc Biol 1998; 18: 185-192
    CrossrefPubMedGoogle Scholar
  • 27 Melo CM, Alencar Filho AC, Tinucci T, Mion Jr D, Forjaz CL. Postexercise hypotension induced by low-intensity resistance exercise in hypertensive women receiving captopril. Blood Press Monit 2006; 11: 183-189
    CrossrefPubMedGoogle Scholar
  • 28 Moraes MR, Bacurau RF, Ramalho JD, Reis FC, Casarini DE, Chagas JR, Oliveira V, Higa EM, Abdalla DS, Pesquero JL, Pesquero JB, Araujo RC. Increase in kinins on post-exercise hypotension in normotensive and hypertensive volunteers. Biol Chem 2007; 388: 533-540
    PubMedGoogle Scholar
  • 29 Nichols WW, Edwards DG. Arterial elastance and wave reflection augmentation of systolic blood pressure: deleterious effects and implications for therapy. J Cardiovasc Pharmacol Ther 2001; 6: 5-21
    CrossrefPubMedGoogle Scholar
  • 30 Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG, Rutherford RB. Inter-society consensus for the management of peripheral arterial disease. Int Angiol 2007; 26: 81-157
    PubMedGoogle Scholar
  • 31 Okamoto T, Min S, Sakamaki-Sunaga M. Arterial compliance and stiffness following low-intensity resistance exercise. Eur J Appl Physiol 2014; 114: 235-241
    CrossrefPubMedGoogle Scholar
  • 32 Polito MD, da Nobrega AC, Farinatti P. Blood pressure and forearm blood flow after multiple sets of a resistive exercise for the lower limbs. Blood Press Monit 2011; 16: 180-185
    CrossrefPubMedGoogle Scholar
  • 33 Queiroz AC, Kanegusuku H, Chehuen MR, Costa LA, Wallerstein LF, Dias da Silva VJ, Mello MT, Ugrinowitsch C, Forjaz CL. Cardiac work remains high after strength exercise in elderly. Int J Sports Med 2013; 34: 391-397
    Article in Thieme ConnectPubMedGoogle Scholar
  • 34 Queiroz AC, Sousa JC, Cavalli AA, Silva Jr ND, Costa LA, Tobaldini E, Montano N, Silva GV, Ortega K, Mion Jr D, Tinucci T, Forjaz CL. Post-resistance exercise hemodynamic and autonomic responses: Comparison between normotensive and hypertensive men. Scand J Med Sci Sports 2014; : - Epub ahead of print
    PubMedGoogle Scholar
  • 35 Rezk CC, Marrache RC, Tinucci T, Mion Jr D, Forjaz CL. Post-resistance exercise hypotension, hemodynamics, and heart rate variability: influence of exercise intensity. Eur J Appl Physiol 2006; 98: 105-112
    CrossrefPubMedGoogle Scholar
  • 36 Ritti-Dias RM, Wolosker N, de Moraes Forjaz CL, Carvalho CR, Cucato GG, Leao PP, de Fatima Nunes Marucci M. Strength training increases walking tolerance in intermittent claudication patients: randomized trial. J Vasc Surg 2010; 51: 89-95
    CrossrefPubMedGoogle Scholar
  • 37 Rodrigues LB, Forjaz CL, Lima AH, Miranda AS, Rodrigues SL, Cardoso Jr CG, Sobral Filho D, Monteiro MF, Gomes SL, Gardner AW, Prado WL, Ritti-Dias RM. A single bout of resistance exercise does not modify cardiovascular responses during daily activities in patients with peripheral artery disease. Blood Press Monit 2014; 19: 64-71
    CrossrefPubMedGoogle Scholar
  • 38 Santana HA, Moreira SR, Asano RY, Sales MM, Cordova C, Campbell CS, Espindola FS, Sposito AC, Nobrega OT, Simoes HG. Exercise intensity modulates nitric oxide and blood pressure responses in hypertensive older women. Aging Clin Exp Res 2013; 25: 43-48
    PubMedGoogle Scholar
  • 39 Silvestro A, Scopacasa F, Oliva G, de Cristofaro T, Iuliano L, Brevetti G. Vitamin C prevents endothelial dysfunction induced by acute exercise in patients with intermittent claudication. Atherosclerosis 2002; 165: 277-283
    CrossrefPubMedGoogle Scholar
  • 40 Thijssen DH, Bleeker MW, Smits P, Hopman MT. Reproducibility of blood flow and post-occlusive reactive hyperaemia as measured by venous occlusion plethysmography. Clin Sci (Lond) 2005; 108: 151-157
    CrossrefPubMedGoogle Scholar
  • 41 Van Bortel LM, Duprez D, Starmans-Kool MJ, Safar ME, Giannattasio C, Cockcroft J, Kaiser DR, Thuillez C. Clinical applications of arterial stiffness, Task Force III: recommendations for user procedures. Am J Hypertens 2002; 15: 445-452
    CrossrefPubMedGoogle Scholar
  • 42 Weitz JI, Byrne J, Clagett GP, Farkouh ME, Porter JM, Sackett DL, Strandness Jr DE, Taylor LM. Diagnosis and treatment of chronic arterial insufficiency of the lower extremities: a critical review. Circulation 1996; 94: 3026-3049
    CrossrefPubMedGoogle Scholar
  • 43 Wilkinson IB, Webb DJ. Venous occlusion plethysmography in cardiovascular research: methodology and clinical applications. Br J Clin Pharmacol 2001; 52: 631-646
    PubMedGoogle Scholar
  • 44 Yoon ES, Jung SJ, Cheun SK, Oh YS, Kim SH, Jae SY. Effects of acute resistance exercise on arterial stiffness in young men. Korean Circ J 2010; 40: 16-22
    CrossrefPubMedGoogle Scholar
  • 45 Zagura M, Kals J, Serg M, Kampus P, Zilmer M, Jakobson M, Unt E, Lieberg J, Eha J. Structural and biochemical characteristics of arterial stiffness in patients with atherosclerosis and in healthy subjects. Hypertens Res 2012; 35: 1032-1037
    CrossrefPubMedGoogle Scholar