ABC | Volume 115, Nº1, July 2020

Short Editorial Ferrari & Martins Physical Exercise and Blood Pressure Reduction Arq Bras Cardiol. 2020; 115(1):15-16 compared to CT on PEH in the 45-60 minutes after the end of the exercise. 11 An important point to be mentioned in relation to the meta-analysis by Perrier-Melo et al. 11 is that, although HIIT significantly reduced diastolic BP, when the study by Maya et al. 12 was omitted from the analysis, the benefit disappeared. In this study, the assessed individuals were physically active and normotensive. Thus, the results found by Perrier-Melo et al. 11 should be viewed with caution regarding the pressure values of individuals with SAH, especially regarding diastolic BP. Despite the interesting study, some limitations should be recalled, such as the low number of studied patients and the heterogeneity of BP measurement methods. Moreover, the inclusion of normotensive, pre-hypertensive and hypertensive individuals in the same forest plots also does not allow a more assertive conclusion, since the magnitude of PEH may be different between these groups; although the authors carried out a sensitivity analysis, they found no differences after removing each of the included studies. 11 Another recent meta-analysis compared the effects of HIIT and MICT in hypertensive individuals. Significant differences were found in systolic BP with both interventions, when compared to the control group: HIIT, 5.64 mmHg and MICT, 3.7 mmHg, as well as in diastolic BP: HIIT, 4.8 mmHg, and MICT, 2.41 mmHg, when compared to the control group. However, HIIT showed a greater magnitude of diastolic BP reduction when compared to MICT. When VO 2max (secondary outcome) was assessed, both interventions increased this important marker when compared to the control groups, but HIIT promoted an even more marked improvement. 13 Although the mechanisms involved in BP reduction are not fully understood, it is postulated that the increase in shear stress (shear stress) with consequent improvement in nitric oxide release, in addition to the reduction of sympathetic nervous activity and peripheral vascular resistance, contribute to these results. 14 Moreover, by potentially increasing plasma levels of apelin and nitrite / nitrate, HIIT can be effective in reducing BP. 15 Finally, although the evidence suggests a potential benefit in reducing training BP with greater intensities intercalated with recovery periods, further studies are required for a definitive conclusion and possible changes in current exercise prescription recommendations for the management of SAH. The results provided by this meta-analysis can contribute to the performance of further and larger studies, in a population consisting only of hypertensive patients, evaluating the acute and sustained reduction in BP with HIIT versus CT at different intensities as an outcome. Meanwhile, we must encourage all individuals, especially those diagnosed with SAH, to practice physical exercises, emphasizing the more appropriate and safer ones, according to the individuality and capacity of each individual. 1. Carrick D, Haig C, Maznyczka AM, Carberry J, Mangion K, Ahmed N,et al. Hypertension, microvascular pathology, and prognosis after an acute myocardial infarction. Hypertension. 2018;72(3):720-30. 2. Garies S, Hao S, McBrien K, Williamson T, Peng M, Khan NA, et al. Prevalence of hypertension, treatment, and blood pressure targets in Canada associated with the 2017 American College of Cardiology and AmericanHeart Association Blood Pressure Guidelines. JAMANetwOpen. 2019;2(3):e190406. 3. MalachiasMVB,PlavnikFL,MachadoCA,MaltaD,ScalaLCN,FuchsS,etal.7th BrazilianGuidelineofArterialHypertension:Chapter1-Concept,Epidemiology andPrimaryPrevention.ArqBrasCardiol.2016;107(3Suppl3):1-6. 4. Mahmood S, Shah KU, Khan TM, Nawaz S, Rashid H, Baqar SWA, et al. Non-pharmacological management of hypertension: in the light of current research. Ir J Med Sci. 2019;188(2):437-52. 5. Oparil S, Acelajado MC, Bakris GL, Berlowitz DR, Cífková R, Dominiczak AF, et al. Hypertension. Nat Rev Dis Primers. 2018 Mar 22;4:18014. 6. Ito S. High-intensity interval training for health benefits and care of cardiac diseases - the key to an efficient exercise protocol. World J Cardiol. 2019;11(7):171-88. 7. Roy M, Williams SM, Brown RC, Meredith-Jones KA, Osborne H, Jospe M, et al. High-intensity interval training in the real world: outcomes from a 12-month intervention in overweight adults. Med Sci Sports Exerc. 2018;50(9):1818-26. 8. Ciolac EG. High-intensity interval training and hypertension: maximizing the benefits of exercise? Am J Cardiovasc Dis. 2012;2(2):102-10. 9. Clark T, Morey R, Jones MD, Marcos L, Ristow M, Ram A, et al. High- intensity interval training for reducing blood pressure: a randomized trial vs. moderate-intensity continuous training inmales with overweight or obesity. Hypertens Res. 2020;43(5):396-403. 10. Ramirez-Jimenez M, Morales-Palomo F, Pallares JG, Mora-Rodriguez R, Ortega JF. Ambulatory blood pressure response to a bout of HIIT inmetabolic syndrome patients. Eur J Appl Physiol. 2017;117(7):1403-11. 11. Perrier-Melo F, et al. Efeito do exercício intervalado versus contínuo sobre a pressão arterial:revisãosistemática e metanalise. Hipotensão pós exercício intervalado versus contínuo. Arq Bras Cardiol. 2020; 115(1):5-14. 12. Maya ATD, Assunção MJ, Brito CJ, Vieira E, Rosa TS, Pereira FB, et al. High intensity interval aerobic exercise induced a longer hypotensive effect when compared to continuous moderate. Sport Sci Health. 2018;14(2):379-85. 13. Leal JM, Galliano LM, Del Vecchio FB. Effectiveness of high-intensity interval training versus moderate-intensity continuous training in hypertensive patients: a systematic review and meta-analysis. Curr Hypertens Rep. 2020;22(3):26. 14. Álvarez C, Ramírez-Campillo R, Cristi-Montero C, Ramírez-Vélez R, Izquierdo M. Prevalence of non-responders for blood pressure and cardiometabolic risk factors among prehypertensivewomen after long-term high-intensity interval training. Front Physiol. 2018 Oct 23;9:1443. 15. IzadiMR,GhardashiAfousiA,AsvadiFardM,BabaeeBigiMA.High-intensity interval training lowers blood pressure and improves apelin and NOx plasma levels in older treated hypertensive individuals. J Physiol Biochem. 2018;74(1):47-55. 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