{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:38:51Z","timestamp":1788309531325,"version":"build-2803163510"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T00:00:00Z","timestamp":1640131200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Blood pressure (BP) and hemodynamic changes occurring in the recovery phase after a single bout of exercise have not been extensively studied in coronary artery patients, despite the potential clinical implications of reducing BP through exercise. This study aimed at investigating the hemodynamic and arterial baroreflex mechanisms possibly involved in post-exercise hypotension (PEH) in patients with coronary artery disease.<\/jats:p><jats:p><jats:bold>Methods<\/jats:bold>: In 42 normotensive coronary artery patients undergone a Cardiac Rehabilitation Program, we evaluated before and after their daily exercise training session: blood pressure (BP) and heart rate (HR). In a subgroup (<jats:italic>n<\/jats:italic>\u2009=\u200929), daily BP profile was also evaluated by ambulatory BP monitoring. In those patients showing PEH (<jats:italic>n<\/jats:italic>\u2009=\u200915), we evaluated: Cardiac Output (CO), Stroke Volume (SV), total peripheral resistances (TPR), forearm (FVR) and calf (CVR) vascular resistances, and spontaneous baroreflex sensitivity (BRS).<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> After exercise TPR was significantly reduced with a similar contribution from CVR and FVR, whereas CO and SV significantly increased. BRS showed a significant reduction mainly due to a BRS decrease in response to hypertensive stimuli. Systolic BP (SBP) was significantly reduced for 12\u2009h after the end of a single exercise session.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> These findings indicate that in coronary artery patients, the recovery phase after exercise is characterized by PEH which is mediated mainly by a generalized peripheral vasodilation and appears to influence BP behavior throughout the daily life. Finally, the cardiac component of the arterial baroreflex seems to contribute indirectly to BP reduction occurring after exercise.<\/jats:p>","DOI":"10.3389\/fphys.2021.788591","type":"journal-article","created":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T18:19:06Z","timestamp":1648664346000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Post-exercise Hypotension in Patients With Coronary Artery Disease"],"prefix":"10.3389","volume":"12","author":[{"given":"Ferdinando","family":"Iellamo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Alfonso","family":"Perrone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Caminiti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Volterrani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacopo M.","family":"Legramante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1136\/heart.88.6.587","article-title":"Hypertension control at hospital discharge after acute coronary event: influence on cardiovascular prognosis-the PREVENIR study","volume":"88","author":"Amar","year":"2002","journal-title":"Heart"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1161\/01.CIR.97.6.553","article-title":"Effects of moderate exercise training on thallium uptake and contractile response to low-dose dobutamine of dysfunctional myocardium in patients with ischemic cardiomyopathy","volume":"97","author":"Belardinelli","year":"1998","journal-title":"Circulation"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1042\/cs0670097","article-title":"Post-exercise reduction of blood pressure in hypertensive men is not due to acute impairment of baroreflex function","volume":"67","author":"Bennet","year":"1984","journal-title":"Clin. Sci."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"H377","DOI":"10.1152\/ajpheart.1988.254.2.H377","article-title":"Evaluation of baroreceptor reflex by blood pressure monitoring in unanesthetized cats","volume":"254","author":"Bertinieri","year":"1988","journal-title":"Am. J. Phys."},{"key":"ref5","first-page":"1025","article-title":"Cardiovascular adjustments to gravitational stress","volume-title":"Handbook of Physiology, Section 2: The Cardiovascular System. Vol. 3.","author":"Blomquist","year":"1983"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1016\/0140-6736(92)93147-F","article-title":"Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis","volume":"340","author":"Celermajer","year":"1992","journal-title":"Lancet"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1111\/j.1440-1681.1989.tb02994.x","article-title":"Peripheral and central mechanisms of baroreflex resetting","volume":"15","author":"Chapleau","year":"1989","journal-title":"Clin. Exp. Pharmacol. Physiol."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1161\/01.HYP.19.2.183","article-title":"Aftereffects of exercise on regional and systemic hemodynamics in hypertension","volume":"19","author":"Cl\u00e9roux","year":"1992","journal-title":"Hypertension"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1113\/jphysiol.1989.sp017654","article-title":"Systemic and forearm vascular resistance changes after upright bicycle exercise in man","volume":"413","author":"Coats","year":"1989","journal-title":"J. Physiol."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"R570","DOI":"10.1152\/ajpregu.1991.260.3.R570","article-title":"Enhanced vagal baroreflex response during 24 h after acute exercise","volume":"260","author":"Convertino","year":"1991","journal-title":"Am. J. Phys."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1038\/sj.jhh.1000976","article-title":"Twenty-four hour blood pressure after exercise in patients with coronary artery disease","volume":"14","author":"Fagard","year":"2000","journal-title":"J. Human. Hypertension"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1161\/01.CIR.94.4.857","article-title":"Statement on exercise: benefits and recommendations for physical activity programs for all americans.","volume":"94","author":"Fletcher","year":"1996","journal-title":"Circulation"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1152\/jappl.1987.63.1.270","article-title":"Blood pressure and hemodynamic responses after exercise in older hypertensives","volume":"63","author":"Hagberg","year":"1987","journal-title":"J. Appl. Physiol."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1097\/00004872-199504000-00011","article-title":"Influence of naloxone on muscle sympathetic nerve activity, systemic and calf haemodynamics and ambulatory blood pressure after exercise in mild essential hypertension","volume":"13","author":"Hara","year":"1995","journal-title":"J. Hypertension"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"3229","DOI":"10.3390\/ijerph18063229","article-title":"Prolonged post-exercise hypotension: effects of different exercise modalities and training status in elderly patients with hypertension","volume":"18","author":"Iellamo","year":"2021","journal-title":"Int. J. Environ. Res. Public Health."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"H994","DOI":"10.1152\/ajpheart.1994.267.3.H994","article-title":"Evaluation of spontaneous baroreflex modulation of sinus node during isometric exercise in healthy humans","volume":"267","author":"Iellamo","year":"1994","journal-title":"Am. J. Phys."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2231","DOI":"10.1097\/00004872-200112000-00017","article-title":"Spontaneous baroreflex modulation of heart rate and heart rate variability during orthostatic stress in tetraplegics and healthy subjects","volume":"19","author":"Iellamo","year":"2001","journal-title":"J. Hypertens."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2588","DOI":"10.1161\/01.CIR.102.21.2588","article-title":"Effects of a residential exercise training on baroreflex sensitivity and heart rate variability in patients with coronary artery disease. A randomized, controlled study","volume":"102","author":"Iellamo","year":"2000","journal-title":"Circulation"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1097\/00004872-199609000-00009","article-title":"Evaluation of reproducibility of spontaneous baroreflex sensitivity at rest and during laboratory tests","volume":"14","author":"Iellamo","year":"1996","journal-title":"J. Hypertens."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1161\/01.CIR.100.1.27","article-title":"Muscle metaboreflex contribution to sinus node regulation during static exercise. Insights from spectral analysis of heart rate variability","volume":"100","author":"Iellamo","year":"1999","journal-title":"Circulation"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1136\/hrt.51.1.54","article-title":"Determination of cardiac output by Doppler echocardiography","volume":"51","author":"Ihelen","year":"1984","journal-title":"Br. Heart J."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1161\/01.HYP.22.5.653","article-title":"Postexercise hypotension. Key features, mechanisms, and clinical significance","volume":"22","author":"Kenney","year":"1993","journal-title":"Hypertension"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"R1037","DOI":"10.1152\/ajpregu.00603.2001","article-title":"Hemodynamic and autonomic correlates of postexercise hypotension in patients with mild hypertension","volume":"282","author":"Legramante","year":"2002","journal-title":"Am. J. Phys."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1250","DOI":"10.1161\/01.CIR.103.9.1250","article-title":"Positive and negative feedback mechanisms in the neural regulation of the cardiovascular function in healthy and spinal cord injured humans","volume":"103","author":"Legramante","year":"2001","journal-title":"Circulation"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1038\/sj.jhh.1001223","article-title":"Post exercise hypotension is sustained during subsequent bouts of mild exercise and simulated activities of daily living","volume":"15","author":"MacDonald","year":"2001","journal-title":"J. Human. Hypertension"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"2327","DOI":"10.1097\/01.hjh.0000249720.05006.d5","article-title":"Mancia G (2006) European Society of Hypertension Scientific Newsletter: clinical value of ambulatory blood pressure monitoring","volume":"24","author":"Mallion","year":"2006","journal-title":"J. Hypertens."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1161\/01.CIR.80.2.234","article-title":"An overview of randomized trials of rehabilitation with exercise after myocardial infarction","volume":"80","author":"O\u2019Connor","year":"1989","journal-title":"Circulation"},{"key":"ref28","first-page":"256","article-title":"Arterial hypertension","volume-title":"Cecil\u2013Textbook of Medicine.","author":"Oparil","year":"1999"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1161\/01.HYP.12.6.600","article-title":"Changes in autonomic regulation induced by physical training in mild hypertension","volume":"12","author":"Pagani","year":"1988","journal-title":"Hypertension"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1557","DOI":"10.1161\/01.CIR.83.5.1557","article-title":"Short-term effect of dynamic exercise on arterial pressare","volume":"83","author":"Pescatello","year":"1991","journal-title":"Circulation"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"2315","DOI":"10.1093\/eurheartj\/ehw106","article-title":"European guidelines on cardiovascular disease prevention in clinical practice: the sixth joint task force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice","volume":"37","author":"Piepoli","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref32","first-page":"453","article-title":"Baroreflex control of systemic arterial pressure and vascular bed","volume-title":"Handbook of Physiology, Section 2: The Cardiovascular System. Vol. 3.","author":"Sagawa","year":"1983"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1161\/01.HYP.18.2.211","article-title":"Postexercise hypotension is not sustained in normal and hypertensive humans","volume":"18","author":"Somers","year":"1991","journal-title":"Hypertension"},{"key":"ref34","first-page":"S129","article-title":"The role of baroreflex sensitivity in post-exercise hypotension","volume":"3","author":"Somers","year":"1985","journal-title":"J. Hypertens."}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2021.788591\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T18:19:12Z","timestamp":1648664352000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2021.788591\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,22]]},"references-count":34,"alternative-id":["10.3389\/fphys.2021.788591"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2021.788591","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,22]]},"article-number":"788591"}}