AUTHOR=Álvarez Cristian , Guede-Rojas Francisco , Ramírez-Campillo Rodrigo , Andrade David C. , Vásquez-Gómez Jaime , Rodríguez-Rodríguez Fernando , Ciolac Emmanuel Gomes , Caamaño-Navarrete Felipe , Delgado-Floody Pedro 

TITLE=Characterizing the interindividual postexercise hypotension response for two order groups of concurrent training in patients with morbid obesity

JOURNAL=Frontiers in Physiology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2022.913645

DOI=10.3389/fphys.2022.913645

ISSN=1664-042X

ABSTRACT=<p><bold>Background:</bold> Postexercise hypotension (PEH) is a common physiological phenomenon occurring immediately after endurance training (ET), resistance training (RT), and ET plus RT, also termed concurrent training (CT); however, there is little knowledge about the interindividual and magnitude response of PEH in morbidly obese patients.</p><p><bold>Aim:</bold> The aims of this study were (1) to investigate the effect of CT order (ET + RT vs. RT + ET) on the blood pressure responses; 2) characterize these responses in responders and nonresponders, and 3) identify potential baseline outcomes for predicting blood pressure decreases as responders.</p><p><bold>Methods:</bold> A quasi-experimental study developed in sedentary morbidly obese men and women (age 43.6 ± 11.3 years; body mass index [BMI] ≥40 kg/m<sup>2</sup>) was assigned to a CT group of ET plus RT (ET + RT; <italic>n</italic> = 19; BMI 47.8 ± 16.7) or RT plus ET order group (RT + ET; <italic>n</italic> = 17; BMI 43.0 ± 8.0). Subjects of both groups received eight exercise sessions over four weeks. Primary outcomes include systolic (SBP), diastolic (DBP), mean arterial pressure [MAP], heart rate at rest [HR], and pulse pressure [PP] measurements before and after 10 min post-exercise. Secondary outcomes were other anthropometric, body composition, metabolic, and physical fitness parameters. Using the delta ∆SBP reduction, quartile categorization (Q) in “high” (Rs: quartile 4), “moderate” (MRs: quartile 3), “low” (LRs: quartile 2), and “nonresponders” (NRs: quartile 1) was reported.</p><p><bold>Results:</bold> Significant pre–post changes were observed in ET + RT in session 2 for SBP (131.6 vs. 123.4 mmHg, <italic>p</italic> = 0.050) and session 4 (131.1 vs. 125.2 mmHg, <italic>p</italic> = 0.0002), while the RT + ET group showed significant reductions in session 4 (134.2 vs. 125.3 mmHg, <italic>p</italic> &lt; 0.001). No significant differences were detected in the sum of the eight sessions for SBP (∑∆SBP) between ET + RT vs. RT + ET (−5.7 vs. −4.3 mmHg, <italic>p</italic> = 0.552). Interindividual analyses revealed significant differences among frequencies comparing Q1 “NRs” (<italic>n</italic> = 8; 22.2%), Q2 “LRs” (<italic>n</italic> = 8; 22.2%), Q3 “MRs” (<italic>n</italic> = 9; 25.0%), and Q4 “HRs” (<italic>n</italic> = 11; 30.5%), <italic>p</italic> &lt; 0.0001. Quartile comparisons showed significant differences in SBP changes (<italic>p</italic> = 0.035). Linear regression analyses revealed significant association between ∑∆SBP with body fat % (β –3.826, <italic>R</italic><sup>2</sup> 0.211 [21.1%], <italic>p</italic> = 0.031), skeletal muscle mass [β –2.150, <italic>R</italic><sup>2</sup> 0.125 (12.5%), <italic>p</italic> = 0.023], fasting glucose [β 1.273, <italic>R</italic><sup>2</sup> 0.078 (7.8%), <italic>p</italic> = 0.003], triglycerides [β 0.210, <italic>R</italic><sup>2</sup> 0.014 (1.4%), <italic>p</italic> = 0.008], and the 6-min walking test [β 0.183, <italic>R</italic><sup>2</sup> 0.038 (3.8%), <italic>p</italic> = 0.044].</p><p><bold>Conclusion:</bold> The CT order of ET + RT and RT + ET promote a similar ‘magnitude’ in the postexercise hypotensive effects during the eight sessions of both CT orders in 4 weeks of training duration, revealing “nonresponders” and ‘high’ responders that can be predicted from body composition, metabolic, and physical fitness outcomes.</p>