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Post-walking exercise hypotension in patients with intermittent claudication.

Gabriel Grizzo Cucato1, Marcel Da Rocha Chehuen, Raphael Mendes Ritti-Dias

  • 11Hospital Israelita Albert Einstein, São Paulo, BRAZIL; 2Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, BRAZIL; 3School of Physical Education, Pernambuco University, Pernambuco, BRAZIL; 4Hospital das Clínicas, University of São Paulo, São Paulo, BRAZIL; and 5School of Health Sciences, University of East Anglia, Norwich, UNITED KINGDOM.

Medicine and Science in Sports and Exercise
|July 18, 2014
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Summary

Intermittent walking exercise (WE) temporarily lowers blood pressure (BP) in patients with intermittent claudication (IC). This effect, mediated by reduced cardiac output and stroke volume, does not persist beyond 24 hours.

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Area of Science:

  • Cardiovascular Physiology
  • Exercise Science
  • Clinical Medicine

Background:

  • Intermittent claudication (IC) is characterized by peripheral arterial disease leading to leg pain during exercise.
  • Blood pressure (BP) regulation is crucial in cardiovascular health, especially in patient populations like those with IC.
  • Understanding the physiological responses to exercise in IC patients is vital for managing their condition.

Purpose of the Study:

  • To investigate the acute effects of intermittent walking exercise (WE) on blood pressure (BP) in patients with intermittent claudication (IC).
  • To explore the underlying physiological mechanisms of BP regulation following WE in this patient group.

Main Methods:

  • Twenty patients with IC underwent two randomized sessions: intermittent walking exercise (WE) and a control (standing rest).
  • Measurements included BP, cardiac output (CO) via CO2 rebreathing, and heart rate variability (HRV) for autonomic modulation.
  • Stroke volume (SV) and systemic vascular resistance (SVR) were calculated; data analyzed using two-way ANOVA.

Main Results:

  • WE significantly reduced systolic, diastolic, and mean BP compared to the control condition.
  • WE led to decreases in stroke volume (SV) and cardiac output (CO).
  • Systemic vascular resistance (SVR) did not increase post-WE, unlike in the control condition.

Conclusions:

  • Intermittent walking exercise induces a significant, acute postexercise hypotension in IC patients.
  • This hypotensive effect is primarily driven by reduced cardiac output and stroke volume.
  • The blood pressure reduction is temporary and not sustained over a 24-hour period.