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Evaluating the effects of exercise training on short-term blood pressure variability: is it a matter of index?

Journal of Human Hypertension volume 34, page 477 (2020)Cite this article

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It is with great interest that we read about the study of Pagonas et al. [1] published in this journal. In that study, authors investigated for the first time the effects of a 12-week interval training program on short-term blood pressure variability (BPV) of patients already treated with antihypertensive drugs. They observed that BPV did not change at the end of the exercise program in comparison with baseline in the exercise group; conversely BP values significantly decreased in the same group. Recently, we compared three small groups of hypertensive subjects that performed a single exercise training session of three different exercise modalities: aerobic continuous, interval, and combined training, this latter including aerobic continuous and resistance exercises [2]. We observed that interval training reduced BP values but increased short-term BPV; conversely aerobic continuous and combined trainings reduced both BP values and variability. We noticed a greater effect on systolic BPV with the combined modality. Apparently our data seems to confirm those of Pagonas et al. However data obtained by these studies are hardly comparable because they used different indices for BPV assessment. Up to now several indices for estimating BPV have been developed and there is no general agreement on what index should be preferred over others [3]. Pagonas et al. used the coefficient of variability, a measure of dispersion that is the ratio between standard deviation and mean BP; instead we used average real variability that, when directly compared to standard deviation, showed a stronger relation with the outcome of hypertensive subjects and had a predictive value that was similar to that of systolic BP [4, 5]. In our opinion, given the growing interest on short-term BPV as a therapeutic target for patients with hypertension there is a need for further trials evaluating the effects of exercise training on daily BP fluctuations. At the same time, in order to get comparable results from different studies on this topic, a general agreement among investigators for adopting the same index of BPV is needed.

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References

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Authors and Affiliations

  1. Cardiology Rehabilitation Unit, S. Raffaele IRCCS, Rome, Italy

    Giuseppe Caminiti, Ferdinando Iellamo & Maurizio Volterrani

  2. Dipartimento di Scienze Cliniche e Medicina Traslazionale, Università Tor Vergata, Roma, Italy

    Ferdinando Iellamo

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  1. Giuseppe Caminiti
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  2. Ferdinando Iellamo
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  3. Maurizio Volterrani
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Correspondence to Giuseppe Caminiti.

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Caminiti, G., Iellamo, F. & Volterrani, M. Evaluating the effects of exercise training on short-term blood pressure variability: is it a matter of index?. J Hum Hypertens 34, 477 (2020). https://doi.org/10.1038/s41371-020-0341-5

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