Effects of aerobic and inspiratory strength muscle training on exaggerated blood pressure response during exercise in hypertensive patients

Background: An exaggerated blood pressure response (EBPR) to exercise predicts future hypertension and cardiovascular disease. Although aerobic exercise (AE) and inspiratory muscle strength training (IMST) lower resting blood pressure (BP), their capacity to attenuate EBPR has not been compared. This study examined the effects of AE and IMST on EBPR during maximal exercise testing in hypertensive patients. Methods: Twenty-four participants were randomly assigned to AE (n = 12, 40–70% of heart rate reserve, 30 minutes) or IMST (n = 12, 55–75% of maximal inspiratory pressure, 30 breaths/day), 5 days/week for 8 weeks. Brachial BP and heart rate were measured at rest, during each stage of a graded cycle-ergometer test, and during recovery. EBPR was defined as peak systolic BP (SBP) ≥ 210 mmHg (men) or ≥ 190 mmHg (women). Primary outcomes were changes in SBP across exercise stages and prevalence of EBPR. Results: Both interventions reduced resting SBP (−8.0 mmHg) and diastolic BP (−4.2 mmHg). The prevalence of EBPR declined from 62.5% to 45.8%, though this did not reach statistical significance (χ² = 1.34, P = 0.25). Subgroup analysis showed greater SBP attenuation at moderate intensity with AE (−9.2 mmHg, P = 0.020) and at higher intensity with IMST (−8.8 mmHg, P = 0.042). Conclusions: Both AE and IMST attenuated SBP responses during submaximal exercise in hypertensive individuals. These findings highlight a potential for exercise training to mitigate EBPR in hypertension.