Amanda L Zaleski1,2, Beth A Taylor1,2, Crystal L Park3, Lucas P Santos4,5, Gregory Panza1,2, Melody Kramarz1, Kyle McCormick1, Paul D Thompson2, Antonio B Fernandez2, Ming-Hui Chen6, Bryan Blissmer7, Kim M Gans8, Linda S Pescatello1. 1. Department of Kinesiology, University of Connecticut, Storrs. 2. Department of Preventive Cardiology, Hartford Hospital, Hartford. 3. Department of Psychology, University of Connecticut, Storrs, Connecticut, USA. 4. Exercise Pathophysiology Laboratory, Hospital de Clínicas de Porto Alegre. 5. Graduate Program in Cardiology and Cardiovascular Sciences, Faculty of Medical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil. 6. Department of Statistics, University of Connecticut, Storrs, Connecticut. 7. College of Health Sciences, University of Rhode Island, Kingston, Rhode Island. 8. Department of Human Development and Family Studies, University of Connecticut, Storrs, Connecticut, USA.
Abstract
BACKGROUND: A single exercise session evokes immediate blood pressure (BP) reductions that persist for at least 24 h, termed postexercise hypotension (PEH). Self-monitoring of PEH may foster positive outcome expectations of exercise, and thus, enhance exercise adherence among adults with hypertension. PURPOSE: To compare the efficacy of self-monitoring of exercise (EXERCISE) versus exercise and PEH (EXERCISE + PEH) to improve exercise adherence and BP control among adults with hypertension. METHODS:Adults with high BP were randomized to EXERCISE (n = 12) or EXERCISE + PEH (n = 12). Participants underwent supervised, moderate intensity aerobic exercise training for 40-50 min/session, 3 days/week for 12 weeks and encouraged to exercise unsupervised at home at least 30 min/day, 1-2 days/week. EXERCISE + PEH also self-monitored BP before and after exercise. Adherence was calculated as [(no. of exercise sessions performed/no. of possible exercise sessions) × 100%]. BP was measured pre and posttraining. RESULTS:Healthy, middle-aged (52.3 ± 10.8 years) men (n = 11) and women (n = 13) with hypertension (136.2 ± 10.7/85.2 ± 8.9 mmHg) completed exercise training with 87.9 ± 12.1% adherence. EXERCISE + PEH demonstrated greater adherence to supervised training (94.3 ± 6.6%) than EXERCISE (81.6 ± 13.2%; P = 0.007). EXERCISE + PEH performed 32.6 ± 22.5 min/week more unsupervised home exercise than EXERCISE (P = 0.004), resulting in greater exercise adherence (107.3 ± 18.7%) than EXERCISE (82.7 ± 12.2%; P = 0.002). Post versus pretraining BP was reduced -7.4 ± 11.3/-4.9 ± 9.9 mmHg (P < 0.025) with no statistical difference between EXERCISE (-5.2 ± 13.3/-3.6 ± 6.1 mmHg) and EXERCISE + PEH (-9.9 ± 11.3/-6.1 ± 6.9 mmHg; P > 0.344). CONCLUSION: The current study is the first to demonstrate that PEH self-monitoring is an efficacious tool to improve exercise adherence among a small sample of adults with hypertension. Future research among a larger, more diverse sample is needed to confirm these novel findings and determine whether EXERCISE + PEH translates to better BP control relative to EXERCISE self-monitoring alone.
RCT Entities:
BACKGROUND: A single exercise session evokes immediate blood pressure (BP) reductions that persist for at least 24 h, termed postexercise hypotension (PEH). Self-monitoring of PEH may foster positive outcome expectations of exercise, and thus, enhance exercise adherence among adults with hypertension. PURPOSE: To compare the efficacy of self-monitoring of exercise (EXERCISE) versus exercise and PEH (EXERCISE + PEH) to improve exercise adherence and BP control among adults with hypertension. METHODS: Adults with high BP were randomized to EXERCISE (n = 12) or EXERCISE + PEH (n = 12). Participants underwent supervised, moderate intensity aerobic exercise training for 40-50 min/session, 3 days/week for 12 weeks and encouraged to exercise unsupervised at home at least 30 min/day, 1-2 days/week. EXERCISE + PEH also self-monitored BP before and after exercise. Adherence was calculated as [(no. of exercise sessions performed/no. of possible exercise sessions) × 100%]. BP was measured pre and posttraining. RESULTS: Healthy, middle-aged (52.3 ± 10.8 years) men (n = 11) and women (n = 13) with hypertension (136.2 ± 10.7/85.2 ± 8.9 mmHg) completed exercise training with 87.9 ± 12.1% adherence. EXERCISE + PEH demonstrated greater adherence to supervised training (94.3 ± 6.6%) than EXERCISE (81.6 ± 13.2%; P = 0.007). EXERCISE + PEH performed 32.6 ± 22.5 min/week more unsupervised home exercise than EXERCISE (P = 0.004), resulting in greater exercise adherence (107.3 ± 18.7%) than EXERCISE (82.7 ± 12.2%; P = 0.002). Post versus pretraining BP was reduced -7.4 ± 11.3/-4.9 ± 9.9 mmHg (P < 0.025) with no statistical difference between EXERCISE (-5.2 ± 13.3/-3.6 ± 6.1 mmHg) and EXERCISE + PEH (-9.9 ± 11.3/-6.1 ± 6.9 mmHg; P > 0.344). CONCLUSION: The current study is the first to demonstrate that PEH self-monitoring is an efficacious tool to improve exercise adherence among a small sample of adults with hypertension. Future research among a larger, more diverse sample is needed to confirm these novel findings and determine whether EXERCISE + PEH translates to better BP control relative to EXERCISE self-monitoring alone.
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