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Hemodynamic Responses to Resistance Exercise in Patients with Coronary Artery Disease
Terje F Gjøvaag1, Peyman Mirtaheri, Kristoffer Simon
11Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics, Oslo and Akershus University College, Oslo, NORWAY; 2Faculty of Technology, Art and Design, Department of Industrial Development, Oslo and Akershus University College, Oslo, NORWAY; 3Faculty of Health Sciences, Department of Physiotherapy, Oslo and Akershus University College, Oslo, NORWAY; 4Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NORWAY; and 5Oslo Vascular Centre, Oslo University Hospital, Aker, Oslo, NORWAY.
Insights
High-load resistance exercise (RE) with fewer repetitions is better for managing blood pressure in coronary artery disease (CAD) patients than moderate-load RE. This study compared hemodynamic responses to different RE intensities in CAD patients.
Area of Science:
- Cardiovascular Physiology
- Exercise Science
- Clinical Cardiology
Background:
- Coronary artery disease (CAD) patients require careful exercise prescription.
- Understanding hemodynamic responses to resistance exercise (RE) is crucial for patient safety.
- International guidelines recommend moderate-load RE for patients, but high-load RE's effects are less understood.
Purpose of the Study:
- To compare the hemodynamic responses to moderate-load (15-repetition maximum, 15RM) versus high-load (4-repetition maximum, 4RM) resistance exercise in patients with coronary artery disease (CAD).
Main Methods:
- 15 medically stable male and female CAD patients (post-PCI or CABG >6 months prior) underwent randomized 15RM and 4RM RE protocols.
- Beat-to-beat monitoring of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), stroke volume (SV), cardiac output (CO), and systemic vascular resistance (SVR) during and after exercise.
Main Results:
- Both 15RM and 4RM RE increased SBP and DBP compared to pre-exercise levels.
- SBP and DBP increased significantly more with 15RM (moderate load) compared to 4RM (high load) RE.
- While stroke volume increased moderately with both, higher heart rate and cardiac output were observed during 15RM RE. Systemic vascular resistance decreased more with 15RM RE.
Conclusions:
- The magnitude of external load is not the sole determinant of blood pressure response during RE in CAD patients.
- Moderate-load, high-repetition RE elicits a greater increase in blood pressure compared to high-load, low-repetition RE.
- High-load, low-repetition resistance exercise may be preferable for blood pressure management in CAD patients.
Purpose:
Investigate hemodynamic responses of resistance exercise (RE) with moderate load (i.e., international guidelines for RE of patients) versus RE with high load in patients with coronary artery disease (CAD).
Methods:
Medically stable male (n = 11) and female patients (n = 4) treated with PCI or percutaneous coronary intervention, or coronary artery bypass surgery a minimum of 6 months before this study, performed three sets of 15RM and 4RM RE in a randomized order on separate days. Beat-to-beat systolic (SBP), diastolic (DBP) blood pressure, heart rate (HR), stroke volume (SV), cardiac output (CO), and systemic vascular resistance (SVR) were monitored at preexercise, and continuously during RE.
Results:
Compared with preexercise, SBP and DBP (mean of three sets) increased by 12% to 13% (both; P < 0.001) and 35% to 40% after 15RM RE (both; P < 0.001). 15RM SBP and DBP were higher than 4RM SBP and DBP (both; P < 0.001). The SBP of the fourth repetition of 15 RM RE was similar to the SBP of the fourth repetition of 4RM RE. Compared with preexercise, SV increased moderately after 4RM and 15 RM RE, respectively (both, P < 0.001). HR increased more after 15RM compared with 4RM RE (P < 0.05); thus, higher CO after 15RM (compared with 4RM RE; P < 0.05) was mainly caused by higher HR. SVR decreased by 15% (P < 0.001) and 50% (P < 0.01) after 4RM and 15RM RE.
Conclusions:
SBP and DBP increased significantly more during moderate load RE; thus, the magnitude of the external load is not the prime determinant of the pressure response during RE. If management of blood pressure is of concern, high load/low rep RE is preferable to medium load/high rep RE.
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