The Relationship between the Blood Pressure Responses to Exercise following Training and Detraining Periods

<div><p>Background</p><p>Exercise training lowers blood pressure (BP), while BP increases and returns to pre-training values with detraining. Yet, there is considerable variability in these BP responses. We examined the relationship between the BP responses after 6 months of training followed by 2 weeks of detraining among the same people.</p><p>Methodology/Principal Findings</p><p>Subjects (n = 75) (X<u>+</u>SD, 50.2±10.6 yr) were sedentary, obese, and had prehypertension. They completed an aerobic (n = 34); resistance (n = 28); or aerobic + resistance or concurrent (n = 13) exercise training program. We calculated a metabolic syndrome <i>z</i> score (MetSz). Subjects were classified as BP responders (BP decreased) or non-responders (BP increased) to training and detraining. Linear and multivariable regression tested the BP response. Chi Square tested the frequency of responders and non-responders. The systolic BP (SBP, r = −0.474) and diastolic (DBP, r = −0.540) response to training negatively correlated with detraining (p<0.01), independent of modality (p>0.05). Exercise responders reduced SBP 11.5±7.8 (n = 29) and DBP 9.8±6.2 mmHg (n = 31); non-responders increased SBP 7.9.±10.9 (n = 46) and DBP 4.9±7.1 mmHg (n = 44) (p<0.001). We found 65.5% of SBP training responders were SBP detraining non-responders; while 60.9% of SBP training non-responders were SBP detraining responders (p = 0.034). Similarly, 80.6% of DBP training responders were DBP detraining non-responders; while 59.1% of DBP training non-responders were DBP detraining responders (p<0.001). The SBP detraining response (r = −0.521), resting SBP (r = −0.444), and MetSz (r = 0.288) explained 44.8% of the SBP training response (p<0.001). The DBP detraining response (r = −0.553), resting DBP (r = −0.450), and MetSz (r = 0.463) explained 60.1% of the DBP training response (p<0.001).</p><p>Conclusions/Significance</p><p>As expected most subjects that decreased BP after exercise training, increased BP after detraining. An unanticipated finding was most subjects that increased BP after exercise training, decreased BP after detraining. Reasons why the negative effects of exercise training on BP maybe reversed with detraining among some people should be explored further.</p><p>Trial Registration Information</p><p>ClinicalTrials.gov <a href="http://clinicaltrials.gov/ct2/results?term=NCT00275145&Search=Search" target="_blank">1R01HL57354; 2003–2008; NCT00275145</a></p></div

Correlates of the blood pressure response after versus before 6 months of exercise training.

<p>SBP, systolic blood pressure; DBP, diastolic blood pressure; MetS z score; metabolic syndrome z score.</p><p>Correlates of the blood pressure response after versus before 6 months of exercise training.</p

The response (Mean±SD) of the metabolic syndrome z score and the individual components of the metabolic syndrome z score after versus before 6 months of exercise training.

<p>MAP, mean arterial pressure; WC, Waist Circumference; TG, Triglycerides.</p><p>*p<0.05, ^†p<0.001 After versus before exercise.</p>‡<p>p<0.05, ^&p<0.001, Responders versus non-responders.</p><p>The response (Mean±SD) of the metabolic syndrome z score and the individual components of the metabolic syndrome z score after versus before 6 months of exercise training.</p

Baseline subject characteristics (Mean±SD) of the total sample and by blood pressure exercise training responders and non-responders.

<p>SBP, systolic blood pressure; DBP, diastolic blood pressure; BMI, body mass index; WC, waist circumference; CHOL, total cholesterol; HDL, high density lipoprotein; LDL, low density lipoprotein; VO_2peak, peak oxygen uptake; MetS z score; metabolic syndrome z score.</p><p>*p<0.05, ^†p = 0.001, Responder vs non-responder.</p><p>Baseline subject characteristics (Mean±SD) of the total sample and by blood pressure exercise training responders and non-responders.</p

Weighted mean effect of exercise modulating depressive symptoms by type of cancer.

<p><b>NOTE:</b> Weighted mean effect size values (<i>d₊</i>) are negative when the exercise intervention was successful in reducing depression compare to standard care.</p><p><i>k</i>, number of studies.</p>a<p>37 studies provided 40 total effect size estimates.</p>b<p>24 studies provided 26 total effect size estimates.</p>c<p>Significance implies rejection of the hypothesis of homogeneity and the inference of heterogeneity.</p

Characteristics related to depressive symptoms change for all cancer survivors.

<p><b>NOTE:</b> Weighted mean effect size values (<i>d₊</i>) are negative when the exercise intervention reduced depression compared to the control group.</p>a<p>Levels represent values of interest of each moderator; in these models, continuous variables were represented in their continuous form; the estimates adjust for the other moderators in the model.</p>b<p><i>d</i>₊ and their 95% CI estimates statistically adjust for the presence of the rest of the moderators in the fixed-effects model, including weekly minutes of exercise×PEDro interaction and their independent linear terms, supervision of exercise, quadratic and linear trends for age, held constant at their means except for the study dimension in question.</p>c<p>β values are standardized.</p>d<p>This is a continuous×continuous interaction. We chose to report PEDro scores of 5 and 10 to highlight the variability along the continuous distribution of PEDro scores, those of very high quality (i.e., 10) versus those of low quality (i.e., 5).</p>e<p>β for interaction. Independent β: weekly aerobic volume, β = −0.09; PEDro methodological score, β = −0.28.</p>f<p>Continuous quadratic trend including linear component.</p

Flow diagram of exercise intervention identification and selection.

<p>Flow diagram of exercise intervention identification and selection.</p

<i>NR3C1</i>–1017 T>C and Muscle Size Response to Resistance Training.

<p><i>NR3C1</i>–1017 T>C (rs4634384) genotypes grouped by a recessive model and their association with the relative muscle size response to resistance training by sex adjusted for BMI (mean±SEM).</p

<i>NR3C1</i>–2722 G>A and Muscle Strength Response to Resistance Training.

<p><i>NR3C1</i>–2722 G>A (rs10482614) genotypes grouped by a recessive model and their association with the relative muscle strength response to resistance training by sex adjusted for age (mean±SEM).</p