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Hemodynamic and autonomic correlates of postexercise hypotension in patients with mild hypertension

Legramante, Jacopo M ; Galante, Alberto ; Massaro, Michele ; Attanasio, Antonio ; Raimondi, Gianfranco ; Pigozzi, Fabio ; Iellamo, Ferdinando

American journal of physiology. Regulatory, integrative and comparative physiology, 2002-04, Vol.282 (4), p.1037-R1043 [Periódico revisado por pares]

United States

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  • Título:
    Hemodynamic and autonomic correlates of postexercise hypotension in patients with mild hypertension
  • Autor: Legramante, Jacopo M ; Galante, Alberto ; Massaro, Michele ; Attanasio, Antonio ; Raimondi, Gianfranco ; Pigozzi, Fabio ; Iellamo, Ferdinando
  • Assuntos: Adult ; Autonomic Nervous System - physiology ; Baroreflex - physiology ; Blood Pressure - physiology ; Cardiac Output - physiology ; Exercise - physiology ; Female ; Heart Rate - physiology ; Humans ; Hypertension - physiopathology ; Hypotension - physiopathology ; Male ; Middle Aged ; Vascular Resistance - physiology
  • É parte de: American journal of physiology. Regulatory, integrative and comparative physiology, 2002-04, Vol.282 (4), p.1037-R1043
  • Notas: ObjectType-Article-2
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  • Descrição: 1  Dipartimento di Medicina Interna, Centro di Riabilitazione Cardiologica "San Raffaele" and Università di Roma "Tor Vergata," 00173 Rome; and 2  Istituto Universitario di Scienze Motorie, 00194 Rome, Italy We investigated the interplay of neural and hemodynamic mechanisms in postexercise hypotension (PEH) in hypertension. In 15   middle-aged patients with mild essential hypertension, we evaluated blood pressure (BP), cardiac output (CO), total peripheral resistance (TPR), forearm (FVR) and calf vascular resistance (CVR), and autonomic function [by spectral analysis of R-R interval and BP variabilities and spontaneous baroreflex sensitivity (BRS)] before and after maximal exercise. Systolic and diastolic BP, TPR, and CVR were significantly reduced from baseline 60-90 min after exercise. CO, FVR, and HR were unchanged. The low-frequency (LF) component of BP variability increased significantly after exercise, whereas the LF component of R-R interval variability was unchanged. The overall change in BRS was not significant after exercise vs. baseline, although a significant, albeit small, BRS increase occurred in response to hypotensive stimuli. These findings indicate that in hypertensive patients, PEH is mediated mainly by a peripheral vasodilation, which may involve metabolic factors linked to postexercise hyperemia in the active limbs. The vasodilator effect appears to override a concomitant, reflex sympathetic activation selectively directed to the vasculature, possibly aimed to counter excessive BP decreases. The cardiac component of arterial baroreflex is reset during PEH, although the baroreflex mechanisms controlling heart period appear to retain the potential for greater opposition to hypotensive stimuli. autonomic nervous system; baroreflex; heart rate variability; hemodynamics
  • Editor: United States
  • Idioma: Inglês
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