Postexercise Hypotension after Heart Transplant: Water- versus Land-Based Exercise

Purpose: Heart transplant recipients (HTx) have a high prevalence of hypertension. Although exercise training promotes blood pressure (BP) reduction in HTx, the effects of a single exercise bout are unknown. Thus, we analyzed the acute effects of heated water-based exercise (HEx) versus land-based exercise (LEx) on ambulatory BP (ABP) in HTx. Methods: Eighteen (six females) clinically stable HTx (time since surgery = 5.0 0.7 yr) age 45.7 2.7 yr underwent 30 min of HEx (walking inside the pool), LEx (walking on a treadmill), and nonexercise control (CON) intervention in random order (2-5 d between interventions). HEx and LEx intensity was set at 11-13 in the 6-20 RPE scale. Twenty-four-hour (24-h) ABP monitoring was performed after each intervention. Results: No significant differences between interventions were found in 24-h and nighttime BP. However, daytime diastolic BP was significantly lower after HEx than CON (-4 +/- 1.6 mm Hg, P = 0.03), and daytime diastolic BP tended to be lower after LEx than CON (-2.3 +/- 1.1 mm Hg, P = 0.052). Hourly analysis showed that systolic and diastolic BP values were lower after HEx (average reductions of 6.6 to 12.3 mm Hg, P < 0.01) and LEx (average reductions of 5 to 8.3 mm Hg, P < 0.05) than after CON in several hours. No significant differences between HEx and LEx were found in any ABP data. Conclusion: HEx and LEx promoted similar reductions in ABP of heart transplant recipients, which suggests that they may be a tool to counteract hypertension in this high-risk population.