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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 31, No 3, May/June 2020
116
AFRICA
Cardiovascular Topics
The effects of aquatic and land exercise on resting blood
pressure and post-exercise hypotension response in
elderly hypertensives
Francisco ADM Júnior, Samuel G Gomes, Fernando F da Silva, Perciliany M Souza, Emerson C
Oliveira, Daniel B Coelho, Raimundo M Nascimento-Neto, Wanderson Lima, Lenice K Becker
Abstract
Objective:
This study compared resting blood pressure (BP)
using ambulatory BP monitoring (ABPM) responses in two
groups of subjects trained in land exercise (LE) and aquatic
exercise (AE), and assessed post-exercise hypotension (PEH)
using ABPM, after land- and aquatic-based exercises.
Methods:
ABPM (24 hours) was used to measure the baseline
BP in elderly hypertensive women trained in LE and AE and
the PEH induced by exercise. For this, 40 subjects were evalu-
ated at rest and after a land- or aquatic-based exercise session
(aerobic: 75% of reserve heart rate combined with resistance
exercise).
Results:
The daytime BP was lower for AE [systolic BP (SBP)
124
±
1.0 mmHg, diastolic BP (DBP) 70
±
1.5 mmHg] than
for LE (SBP 134
±
0.9 mmHg, DBP 76
±
0.9 mmHg), but
there were no differences at night-time. The aquatic exercise-
induced PEH in the second hour was maintained at the 24th
hour post-exercise. For land exercise-induced PEH, it was
maintained at the 12th hour post-exercise. The SBP and DBP
were lower at the 24th hour for AE than for LE.
Conclusion:
Elderly hypertensive people trained in AE had
lower baseline BP during the daytime. SBP and DBP values
were lower for individuals trained in AE, and their PEH was
more rapid and longer lasting after AE.
Keywords:
aquatic exercise, land exercise, hypertension, elderly
Submitted 26/6/19, accepted 1/9/19
Published online 25/10/19
Cardiovasc J Afr
2020;
31
: 116–122
www.cvja.co.zaDOI: 10.5830/CVJA-2019-051
Hypertension (HTN) has been the subject of worldwide study
for its clinical aspects or as a health problem. HTN is considered
one of the main determinants of cardiovascular morbidity
and mortality.
1,2
Among non-pharmacological therapies
recommended for HTN treatment, exercise training is essential,
with reductions of around –3.5 mmHg for systolic and –3 mmHg
for diastolic blood pressure (BP) being reported.
3
Aerobic exercise for periods of 30 minutes of vigorous or
60 minutes of moderate intensity three to five times a week
4
is
universally the most recommended measure to lower BP among
those with HTN.
5-7
Resistance training with nine exercises three
times a week for 12 weeks, at 75% intensity on one maximal
repetition (1RM), with a volume of six to 10 repetitions,
promotes a greater nocturnal reduction (> 10%) in diastolic BP
(DBP) among older hypertensive subjects than other forms of
training.
8
Individuals can benefit from one session of exercise with
immediate or short-term effects that persist for up to 24 hours
after an acute exercise bout, a response that is termed post-
exercise hypotension
(PEH); this effect is considered an important
positive factor in HTN treatment.
9-11
Although the modalities of
physical exercise (aerobic or resistance exercise) promote different
responses in PEH, the magnitudes of PEH that they induce may
be distinct. Aerobic exercise seems to promote a higher and
longer PEH,
12
and the intensity of the exercise appears to have an
influence on PEH.
13
For resistance training there are conflicting
data about its effect on PEH due to variance in factors such as the
muscle mass involved, the intensity of exercise, and the interval
and volume of sets and rest.
13,14
Aquatic physical exercise (AE) offers advantages over land
exercise (LE) for the elderly as it involves lower risk of injury
than LE owing to water buoyancy, and guards against joint
degradation by decreasing weight-bearing loads
15-17
and reduced
joint load.
18
In addition, aquatic-based exercise promotes
physiological adjustments resulting from immersion that can
affect BP as well as cardiac work, particularly reduction in
sympathetic activity and redistribution of blood volume from
the lower limbs and abdomen to the upper body.
19,20
Therefore,
School of Physical Education, Federal University of Ouro
Preto, Brazil
Francisco ADM Júnior, BSc
Samuel G Gomes, MSc
Fernando F da Silva, BSc
Emerson C Oliveira, PhD
Daniel B Coelho, PhD
Lenice K Becker, PhD,
lenice@ufop.edu.brDepartment of Biological Sciences/NUPEB, Federal
University of Ouro Preto, Brazil
Perciliany M Souza, MSc
Wanderson Lima, PhD
Department of Medicine, Federal University of Ouro Preto,
Brazil
Raimundo M Nascimento-Neto, PhD