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Journal of Exercise Physiologyonline
December 2014
Volume 17 Number 6
Official Research
Editor-in-Chief
Journal
of the
American
Tommy
Boone,
PhD,
MBA
Review Society
Board of Exercise
Physiologists
Todd Astorino,
PhD
Julien Baker,
PhD
ISSN 1097-9751
Steve Brock, PhD
Lance Dalleck, PhD
Eric Goulet, PhD
Robert Gotshall, PhD
Alexander Hutchison, PhD
M. Knight-Maloney, PhD
Len Kravitz, PhD
James Laskin, PhD
Yit Aun Lim, PhD
Lonnie Lowery, PhD
Derek Marks, PhD
Cristine Mermier, PhD
Robert Robergs, PhD
Chantal Vella, PhD
Dale Wagner, PhD
Frank Wyatt, PhD
Ben Zhou, PhD
Official Research Journal
of the American Society of
Exercise Physiologists
ISSN 1097-9751
JEPonline
Post-Exercise Hypotension between Different
Protocols of Resistance Training for Beginners
M. Macedo1, A. S. Silva², R. R. Olher3, H. J. Coelho Junior2,4,
R. Palmeira2, Ricardo Y. Asano2,5
Universitário UNIRG – Gurupi/TO – Brazil, 2Universidade
de Mogi das Cruzes – Brazil, 3Universidade Católica de Brasília –
Brasília- Brazil, 4Universidade Estadual de Campinas – Campinas –
Brazil, 5Faculdade de Ciências e Letras de Bragança Paulista –
Brazil
1Centro
ABSTRACT
Macedo M, Silva AS, Olher RR, Coelho Junior HJ, Palmeira R,
Asano RY. Post-Exercise Hypotension between Different Protocols
of Resistance Training for Beginners. JEPonline 17(6):58-65.
Evidence indicates that resistance training (RT) promotes postexercise hypotension (PEH), which is considered important in
preventing hypertension (HTN). But, the most efficient RT protocol
to keep blood pressure normal is still unclear. The aim of this study
was to analyze and compare the impact of different RT protocols on
PEH. Twelve male and female subjects (22.0 ± 1 yrs of age with a
mass body index of 24.9 ± 2 m2) participated in this study. The
sample size was calculated using the GPower 3.0.10 software for a
statistical power of 80% with an alpha of 5% (P≤0.05). The subjects
performed in randomized order two experimental RT protocols: (a)
the strength training (ST) protocol suggested for beginners (80% 1RM); and (b) the muscular endurance (ME) protocol (65% 1-RM).
Heart rate and blood pressure were measured before and every 15
min of recovery after the session (up to 60 min). While both
protocols resulted in PEH, the ST protocol produced a longer PEH
response than did the ME protocol. Therefore, the findings indicate
that for beginners, the ST protocol is more effective in producing
PEH.
Key Words: Hypotension, Resistance Training, Hypertension
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INTRODUCTION
For several decades, health care organizations have indicated that physical exercise is helpful in the
treatment if not the prevention of hypertension. Specifically, the American College of Sports and
Medicine (1) and the JAMA (6) have published comprehensive reports, including but not limited to,
“Exercise and Hypertension” and the “Seventh Report of the Joint National Committee on Prevention,
Detection, Evaluation, and Treatment of High Blood Pressure,” respectively.
Regarding the modality of physical exercise, recent meta-analytic data have shown that resistance
training (RT) can be an effective tool to decrease blood pressure in subjects with normal blood
pressure and in subjects with elevated blood pressure (i.e., hypertension) as well as certain risk
factors (e.g., body fat) for cardiovascular disease (CVD) (7,8). Furthermore, RT is very useful in
building and maintaining muscle strength and power in adults, which helps to promote an increase in
health and quality of life (15,20).
In addition to the chronic effects of RT on blood pressure, CVD risks and quality of life, beneficial
effects can also be observed immediately after exercise (e.g., such as a decrease on blood pressure
levels below the resting levels). For example, Asano and colleagues (2) and and Asano et al. (3)
reported that blood pressure levels can decrease below to the resting levels. This phenomenon is
called post-exercise hypotension (PEH) (2,3). However, there is no consensus in the literature about
which intensity of RT is more efficient in producing PEH (3,11,14,16).
Bentes et al. (4) and Mohebbi et al. (14) did not observe a difference in PEH between low (40%) and
high intensity (80%) RT. On the other hand, Lizardo and Simões (11) observed a PEH response in
diastolic blood pressure (DBP) and mean arterial pressure (MAP) after low intensity session (30%). In
turn, Polito et al. (16) observed that the duration of PEH on systolic blood pressure (SBP) was dosedependent of the intensity of RT.
Therefore, the aim of this study was to analyze the PEH response on normotensive young adults
during different RT protocols that are suggested for beginners lifting weights (e.g., muscle endurance
and hypertrophy). If there is a significant PEH response resulting from RT, it would be reasonable to
conclude that RT may help to prevent hypertension in young adults as they age (21).
METHODS
Subjects
This study was developed in accordance with the Declaration of Helsinki, in Resolution 196/96 of the
National Health Council. All subjects signed a free consent form that contained that explained the
research objectives and risks to their integrity during the study. The Ethics Committee of the Centro
Universitário-UNIRG approved this experiment.
The trial was performed based on a crossover methodology (one group performed both sessions).
The sample was composed of 12 subjects (8 males and 4 females; 22.0 ± 1 yrs old, body mass index
24.9 ± 2 m²). The minimum sample size was calculated using the software GPower 3.0.10, for
minimum statistical power of 80% with an alpha of 5% (P≤0.05). Potential subjects were excluded
from the study if they: (a) had cardiovascular complications, participated in a rehabilitation program 6
months prior to the study, or physical problems that might stop the RT protocol; (b) smoked; or (c)
used beta-blockers and/or diuretics. For the safety of the subjects, the pre-exercise resting blood
pressure (BP) could not exceed a SBP of 160 mmHg and a DBP of 100 mmHg. Furthermore, if during
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exercise blood pressure was ≥250 mmHg for systolic or increased 12 mmHg after the warm-up, the
exercise protocol was stopped.
The subjects performed strength training (ST) and muscular endurance (ME) at random sequence
with a minimal interval of 2 wks between sessions. The design of both resistance exercise sessions
was based on the strength training guidelines of American College of Sports Medicine (1). The
subjects did not perform exercise during the interval sessions.
On a first visit, the subjects performed a test of one-repetition maximum (1-RM) in all exercises to be
used in protocols for determining the maximum load on each exercise. The procedure began with a
warm-up of ~4 to 5 min that was followed by low intensity static stretching. The warm-up was initiated
with a load of ~50% of 1-RM. The test began 2 min after the warm-up. The subjects were instructed
to perform two full repetitions with maximum range of motion. If the two repetitions were fulfilled in the
first attempt or if they were not completed correctly, a second attempt was initiated after a recovery
interval of 3 to 5 min with a higher load (first option) or lower (second chance) than previously used. A
third and final attempt was repeated if the load corresponding to a single maximum repetition had not
been determined. The load recorded as 1-RM was the one in which the subject was able to perform
only a single correct and complete repetition. The transition interval between exercises was of 3 to 5
min (5).
Experimental Protocols
The muscular endurance (ME) session consisted of 65% (low intensity) of 1-RM, 3 sets of 15
repetitions with a resting interval of 60 sec between sets and a moderate cadence (2-sec concentric
[CON]: 2-sec eccentric [ECC]). The strength training session consisted of 80% (high intensity) 1-RM,
3 sets of 8 repetitions with a rest interval of 90 sec between sets and a moderate cadence (2-sec
CON: 2-sec ECC). The exercises in both sessions were the bench press, high rowing, leg extension,
leg curl, triceps curl, and biceps curl.
Determination of Cardiovascular Parameters and PEH
Systolic blood pressure, DBP, and HR were measured using the INMETRO Brand® Premium RS380
device. Mean arterial pressure (MAP) was determined by the following equation: MAP = (SBP + 2 x
DBP) ÷ 3. After arriving at the laboratory, the subjects remained seated in the upright sitting position
for 15 min prior to determining the baseline (rest) measurements. At the end of the experiment, the
subjects remained in the sitting position to determine the occurrence of PEH. The recovery
hemodynamic parameters were measured after 15 min (rec15), 30 min (rec30), 45 min (rec45), and
60 min (rec60) after the end of the exercise.
Statistical Analyses
To compare SBP, DBP, and HR between the experimental sessions, descriptive statistics was used.
The data were presented as average and standard deviation (±SD). The data were submitted to the
Shapiro Wilk test for normality. For comparison of the sample-dependent variables between the
sessions, the ANOVA split-splot (mixed ANOVA) with Bonferroni correction for intragroup and
intergroup comparisons was applied. The level of significance was set at P≤0.05, and the statistical
analyses were performed using the Statistical Package for Social Sciences (SPSS) 15.0.
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RESULTS
During exercise, the ME session demonstrated an increase in HR compared to the baseline measure.
In turn, the ST session demonstrated a trend that was not statistically significant (P>0.05). There
were no significant changes after the end of exercise (Figure 1.)
Figure 1. Mean and Standard Deviation of Heart Rate (HR) during the ME and ST Sessions
Compared to Rest (P≤0.05).
Although the SBP demonstrated a trend in producing PEH in both sessions, the responses were not
significantly different from each other (P>0.05) (Figure 2).
Figure 2. Mean and Standard Deviation of Systolic Blood Pressure (SBP) during the ME and
ST Sessions Compared to Rest (P>0.05).
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During recovery, PEH was observed at 15 min, 30 min, and 45 min in the ST session. In turn, ME
resulted in PEH only at the 15 min point of recovery. When the sessions were compared in the same
time, no significant difference was observed (Figure 3).
Figure 3. Mean and Standard Deviation of Diastolic Blood Pressure (DBP) during the ME and
ST Sessions Compared to Rest (P≤0.05).
The subjects’ MAP responses indicated significant changes (P≤0.05) in PEH at 15 min, 30 min, and
45 min of recovery for the ST session. There were no statistical differences in MAP for the ME
session (Figure 4).
Figure 4. Mean and Standard Deviation of the Mean Arterial Pressure (MAP) during the ME and
ST Sessions Compared to Rest (P≤0.05).
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DISCUSSION
The primary finding in this study indicate that the ST session promoted PEH for a longer time on DBP
in sedentary young adults than the ME session. Also, the data indicate that ST resulted in PEH via
the subjects’ MAP response, which occurred after the ME session. To our knowledge, this is the first
study to demonstrate prolonged PEH on DBP after high intensity RT in comparison with low intensity
RT in healthy young adults. Other studies (11,16) have observed no differences between high and
low RT (4) or PEH just after a low intensity RT session without significant changes after high
resistance exercise.
This discrepancy in the results may be explained by the differences between the subjects of the
different studies. In the present study, all the subjects were sedentary for at least 6 months while the
other studies (4,11,16) evaluated practitioners of resistance exercise (4,11,16). In spite of the studies
that evaluated subjects with normal levels of blood pressure, the adaptations in the cardiovascular
system subsequent to engaging in RT programs may have decreased the effects of a single session.
This point cannot be ruled out.
The changes in DBP and MAP after exercise may be explain by the balance between cardiac output
(CO) and peripheral vascular resistance (PVR) (18). Changes in blood volume, due to the shift of
plasma liquid to the interstitial space, may also have facilitated the spreading of blood. This overall
effect may be directly linked to the decrease in venous return and, therefore, the decrease in cardiac
preload (12,18). As a result, the changes in CO and PVR are likely the primary reason for the
decrease in DBP and MAP (18). Then, too, since high intensity exercise has been demonstrated to
increase nitric oxide (NO) more so than low intensity exercise (2,3), an increase in NO may have
worked to either maintain or decrease PVR and the resulting changes in DBP and MAP. Some
studies (13,19) has shown that inhibition of NO lead to increase on MAP (~15%) and PVR (~64%).
The fact that the RT and PEH research findings differ in volume and intensity as well as in the order
of the RT exercises makes it difficult to interpret the best relationship of these variables to PEH.
There are several limitations in regards to the findings in this study. First, the lack of a control session
to analyze the resting values vs. the exercise values should be evaluated. Second, the determination
of blood pressure for a longer period of time after the sessions and, third, the fact that the time and/or
consumption of food were not standardized prior to data collective need clarification as possible
confounding variables.
CONCLUSIONS
While both sessions (protocols) resulted in PEH, the ST session produced a longer PEH response
than did the ME session. Thus, in terms of the likelihood of preventing hypertension, the findings
indicate that the ST protocol is more effective.
Address for correspondence: Ricardo Yukio Asano, PhD, University of Mogi das Cruzes, 200 Dr.
Cândido Xavier de Almeida Souza Avenue. Mogi das Cruzes, 08770490, Brazil. E-mail:
ricardokiu@ig.com.br Telephone: (55) 11 97011-5500 Fax: (55) 11 40331129
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