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Post‐effects of walking intensity on cardiovascular function and autonomic regulation in patients with intermittent claudication
Author(s) -
Chehuen Marcel,
Lima Aluisio H.,
Silva Natan Daniel,
Costa Luiz Augusto Riani,
Miyasato Roberto Sanches,
Wolosker Nelson,
Forjaz Cláudia
Publication year - 2017
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.31.1_supplement.1020.8
Subject(s) - medicine , rate pressure product , cardiology , heart rate , blood pressure , intermittent claudication , claudication , physical therapy , physical medicine and rehabilitation , vascular disease , arterial disease
Patients with intermittent claudication (IC) exhibit limited walking capacity and often present cardiovascular alterations, such as high blood pressure (BP), endothelial dysfunction and cardiac autonomic dysfunction. Walking training is recommended to these individuals to improve walking capacity, and some authors suggest that maximal walking (until maximal pain) may be more effective than submaximal walking. An acute submaximal walking session has been shown to promote post‐exercise hypotension, while the effect of maximal walking on this parameter is unknown. Objective To compare the acute post‐effect of submaximal and maximal walking on cardiovascular function and autonomic regulation in patients with IC. Methods Thirty patients with IC (66 ± 11 years) underwent two experimental session: one submaximal (15 bouts of 2 min of walking at the heart rate (HR) of pain threshold interpolated by 2 min of upright rest) and one maximal (walking at 2 mph with 2% increase in grade every 2 min until maximal leg pain). HR (ECG), BP (auscultatory), rate pressure product (RPP), resting and after reactive hyperemia blood flow (BF) (plethysmography), and low (LF) and high (HF) frequency components of HR variability were measured before and 30 minutes after the walking protocols. A 2‐way ANOVA for repeated measures was used (P<0.05). Results In comparison with the pre‐exercise values, systolic and mean BP decreased and diastolic BP did not change after the submaximal walking, while these BPs increased after the maximal walking (−7±7 vs. +5±7, −3±3 vs. +5±5 and 0±3 vs. +5±4 mmHg, respectively). HR increased similarly after the submaximal and the maximal walking (+3±4 vs. +3±6 bpm, respectively), while RPP did not change after the submaximal, but increased after the maximal walking (−158±645 vs. +752±791 mmHg*bpm). Resting forearm and leg BF (+0.24±0.22 vs. +0.27±0.22 and +0.78±0.79 vs. +0.66±1.03 ml.100ml tissue −1 .min −1 , respectively) as well as forearm BF after reactive hyperemia (+1.7±4.5 vs. +2.2±3.9 ml.100ml tissue −1 .min −1 , respectively) increased similarly after the submaximal and maximal walking, while leg BF after reactive hyperemia did not change after any session (0.0±3.5 vs. −0.1±2.6 ml.100ml tissue −1 .min −1 , respectively). LF increased, HF decreased and LF/HF increased similarly after the submaximal and the maximal walking (+8±21 vs. +9±20 nu; −9±17 vs. −10±20 nu and 0.2±0.4 vs. 0.2±0.5, respectively). Conclusion In patients with IC, an acute submaximal but not maximal walking session promotes post‐exercise hypotension; while cardiac work (RPP) increases only after maximal walking. On the other hand, BF, vasodilation, HR and cardiac sympathovagal modulation increases after both maximal and submaximal walking. Support or Funding Information Financial support: CNPQ e FAPESP.