ABC | Volume 113, Nº2, August 2019

Original Article Casonatto et al. Citrulline and post-exercise hypotension Arq Bras Cardiol. 2019; 113(2):218-228 Figure 1 – Study design. 40 participants 10 Control-Placebo –10, –5 and 0 minutes Rest blood pressure measures Seated position 50 min Seated position 50 min 40 min 40 min 5 min 5 min warm-up warm-up 5 min –120 minutes Supplementation –20 minutes Rest period start 50 minutes Exercise period Ambularial blood pressure monitoring (24 hours) 5 min cooldown cooldown Exercise (run/walk 60-70% HRreserve) Exercise (run/walk 60-70% HRreserve) 60, 70, 80, 90, 100 and 110 minutes Office blood pressure measures 10 Control-Citrulline 10 Exercise-Placebo 10 Exercise-Citrulline Table 2 – Absolute (rest, 60 min, awake, asleep, and 24 hours) and relative (Δ% 60 min, Δ% Awake, Δ% Asleep, Δ% 24 hours) blood pressure changes Control-Placebo Control-Citrulline Exercise-Placebo Exercise-Citrulline F p Mean SD Mean SD Mean SD Mean SD SBP Rest (mmHg) 140 19 132 15 136 12 142 20 0.714 0.550 60 min (mmHg) 138 19 137 14 130 9 127 15 1.240 0.310 Awake (mmHg) 127 11 128 8 124 11 126 8 0.334 0.801 Asleep (mmHg) 125 16 120 14 126 10 126 15 0.465 0.709 24 hours (mmHg) 128 11 125 9 127 10 125 13 0.216 0.884 Δ% 60 min –2.3 3.4 5.4 9.4 –6.3 11.4 –15.0** 8.1 9.737 < 0.001 Δ% Awake –9.7 12.5 –4.2 12.3 –9.1 15.2 –21.0 16.7 2.469 0.078 Δ% Asleep –15.8 14.0 –9.8 16.2 –9.5 19.5 –17.0 14.1 0.588 0.627 Δ% 24 hours –11.5 12.4 –6.0 12.6 –9.2 16.3 –20.1 16.8 1.935 0.141 DBP Rest (mmHg) 82 5 80 9 86 11 85 10 0.889 0.456 60 min (mmHg) 83 9 84 8 86 10 85 10 0.237 0.870 Awake (mmHg) 80 8 75 8 79 7 71 9 2.847 0.051 Asleep (mmHg) 75 11 70 8 76 10 71 10 1.083 0.369 24 hours (mmHg) 82 8 73 7 79 8 71* 9 3.999 0.015 Δ% 60 min 0.4 5.9 4.1 4.8 1.0 7.2 0.1 7.4 0.796 0.504 Δ% Awake –1.5 5.2 –4.7 7.3 –6.8 8.1 –13.9† 6.2 5.917 0.002 Δ% Asleep –6.6 9.1 –10.0 8.0 –9.2 11.1 –13.2 7.3 0.923 0.439 Δ% 24 hours –3.3 6.1 –6.8 6.9 –7.6 8.4 –14.5* 6.4 4.505 0.009 SD: standard deviation; SBP: systolic blood pressure; DBP: diastolic blood pressure; Δ%: +/- percent change from “rest” value. *: p < 0.05 vs control-placebo (Tukey post-hoc); **: p < 0.05 vs control-placebo and control-citrulline (Games-Howell post-hoc); †: p < 0.05 vs. control-placebo and control-citrulline (Tukey post-hoc). 221