Key result
Combined exercise raises post-exercise cSBP ~10 mmHg in CAD patients but lowers it in controls.
Why the study?
The post-exercise hypotension response is controversial in CAD, potentially due to differential effects on central versus brachial blood pressure, exercise intensity, and inter-individual variability.
Does an acute bout of combined exercise affect central and brachial blood pressure differently in patients with stable CAD compared to controls?
RCT (n=35)
Crossover
Does an acute bout of combined exercise affect central and brachial blood pressure differently in patients with stable CAD compared to controls?
Patients with stable CAD exhibit a sustained increase in central systolic blood pressure after exercise, unlike healthy controls who show post-exercise hypotension, despite no changes in brachial blood pressure in either group.
Answers are grounded in this paper and cite their sources.
Raises central SBP post-exercise in stable CAD despite unchanged brachial BP; challenges post-exercise hypotension assumptions for central hemodynamics.
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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Marôco et al. (2025) conducted an RCT in Coronary artery disease (CAD) (n=35). High and moderate-intensity combined exercise vs. Aged-matched controls without CAD was evaluated on Change in central systolic blood pressure (cSBP) 30 minutes post-exercise (95% CI 4 to 17, p=0.001). Combined exercise persistently increased central systolic blood pressure during recovery in patients with CAD (+10 mmHg, P=0.001) but reduced it in controls (-13 mmHg, P=0.003).
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