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An acute bout of aerobic exercise alters interarm systolic blood pressure difference

Holmstrup, Michael E.; Clarke, Melanie M.; Conner, Cailin R.; Jensen, Brock T.

doi: 10.1097/MBP.0000000000000232
Clinical Methods and Pathophysiology

Background Clinically, when a difference of at least 10 mmHg in systolic blood pressure (SBP) between arms exists, it is identified as an interarm systolic blood pressure difference (ISBPD). At rest, ISBPD is linked with hypertension, peripheral vascular disease, and increased premature mortality. Exercise may reveal underlying cardiovascular pathologies otherwise absent at rest. However, there have been no investigations to examine the effect of exercise on ISBPD.

Aim The aim of this investigation was to determine whether exercise may alter ISBPD when detected at rest or reveal ISBPD when it was not observed in the resting condition.

Methods An experienced investigator sequentially measured SBP using standard auscultation in each arm (alternating order) in 85 normotensive individuals (22±6 years, 39 male, 46 female). ISBPD was quantified before exercise (PRE). Participants then completed a three-stage protocol on a cycle ergometer. A cadence of 50 rpm was maintained at a workload of 3 (EX-3; light) and 6 (EX-6; moderate) METS and during an active recovery (REC). At each stage, SBP was measured upon achieving steady-state heart rate. A logistic regression analysis was used to determine the change in odds ratio of ISBPD when exposed to exercise.

Results Thirteen percent (n=11) of patients presented with ISBPD during PRE and the degree of ISBPD was lower (3.81 mmHg; P<0.05) in REC than PRE. In individuals who did not present with ISBPD during PRE (n=74), progression from EX-3 to EX-6 significantly increased the odds of developing ISBPD (4.31; P<0.05).

Conclusion In individuals with ISBPD at PRE, active recovery from exercise attenuated the difference between interarm SBP. Moderate-intensity exercise resulted in ISBPD not otherwise present at rest.

Department of Exercise and Rehabilitative Sciences, Slippery Rock University, Slippery Rock, Pennsylvania, USA

Correspondence to Brock T. Jensen, PhD, Department of Exercise and Rehabilitative Sciences, Slippery Rock University, Slippery Rock, 339 Patterson Hall, PA 16057, USA Tel: +1 724 738 4138; fax: +1 724 738 4667; e-mail:

Received May 24, 2016

Received in revised form October 18, 2016

Accepted November 8, 2016

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