Document Type : Research Article

Authors

1 Department of Sport Sciences, Shiraz University, Shiraz, Iran

2 Department of Cardiology, Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Background: Exercise is believed to be a non-pharmacological approach to treat hypertension. The present study was conducted to investigate the impact of high-intensity interval training (HIIT) and isometric handgrip (IHG) exercise on hemodynamic responses of High blood pressure women.
Methods: In this experimental study 45 sedentary women (age, 45±5 years) from the Al-Zahra Heart Hospital, Shiraz-Iran (2019) with pre to stage 1 hypertension, without any chronic disease, who volunteered to participate in the research. The subjects were randomly divided into three groups of 15 members: Acute HIIT, Acute IHG exercise, and control. Blood pressure (systolic, diastolic, and mean), rate pressure product and heart rate were measured employing Aneroid Sphygmomanometer Polar HR recorder at the pre-workout time, 0 (immediately after exercise), 5, 10, 15, 30, 45, 60 minutes during the recovery period. The data were analyzed using repeated-measures ANOVA and Bonferroni post hoc test.
Results: Our results revealed a significant difference among the study groups regarding blood pressure factors (systolic and mean), heart rate and rate pressure product (P=0.001). The significant decrease in blood pressure in HIIT (P=0.001) and IHG (P=0.001) groups during 60 and 30 minutes of recovery was equal to 10 and 7 mmHg, respectively, and no significant difference was observed in the control group at different times. In response to the HIIT protocol, the heart rate and rate pressure product were significantly higher than the IHG and control groups.
Conclusion: Over the recovery period, there was a significant improvement in hemodynamic factors of hypertensive women independent of the type of exercise. However, HIIT training had a longer lasting decrease in blood pressure.

Keywords

1. Organization WH. Global status report on noncommunicable diseases 2014: World Health Organization; 2014. ## 2. Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J. Am. Coll. Cardiol. 2018;71(19): 127-248. doi:10.1016/j.jacc.2017.11.006.[PubMed: 29146534]. ## 3. Corso LM, Macdonald HV, Johnson BT, Farinatti P, Livingston J, Zaleski AL, et al. Is Concurrent Training Efficacious Antihypertensive Therapy? A Meta-analysis. Med Sci Sports Exerc. 2016;48(12):2398-406. doi:10.1249/MSS.0000000000001056.[PubMed: 27471784]. ## 4. Pescatello LS, MacDonald HV, Lamberti L, Johnson BT. Exercise for hypertension: a prescription update integrating existing recommendations with emerging research. Curr Hypertens Rep. 2015;17(11):87. doi:10.1007/s11906-015-0600-y.[PubMed: 4589552]; [PubMed Central: PMC4589552]. ## 5. Ciolac EG, Guimaraes GV, D’Avila VM, Bortolotto LA, Doria EL, Bocchi EA. Acute aerobic exercise reduces 24-h ambulatory blood pressure levels in long-term-treated hypertensive patients. Clinics (Sao Paulo). 2008;63(6):753-8. doi:10.1590/s1807-59322008000600008. ## 6. 6.Ciolac EG, Guimaraes GV, VM DA, Bortolotto LA, Doria EL, Bocchi EA. Acute effects of continuous and interval aerobic exercise on 24-h ambulatory blood pressure in long-term treated hypertensive patients. Int J Cardiol. 2009;133(3):381-7. doi:10.1016/j.ijcard.2008.02.005.[PubMed: 18501444]. ## 7. Ciolac EG, Bocchi EA, Bortolotto LA, Carvalho VO, Greve JM, Guimaraes GV. Effects of high-intensity aerobic interval training vs. moderate exercise on hemodynamic, metabolic and neuro-humoral abnormalities of young normotensive women at high familial risk for hypertension. Hypertens Res. 2010;33(8):836-43. doi: 10.1038/hr.2010.72.[PubMed: 20448634]. ## 8. Guimaraes GV, Ciolac EG, Oliveira V, Carvalho VMD, Bortolotto LA, Alcides E. Effects of continuous vs. interval exercise training on blood pressure and arterial stiffness in treated hypertension. Hypertens Res. 2010;33:627-32. doi:10.1038/hr.2010.42 [PubMed: 20379194]. ## 9. Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc. 2013;2(1):e004473. doi:10.1161/JAHA.112.004473. ## 10. Dishman RK. Advances in exercise adherence: human kinetics publishers; 1994. ## 11. Hussain SR, Macaluso A, Pearson SJ. High-intensity interval training versus moderate-intensity continuous training in the prevention/management of cardiovascular disease. Cardiol Rev. 2016;24(6):273-81. doi:10.1097/crd.0000000000000124.[PubMed: 27548688]. ## 12. Miyashita M, Burns SF, Stensel DJ. Accumulating short bouts of running reduces resting blood pressure in young normotensive/pre-hypertensive men. J Sports Sci. 2011;29(14):1473-82. doi:10.1080/02640414.2011.593042.[PubMed: 21988649]. ## 13. Nascimento L, Santos A, Lucena J, Silva L, Almeida A, Brasileiro-Santos M. Acute and chronic effects of aerobic exercise on blood pressure in resistant hypertension: study protocol for a randomized controlled trial. Trials. 2017;18(1):250. doi:10.1186/s13063-017-1985-5.[PubMed: 28578691]; [PubMed Central: PMC5457580]. ## 14. Eicher JD, Maresh CM, Tsongalis GJ, Thompson PD, Pescatello LS. The additive blood pressure lowering effects of exercise intensity on post-exercise hypotension. Am Heart J. 2010;160(3):513-20. doi:10.1016/j.ahj.2010.06.005.[PubMed: 20826261]. ## 15. Ramirez-Jimenez M, Morales-Palomo F, Pallares JG, Mora-Rodriguez R, Ortega JF. Ambulatory blood pressure response to a bout of HIIT in metabolic syndrome patients. Eur J Appl Physiol. 2017;117(7):1403-11. doi:10.1007/s00421-017-3631-z.[PubMed: 28493030]. ## 16. Brook RD, Appel LJ, Rubenfire M, Ogedegbe G, Bisognano JD, Elliott WJ, et al. Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the american heart association. Hypertension. 2013;61(6):1360-83. doi:10.1161/HYP.0b013e318293645f.[ PubMed: 23608661]. ## 17. Badrov MB, Bartol CL, DiBartolomeo MA, Millar PJ, McNevin NH, McGowan CL. Effects of isometric handgrip training dose on resting blood pressure and resistance vessel endothelial function in normotensive women. Eur J Appl Physiol. 2013;113(8):2091-100. doi:10.1007/s00421-013-2644-5.[PubMed: 23588257]. ## 18. Millar P, MacDonald M, McCartney N. Effects of isometric handgrip protocol on blood pressure and neurocardiac modulation. Int J Sports Med. 2011;32(03):174-80. doi:10.1055/s-0030-1268473.[PubMed: 21165806]. ## 19. Souza LR, Vicente JB, Melo GR, Moraes VC, Olher RR, Sousa IC, et al. Acute hypotension after moderate-intensity handgrip exercise in hypertensive elderly people. J Strength Cond Res. 2018;32(10):2971-7. doi:10.1519/JSC.0000000000002460. [PubMed: 29384998]. ## 20. Van Assche T, Buys R, De Jaeger M, Coeckelberghs E, Cornelissen V. One single bout of low-intensity isometric handgrip exercise reduces blood pressure in healthy pre-and hypertensive individuals. J Sport Med Phys Fit. 2017;57(4):469-75. doi:10.23736/S0022-4707.16.06239-3.[PubMed: 27029960]. ## 21. Carlson DJ, McFarlane JR, Dieberg G, Smart NA. Rate pressure product responses during an acute session of isometric resistance training: a randomized trial. J Hypertens Cardio. 2017;2(3):1. ## 22. Ash GI, Taylor BA, Thompson PD, MacDonald HV, Lamberti L, Chen MH, et al. The antihypertensive effects of aerobic versus isometric handgrip resistance exercise. J Hypertens. 2017;35(2):291-9. doi:10.1097/HJH.0000000000001176.[PubMed: 27861249]; [PubMed Central: PMC5713890]. ## 23. Shakoor E, Salesi M, Jahromi MK, Sadeghi H, Karimi MH, Yusof A. The effect of exercise on interferon gamma, body fat and bmi of kidney transplant patients. Rev Bras Med Esporte. 2018;24(5):333-7. doi:10.1590/1517-869220182405187030. ## 24. Sharman JE, La Gerche A, Coombes JS. Exercise and cardiovascular risk in patients with hypertension. Am J Hypertens. 2015;28(2):147-58. doi: 10.1093/ajh/hpu191.[PubMed: 25305061]. ## 25. Dorans KS, Mills KT, Liu Y, He J. Trends in prevalence and control of hypertension according to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline. J Am Heart Assoc. 2018;7(11):e008888. doi:10.1161/JAHA.118.008888.[PubMed: 29858369]; [PubMed Central: PMC6015372]. ## 26. Gibbons RJ, Balady GJ, Beasley JW, Bricker JT, Duvernoy WF, Froelicher VF, et al. ACC/AHA guidelines for exercise testing: a report of the American College of Cardiology/American Heart Association task force on practice guidelines (committee on exercise testing). J Am Coll Cardiol. 1997;30(1):260-311. doi: 10.1016/s0735-1097(97)00150-2.[PubMed: 9207652]. ## 27. Angadi SS, Mookadam F, Lee CD, Tucker WJ, Haykowsky MJ, Gaesser GA. High-intensity interval training vs. moderate-intensity continuous exercise training in heart failure with preserved ejection fraction: a pilot study. J Appl Physiol (1985). (Bethesda, Md : 1985). 2015;119(6):753-8. doi:10.1152/japplphysiol.00518.2014.[PubMed: 25190739]. ## 28. Ketelhut S, Milatz F, Heise W, Ketelhut RG. Influence of a high-intensity interval training session on peripheral and central blood pressure at rest and during stress testing in healthy individuals. Vasa. 2016;45(5):373-7. doi:10.1024/0301-1526/a000560.[PubMed: 27594392]. ## 29. Olher RRV, Bocalini DS, Bacurau RF, Rodriguez D, Figueira Jr A, Pontes Jr FL, et al. Isometric handgrip does not elicit cardiovascular overload or post-exercise hypotension in hypertensive older women. Clin Interve Aging. 2013;8:649-55. doi:10.2147/CIA.S40560.[PubMed: 23766641]; [PubMed Central: PMC3678710]. ## 30. Pagonas N, Vlatsas S, Bauer F, Seibert FS, Zidek W, Babel N, et al. Aerobic versus isometric handgrip exercise in hypertension: a randomized controlled trial. J Hypertens. 2017;35(11):2199-206. doi:10.1097/hjh.0000000000001445.[PubMed: 28622156]. ## 31. Carpio-Rivera E, Moncada-Jimenez J, Salazar-Rojas W, Solera-Herrera A. Acute Effects of Exercise on Blood Pressure: A Meta-Analytic Investigation. Arq Bras Cardiol. 2016;106(5):422-33. doi:10.5935/abc.20160064.[PubMed: 27168471]; [PubMed Central: PMC4914008]. ## 32. Taylor KA, Wiles JD, Coleman DD, Sharma R, O’Driscoll JM. Continuous Cardiac Autonomic and Haemodynamic Responses to Isometric Exercise. Med Sci Sports Exerc.2017;49(8):1511-9. doi:10.1249/mss.0000000000001271.[PubMed: 28708775]. ## 33. McGowan CL, Visocchi A, Faulkner M, Verduyn R, Rakobowchuk M, Levy AS, et al. Isometric handgrip training improves local flow-mediated dilation in medicated hypertensives. Eur J Appl Physiol. 2007;99(3):227-34. doi:10.1007/s00421-006-0337-z.[PubMed: 17106718]. ## 34. Millar PJ, McGowan CL, Cornelissen VA, Araujo CG, Swaine IL. Evidence for the role of isometric exercise training in reducing blood pressure: Potential mechanisms and future directions. Sports Med. 2014;44(3):345-56. doi:10.1007/s40279-013-0118-x. [PubMed: 24174307]. ## 35. Bertagnoli K, Hanson P, Ward A. Attenuation of exercise-induced ST depression during combined isometric and dynamic exercise in coronary artery disease. Am J Cardiol. 1990;65(5):314-7. doi:10.1016/0002-9149(90)90294-b.[PubMed: 2301259]. ## 36. O’Connor P, Sforzo GA, Frye P. Effect of breathing instruction on blood pressure responses during isometric exercise. Phys Ther.1989;69(9):757-61.doi:10.1093/ptj/69.9.757.[PubMed: 2772038]. ##