Use of low volume, high effort resistance training to manage blood pressure in hypertensive patients inside a public hospital: a proof of concept study
https://doi.org/10.4081/ejtm.2021.9547
Accepted: 19 December 2020
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Physical exercise has been shown to have an important role in the prevention and treatment of arterial hypertension. However, the general exercise recommendations are time consuming, which might be detrimental to exercise adoption. Based on this, minimal doses of exercise have been suggested as an alternative approach and this report investigates the feasibility and effects of low volume and high effort resistance training for hypertensive patients in a hospital setting. This is a pilot non-randomized prospective study where 15 sedentary hypertensive patients (11 women and 4 men) performed 24 resistance training sessions over 12 weeks at a public hospital. The resistance training sessions consisted of two sets of four exercises, with a rest interval of two minutes between sets. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured 10 minutes before and 10 minutes after each training. No injuries or intercurrence were reported during the study. SBP decreased significantly when compared the first and last sessions, when the measures were performed at rest (152 ± 16 mmHg vs. 122 ± 9 mmHg vs, p<0.05), and after (137 ± 13 mmHg vs. 115 ± 5 mmHg, p<0.05) the resistance training session. Similarly, DBP also decreased significantly when the values from the last session were compared with the first session, when measured at rest (83 ± 14 mmHg vs 73 ± 9 mmHg, p<0.05). Low volume and high effort resistance training seems to be a feasible non-pharmacological strategy to help controlling blood pressure in hypertensive patients within a hospital.
Malachias MVB, Ferreira S Filho, Souza WKSB, Ribeiro JM, Miranda RD, Jardim TSV. 7th Brazilian Guideline of Arterial Hypertension: Chapter 11 - Arterial Hypertension in the elderly. Arq Bras Cardiol. 2016 Sep;107(3 Suppl 3):64-66.
Malachias MVB, Franco RJ, Forjaz CLM, Pierin AMG, Gowdak MM, Klein MRST, Matsudo V. 7th Brazilian Guideline of Arterial Hypertension: Chapter 6 - Non-pharmacological treatment. Arq Bras Cardiol. 2016 Sep;107(3 Suppl 3):30-34.
Malachias M, Plavnik FL, Machado CA, Malta D, Scala LCN, Fuchs S. 7th Brazilian Guideline of Arterial Hypertension: Chapter 1 - Concept, Epidemiology and Primary Prevention. Arq Bras Cardiol. 2016 Sep;107(3 Suppl 3):1-6.
Pescatello LS, Buchner DM, Jakicic JM, Powell KE, Kraus WE, Bloodgood B, Campbell WW, Dietz S, Dipietro L, George SM, Macko RF, McTiernan A, Pate RR, Piercy KL; 2018 PHYSICAL ACTIVITY GUIDELINES ADVISORY COMMITTEE. Physical Activity to Prevent and Treat Hypertension: A Systematic Review. Med Sci Sports Exerc. 2019;51(6):1314– 23. DOI: https://doi.org/10.1249/MSS.0000000000001943
Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, Minson CT, Nigg CR, Salem GJ, Skinner JS. Exercise and physical activity for older adults. Med Sci Sport Exerc. 2009;41:1510–30. DOI: https://doi.org/10.1249/MSS.0b013e3181a0c95c
Pate BRR, Neill JO, Dowda M, Farrell SW, O'Neill JR.. Physical Activity Guidelines for Americans. 2nd ed. Services USD of Health and Human Services, editor. Washington, DC; 2018. 1–118 p.
Tulloch H, Sweet SN, Fortier M, Capstick G, Kenny GP, Sigal RJ. Exercise facilitators and barriers from adoption to maintenance in the diabetes aerobic and resistance exercise trial. Can J Diabetes. 2013;37(6):367–74. DOI: https://doi.org/10.1016/j.jcjd.2013.09.002
Fisher JP, Steele J, Gentil P Giessing J, Westcott WL. A minimal dose approach to resistance training for the older adult; the prophylactic for aging. Exp Gerontol. 2017 Dec;99:80–6. DOI: https://doi.org/10.1016/j.exger.2017.09.012
Souza D, Barbalho M, Vieira CA, Martins WR, Cadore EL, Gentil P. Minimal dose resistance training with elastic tubes promotes functional and cardiovascular benefits to older women. Exp Gerontol. 2019 Jan;115:132-138. DOI: https://doi.org/10.1016/j.exger.2018.12.001
Seguro C, Viana R, Lima G, Galvão L, Silva L, Jardim T, Jardim P, Gentil P. Improvements in health parameters of a diabetic and hypertensive patient with only 40 minutes of exercise per week: a case study. Disabil Rehabil 2020 Oct;42(21):3119-3125. DOI: https://doi.org/10.1080/09638288.2019.1583780
Cornelissen VA, Fagard RH, Coeckelberghs E, Vanhees L. Impact of resistance training on blood pressure and other cardiovascular risk factors: a meta-analysis of randomized, controlled trials. Hypertension. 2011/09/08. 2011;58(5):950–8.
Sardeli AV, Griffith GJ, dos Santos MVMA, Ito MSR, Nadruz W, Chacon-Mikahil MPT Do baseline blood pressure and type of exercise influence level of reduction induced by training in hypertensive older adults? A meta-analysis of controlled trials. Exp Gerontol. 2020 Oct;140. DOI: https://doi.org/10.1016/j.exger.2020.111052
Artero EG, Lee DC, Ruiz JR, Sui X, Ortega FB, Church TS, Lavie CJ, Castillo MJ, Blair SN. A prospective study of muscular strength and all- cause mortality in men with hypertension. J Am Coll Cardiol. 2011/04/30. 2011;57(18):1831–7.
Vera-Cala LM, Orostegui M, Valencia-Angel LI, López N, Bautista LE.. Accuracy of the Omron HEM-705 CP for blood pressure measurement in large epidemiologic studies. Arq Bras Cardiol. 2011 May;96(5):393–8. DOI: https://doi.org/10.1590/S0066-782X2011005000038
Malachias MVB, Gomes MAM, Nobre F, Alessi A, Feitosa AD, Coelho EB. 7th Brazilian Guideline of Arterial Hypertension: Chapter 2 - Diagnosis and Classification. Arq Bras Cardiol. 2016 Sep;107(3 Suppl 3):7-13.
Steele J, Fisher J, Giessing J, Gentil P. Clarity in reporting terminology and definitions of set endpoints in resistance training. Muscle Nerve. 2017 Sep;56(3):368–74. DOI: https://doi.org/10.1002/mus.25557
Gentil P, Bottaro M. Influence of supervision ratio on muscle adaptations to resistance training in nontrained subjects. J Strength Cond Res. 2009/08/08. 2010;24(3):639–43.
Paoli A, Gentil P, Moro T, Marcolin G, Bianco A. Resistance training with single vs. multi-joint exercises at equal total load volume: Effects on body composition, cardiorespiratory fitness, and muscle strength. Front Physiol. 2017;8(DEC). DOI: https://doi.org/10.3389/fphys.2017.01105
Gentil P, Steele J, Fisher J. Why intensity is not a bad word - Benefits and practical aspects of high effort resistance training to the older. Clin Nutr. 2017 Oct;36(5):1454–5. DOI: https://doi.org/10.1016/j.clnu.2017.05.024
Cucato GG, Lima AHRA, Cavalcante BR, Sobral- Filho DC, Ritti-Dias RM. Effects of resistance training on cardiovascular function in patients with peripheral artery disease: A randomized controlled trial. J Strength Cond Res. 2018;32(4):1072–80. DOI: https://doi.org/10.1519/JSC.0000000000001914
Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC Jr, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA Sr, Williamson JD, Wright JT Jr. 2017 ACC/AHA/AAPA/ABC/ACPM/ AGS/APhA/ASH /ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practic. J Am Coll Cardiol. 2018;71(19):e127–248.
Li Y, Wei FF, Thijs L, Boggia J, Asayama K, Hansen TW, Kikuya M, Björklund-Bodegård K, Ohkubo T, Jeppesen J, Gu YM, Torp-Pedersen C, Dolan E, Liu YP, Kuznetsova T, Stolarz-Skrzypek K, Tikhonoff V, Malyutina S, Casiglia E, Nikitin Y, Lind L, Sandoya E, Kawecka-Jaszcz K, Mena L, Maestre GE, Filipovský J, Imai Y, O'Brien E, Wang JG, Staessen JA; International Database on Ambulatory blood pressure in relation to Cardiovascular Outcomes (IDACO) Investigators. Ambulatory hypertension subtypes and 24-hour systolic and diastolic blood pressure as distinct outcome predictors in 8341 untreated people recruited from 12 populations. Circulation. 2014;130(6):466–74. DOI: https://doi.org/10.1161/CIRCULATIONAHA.113.004876
Lewington S, Clarke R, Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration. Age- specific relevance of blood pressure to cause- specific mortality is best assessed by collaborative meta-analysis of individual participant data from the separate prospective studies. Lancet. 2002;360:1903–13. DOI: https://doi.org/10.1016/S0140-6736(02)11911-8
Gjøvaag TF, Mirtaheri P, Simon K, Berdal G, Tuchel I, Westlie T, Bruusgaard KA, Nilsson BB, Hisdal J. Hemodynamic responses to resistance exercise in patients with coronary artery disease. Med Sci Sports Exerc. 2016;48(4):581–8. DOI: https://doi.org/10.1249/MSS.0000000000000811
Fleck SJ, Dean LS. Resistance-training experience and the pressor response during resistance exercise. J Appl Physiol. 1987/07/01. 1987;63(1):116–20.
Lamotte M, Niset G, van de Borne P. The effect of different intensity modalities of resistance training on beat-to-beat blood pressure in cardiac patients. Eur J Cardiovasc Prev Rehabil. 2005/02/11. 2005;12(1):12–7.
Vale AF, Carneiro JA, Jardim PC V, Jardim TV, Steele J, Fisher JP , Gentil P . Acute effects of different resistance training loads on cardiac autonomic modulation in hypertensive postmenopausal women. J Transl Med. 2018 Aug;16(1):240. DOI: https://doi.org/10.1186/s12967-018-1615-3
Gentil P, Soares SR, Pereira MC, da Cunha RR, Martorelli SS, Martorelli AS, Bottaro M. Effect of adding single-joint exercises to a multi-joint exercise resistance-training program on strength and hypertrophy in untrained subjects. Appl Physiol Nutr Metab. 2013/03/30. 2013;38(3):341–4.
de França HS, Branco PA, Guedes Junior DP, Gentil P, Steele J, Teixeira CV. The effects of adding single-joint exercises to a multi-joint exercise resistance training program on upper body muscle strength and size in trained men. Appl Physiol Nutr Metab. 2015/08/06. 2015;40(8):822– 6.
Gentil P, Fisher J, Steele J. A Review of the Acute Effects and Long-Term Adaptations of Single- and Multi-Joint Exercises during Resistance Training. Sport Med. 2017;47(5):843–55. DOI: https://doi.org/10.1007/s40279-016-0627-5
Arazi H, Asadi A, Alipour V. Blood pressure responses to resistive exercise in trained female athletes: Infl uence of velocity of movement. Interv Med Appl Sci. 2014;6(4):170–4. DOI: https://doi.org/10.1556/IMAS.6.2014.4.5
Barbalho MSM, Gentil P, Izquierdo M, Fisher J, Steele J, Raiol RA. There are no no-responders to low or high resistance training volumes among older women. Exp Gerontol. 2017 Sep;99(12):18– 26. DOI: https://doi.org/10.1016/j.exger.2017.09.003
Abrahin O, Rodrigues RP, Nascimento VC, Da Silva-Grigoletto ME, Sousa EC, Marçal AC. Single- and multiple-set resistance training improves skeletal and respiratory muscle strength in elderly women. Clin Interv Aging. 2014;9:1775– 82.
Piercy KL, Troiano RP, Ballard RM, Carlson SA, Fulton JE, Galuska DA, George SM, Olson RD. The physical activity guidelines for Americans. JAMA - J Am Med Assoc. 2018;320(19):2020–8. DOI: https://doi.org/10.1001/jama.2018.14854
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