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Older Women With Controlled ISH: Exercise and Blood Pressure
Study Questions:
What are the cardiovascular responses to static and dynamic exercises of older women with isolated systolic hypertension (ISH), and how do they compare with those of same-aged normotensive women?
Methods:
Older women (>60 years old) with controlled ISH or normal blood pressures were recruited to perform dynamic (cycle ergometer) and static (handgrip) exercises. Their systolic blood pressures (SBP) and diastolic blood pressures (DBP), heart rates, brachial pulse transit times (an index of artery compliance), and respiratory rates were measured pre-, during, and post-exercise, as was post-exercise circulatory occlusion (an index of metaboreflex regulation of blood pressure). The cardiovascular responses to dynamic and static exercises were compared by two-way repeated analysis of variance tests with post-hoc analysis to compare the absolute blood pressure measurements at rest, during exercise, and during recovery for women with ISH versus women with normal blood pressure.
Results:
With dynamic cycle exercise, SBP increased for both groups but was significantly greater for women with ISH at all time points, including a significantly higher absolute increase in SBP at the end of exercise. DBP did not increase significantly for either group. With static handgrip exercise, SBP increased for both groups and was significantly higher for women with ISH, and DBP increased for both groups but was not significantly different between groups. The brachial pulse transit times were shorter in women with ISH than in normotensive women. Also with static handgrip exercise, resting heart rate was higher in the women with ISH but changed to a similar extent in both groups throughout the exercise, post-exercise circulatory occlusion, and recovery.
Conclusions:
This study demonstrated that older women with well-controlled ISH had greater SBP increases than age-matched normotensive women when doing both dynamic and static exercises. This was likely due to already-higher resting SBP and to exaggerated end-exercise elevations, often to concerning levels. The shorter brachial pulse transit times in women with ISH and similar DBP responses in both groups indicate stiff arterial compliance as the primary cause, consistent with the primary factor contributing to ISH.
Perspective:
Exercise is essential for optimal health throughout life and especially for older people. However, high SBP responses to dynamic and static exercise in older women with ISH may put these patients at higher risk for cardiovascular incidents. More research is needed to determine if performing exercise in shorter intervals and at intensities less than 50% of estimated maximum heart rate ameliorates the high SBP response.
Clinical Topics: Diabetes and Cardiometabolic Disease, Geriatric Cardiology, Prevention, Sports and Exercise Cardiology, Vascular Medicine, Exercise, Hypertension
Keywords: Aneurysm, Blood Pressure, Blood Pressure Determination, Exercise, Female, Geriatrics, Hypertension, Respiratory Rate, Sports
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