Post-Exercise Hypotension Induced by a short Isometric Exercise session versus Combined Exercise in Hypertensive Patients with Ischemic Heart Disease: a Pilot Study

Background: Short sessions of isometric exercise have been shown to reduce blood pressure (BP) in normotensive and hypertensive subjects. However, there are few data in hypertensive patients with underlying ischemic heart disease (IHD). In the present study we compared post-exercise hypotension (PEH) induced by isometric versus combined, aerobic plus dynamic resistance, exercise in IHD patients. Methods: Twenty-five stable patients with established IHD and with treated hypertension were enrolled. The study had a cross-over design. All patients performed in a random order and in different days: 1) Isometric exercise session (IES) consisting of bilateral knee extension, performed at 20% of maximal voluntary contraction and lasting 20 minutes; 2) Combined exercise session (CES) including moderate-intensity continuous exercise at and dynamic resistance exercise performed at 60% of 1 repetition maximum, and lasting 60 minutes. 3) Control session (no exercise). BP was measured at rest, immediately after the training and then every 15 minutes up to 90 minutes. Results: The repeated measures ANOVA analysis showed that: systolic BP significantly decreased after CES session compared to control (F = 6.2; p 0.001) and to IES session (F = 4.4; p 0.004). Systolic BP significantly decreased after IES compared to control (F = 3.6; p 0.036). Diastolic BP did not show significantly changes after CES and IES compared to control (CES vs control: F=2.2; p 0.142; IES vs control (F=2.5; p 0.062). There were not significant differences in diastolic BP changes between CES and IES (CES vs IES: F=1.8; p 0.156). Conclusion: We observed that CES was more effective than IES in reducing systolic BP; IES was as effective as CES in inducing diastolic PEH in hypertensive patients with underlying IHD.