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The Relationship between Postexercise Hypotension and Heart Rate Variability before and after Exercise Training.

Burak T CilhorozAmanda ZaleskiBeth TaylorAntonio B FernandezLucas P SantosThijs VonkPaul D ThompsonLinda S Pescatello
Published in: Journal of cardiovascular development and disease (2023)
Because data are scarce, we examined the relationship between postexercise hypotension (PEH) and heart rate variability (HRV) before and after aerobic exercise training among adults with hypertension. Participants completed a 12 w aerobic training program. Before and after training, they performed a peak graded exercise stress test (GEST) and nonexercise control (CONTROL) and were left attached to an ambulatory BP monitor. Prior to CONTROL, HRV was measured supine for 5 min using a 12-lead electrocardiogram (ECG). The participants ( n = 18) were middle-aged (52.1 ± 11.7 y) and 50% men with hypertension (131.7 ± 9.8/85.9 ± 8.5 mmHg) and obesity (30.0 ± 3.7 kg·m -2 ). Before training, ambulatory systolic BP (ASBP) and diastolic ABP (ADBP) decreased by 3.2 ± 2.1 mmHg and 2.5 ± 1.5 mmHg, respectively, from baseline after the GEST versus CONTROL ( p < 0.05). After training, ASBP tended to decrease by 3.5 ± 2.2 mmHg ( p = 0.055) and ADBP decreased by 1.7 ± 2.5 mmHg ( p = 0.001) from baseline after the GEST versus CONTROL. Before training, HRV high frequency (HFms 2 ) (β = -0.441), age (β = 0.568), and resting SBP (β = 0.504) accounted for 66.8% of the ASBP response ( p = 0.001), whereas the low frequency (LF)/HF ratio (β = 0.516) and resting DBP (β = 0.277) accounted for 35.7% of the ADBP response ( p = 0.037). After training, the standard deviation of NN intervals (SDNN) (β = -0.556), age (β = 0.506), and resting SBP (β = 0.259) accounted for 60.7% of the ASBP response ( p = 0.004), whereas SDNN (β = -0.236) and resting DBP (β = 0.785) accounted for 58.5% of the ADBP response ( p = 0.001). Our preliminary findings show that adults with hypertension and parasympathetic suppression (i.e., lower SDNN and HFms 2 and higher LF/HF) may elicit PEH to the greatest degree independent of training status versus adults with parasympathetic predominance, suggesting that resting HRV may be an important determinant of PEH.
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