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Letters to the Editor-in-Chief

Concerning Postexercise Hypotension

Tipton, Charles M. Ph.D., FACSM

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Exercise and Sport Sciences Reviews: April 2011 - Volume 39 - Issue 2 - p 109
doi: 10.1097/JES.0b013e3182164376
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Dear Editor-in-Chief:

In the July 2010, Exercise and Sport Sciences Reviews published the article by Chen and Bonham (3) entitled "Postexercise Hypotension: Central Mechanisms," which was an interesting and informative update on an important subject for exercise physiologists. I commend the editors for bringing it to the attention of their readers.

However, I would like to add a historical perspective associated with the concept. Specifically, in 1898, Leonard Hill of the London Hospital Medical College published the results of a subject who ran 400 yd "as rapidly as possible" and recorded (Hill-Barnard sphygmometer) 10 min later a 10- to 15-mm Hg reduction in resting pressure that became 30-35 mm Hg after 60 min. Hill ((4), p.xxii) concluded, "The arterial pressure becomes depressed below the normal resting pressure after severe muscular work."

In the classical exercise heart rate and blood pressure study conducted by Wilbur Bowen (1) of Michigan in 1904 (demonstrated vagal withdraw), he graphically demonstrated in figure 2, p.65, the existence of a postexercise decrease in blood pressure of approximately 10 mm Hg, which persisted for 10 min after 32 min of light-moderate work (400 kg·m).

Concerned about heart strain, Oswald Lowsley (6) of Johns Hopkins, in 1911, studied the effects of (a) brief moderate exercise, (b) rapid exercise, (c) vigorous exercise as wrestling and short runs, (d) fatiguing exercise as running from 5-9 miles, and (e) exhausting exercise from runs of 10, 13, or 20 miles from between 4 and 25 subjects. Systolic and diastolic pressures were measured at the end of exercise and during recovery as were the minutes to return to preexercise pressures. Pressures that were below the preexercise values were considered to be within the subnormal category. Decreased pressures during the subnormal category were found with all five exercise categories and ranged from 16 to 20 mm Hg for systolic blood pressure and from 7 to 10 mm Hg for diastolic pressure with the time to return to normal resting pressures ranging from 31 to 232 min (exhausting exercise) for systolic blood pressure and 31 to 152 min for diastolic pressures. Postexercise hypotension was reported by Bramwell and Ellis (2) for nine marathoners who competed in the 1928 Olympics. They reported mean reductions of 17/16 mm Hg for systolic and diastolic pressures, respectively, when recorded immediately after the race.

Lastly, in 1966, Kral et al. (5) were among the first to observe its occurrence with juvenile and essential hypertensive subjects. As rodents have become important in identifying contributing factors responsible for the occurrence of postexercise hypotension, investigators who incorporate them in their studies should not ignore the 1976 pioneering investigation of Shyu and Thoren (7) with hypertensive rats.

Although this interesting and informative article by Chen and Bohhan will likely become a required reading for those interested in postexercise hypertension, we should not forget to acknowledge those who have helped establish this important concept.

Charles M. Tipton, Ph.D., FACSM

Department of Physiology

University of Arizona

Tucson, AZ

References

1. Bowen WP. Changes in heart rate, blood pressure, and duration of systole resulting from bicycling. Am. J. Physiol. 1904; 11:59-77.
2. Bramwell C, Elis R. Some observations on the circulatory mechanisms in marathon runners. Quart. J. Med. 1931; 24:329-48.
3. Chen CY, Bonham AC. Postexercise hypotension: central mechanisms. Exerc. Sports Sci. Rev. 2010; 38:122-7.
4. Hill L. Arterial pressure in man while sleeping, resting, working, bathing. J. Physiol. 1898; 22:xxvi-xxx.
5. Kral J, Chrastek J, Adamirova J. The hypotensive effect of physical activity. In: Raab W, editor. Prevention of Ischemic Heart Disease: Principles and Practice. Springfield (IL): Charles C. Thomas; 1966, p. 359-71.
    6. Lowsley O. The effects of various forms of exercise on systolic, diastolic, and pulse pressures and pulse rate. Am. J. Physiol. 1911; 27:446-66.
    7. Shyu BC, Thoren P. Circulatory events following spontaneous muscle exercise in normotensive and hypotensive rats. Acta Physiol. Scand. 1976; 128:513-24.
    ©2011 The American College of Sports Medicine