Post-exercise differential response of central and brachial blood pressure in patients with coronary artery disease: A randomized crossover trial.

The post-exercise hypotension response is controversial among patients with coronary artery disease (CAD). Factors behind this disparity may include post-exercise differential effects on central and brachial blood pressure (BP), exercise intensity and inter-individual variability. Thus, we investiga...

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Main Authors: João Luís Marôco, Vitor Angarten, Rita Pinto, Vanessa Santos, Bo Fernhall, Helena Santa-Clara, Xavier Melo
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0317212
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author João Luís Marôco
Vitor Angarten
Rita Pinto
Vanessa Santos
Bo Fernhall
Helena Santa-Clara
Xavier Melo
author_facet João Luís Marôco
Vitor Angarten
Rita Pinto
Vanessa Santos
Bo Fernhall
Helena Santa-Clara
Xavier Melo
author_sort João Luís Marôco
collection DOAJ
description The post-exercise hypotension response is controversial among patients with coronary artery disease (CAD). Factors behind this disparity may include post-exercise differential effects on central and brachial blood pressure (BP), exercise intensity and inter-individual variability. Thus, we investigate group and individual central and brachial BP responses 5, 15 and 30-min after combined exercise of different intensities in participants with and without CAD. Seventeen participants with stable CAD and eighteen aged-matched controls (52-81 years) completed an acute bout of high and moderate-intensity combined exercise. Brachial and central systolic (cSBP) pressures were assessed via oscillometry and carotid tonometry, respectively. Central pulse wave velocity was also measured. Group mean changes were examined with linear mixed models, and bSBP and cSBP post-exercise individual responsiveness quantified via the region of practical equivalence and highest density interval, a Bayesian decision rule. Regardless of exercise intensity, cSBP was persistently increased during recovery in participants with CAD (difference 30 -baseline (d30-bas) = 10, 95% CI: 4 to 17 mmHg, p = 0.001) but reduced in controls (d30-bas = -13, 95% CI: -19 to -7 mmHg, p = 0.003). bSBP was unchanged in both groups (CAD: d30-bas = 1, 95% CI: -3 to 6 mmHg, p = 0.995, control: d30-bas = -4, 95% CI: -2 to 8 mmHg, p = 0.999). Most participants with CAD exhibited sustained elevations in cSBP (n = 10), while most controls were post-exercise hypertensive responders (n = 11) with changes >|5| mmHg. We found differential post-exercise effects on central and brachial BP independent from combined exercise intensity but not clinical population. Clinical trials.gov registration ID: NCT06617117.
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spelling doaj-art-6c8358d90e39418b8ea3db37599490332025-08-20T01:49:32ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01202e031721210.1371/journal.pone.0317212Post-exercise differential response of central and brachial blood pressure in patients with coronary artery disease: A randomized crossover trial.João Luís MarôcoVitor AngartenRita PintoVanessa SantosBo FernhallHelena Santa-ClaraXavier MeloThe post-exercise hypotension response is controversial among patients with coronary artery disease (CAD). Factors behind this disparity may include post-exercise differential effects on central and brachial blood pressure (BP), exercise intensity and inter-individual variability. Thus, we investigate group and individual central and brachial BP responses 5, 15 and 30-min after combined exercise of different intensities in participants with and without CAD. Seventeen participants with stable CAD and eighteen aged-matched controls (52-81 years) completed an acute bout of high and moderate-intensity combined exercise. Brachial and central systolic (cSBP) pressures were assessed via oscillometry and carotid tonometry, respectively. Central pulse wave velocity was also measured. Group mean changes were examined with linear mixed models, and bSBP and cSBP post-exercise individual responsiveness quantified via the region of practical equivalence and highest density interval, a Bayesian decision rule. Regardless of exercise intensity, cSBP was persistently increased during recovery in participants with CAD (difference 30 -baseline (d30-bas) = 10, 95% CI: 4 to 17 mmHg, p = 0.001) but reduced in controls (d30-bas = -13, 95% CI: -19 to -7 mmHg, p = 0.003). bSBP was unchanged in both groups (CAD: d30-bas = 1, 95% CI: -3 to 6 mmHg, p = 0.995, control: d30-bas = -4, 95% CI: -2 to 8 mmHg, p = 0.999). Most participants with CAD exhibited sustained elevations in cSBP (n = 10), while most controls were post-exercise hypertensive responders (n = 11) with changes >|5| mmHg. We found differential post-exercise effects on central and brachial BP independent from combined exercise intensity but not clinical population. Clinical trials.gov registration ID: NCT06617117.https://doi.org/10.1371/journal.pone.0317212
spellingShingle João Luís Marôco
Vitor Angarten
Rita Pinto
Vanessa Santos
Bo Fernhall
Helena Santa-Clara
Xavier Melo
Post-exercise differential response of central and brachial blood pressure in patients with coronary artery disease: A randomized crossover trial.
PLoS ONE
title Post-exercise differential response of central and brachial blood pressure in patients with coronary artery disease: A randomized crossover trial.
title_full Post-exercise differential response of central and brachial blood pressure in patients with coronary artery disease: A randomized crossover trial.
title_fullStr Post-exercise differential response of central and brachial blood pressure in patients with coronary artery disease: A randomized crossover trial.
title_full_unstemmed Post-exercise differential response of central and brachial blood pressure in patients with coronary artery disease: A randomized crossover trial.
title_short Post-exercise differential response of central and brachial blood pressure in patients with coronary artery disease: A randomized crossover trial.
title_sort post exercise differential response of central and brachial blood pressure in patients with coronary artery disease a randomized crossover trial
url https://doi.org/10.1371/journal.pone.0317212
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