Hypertensive responses to exercise after 12-weeks of high-intensity interval training or moderate-to-vigorous intensity continuous training in patients with persistent and permanent atrial fibrillation: a non-prespecified post-hoc analysis of a randomized clinical trial.
Kimberley L Way, Tori O Roberts, Tasuku Terada et al.
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In 30 seconds
This non-prespecified post-hoc analysis of a randomized clinical trial examined exercise blood-pressure responses in adults with persistent or permanent atrial fibrillation assigned to 12 weeks of high-intensity interval training or moderate-to-vigorous continuous training. Blood pressure was measured after a six-minute walk test. A clinically meaningful peak systolic blood-pressure reduction (at least 10 mmHg) occurred in a greater proportion of continuous-training participants than interval-training participants (43% vs 19%, p=0.029). Across the cohort, findings suggested a small reduction in hypertensive response relative to fitness; the authors concluded that either training approach may reduce these responses.
Key findings
- Clinically meaningful peak systolic blood-pressure reductions occurred in 43% with continuous training versus 19% with interval training (p=0.029).
- Across the cohort, 55% experienced a reduction in hypertensive response relative to fitness; the reported values were 42 ± 8 mmHg/METs at baseline and 41 + 14 mmHg/METs at follow-up (p=0.0501).
- Among females, clinically meaningful peak systolic blood-pressure reductions occurred in 43% with continuous training versus 7% with interval training.
Why it matters
Exercise-related blood-pressure responses may be relevant when assessing cardiovascular responses to training in people with atrial fibrillation. These findings suggest that aerobic training could be associated with modest improvement, while the larger proportion with meaningful peak systolic reductions in the continuous-training group may inform further study of training approaches. The results are exploratory rather than definitive.
What to keep in mind
This was a non-prespecified post-hoc analysis, and blood pressure was assessed immediately after a six-minute walk test; the findings do not establish effects on longer-term clinical outcomes.