Abstract

Arterial hypertension is responsible for high morbidity and mortality. Despite increasing awareness of the consequences of uncontrolled hypertension and the publication of several recommendations and guidelines, blood pressure control rates are suboptimal, and approximately half of the patients do not reach the targets. Defined as an increase in blood pressure, hypertension is characterized by hemodynamic abnormalities in cardiac output, systemic vascular resistance, or arterial compliance. Therefore, the approach to arterial hypertension can be improved by the knowledge of the hemodynamics underlying the blood pressure increase. Impedance Cardiography has emerged as a new strategy to customize therapy and monitor patients aiming to improve blood pressure control according to the hemodynamic profile, rather than a blind intensive care approach. This is a review of impedance cardiography evidence, its benefits, actual and future applications in the approach and management of arterial hypertension.

Exercise training is a key recommendation for maintenance of a healthy life style. It is well established that regular physical exercise provides innumerous physiological and psychological benefits not only to young healthy subjects, but also individuals with diabetes, heart failure, Parkinson disease, multiple sclerosis, claudication, autonomic failure, hypertension, among others. A well-documented physiological response to exercise is called post-exercise hypotension (PEH), in which a single bout of exercise leads to a decrease in arterial blood pressure. The first study showing PEH was published in 1898 by Dr. L. Hill. Thereafter, several authors confirmed these results showing that a single bout of exercise can reduce arterial blood pressure below pre-exercise values. However, one question that remains to be answered is which exercise modality produces greater PEH?

Previous studies have shown that continuous aerobic (CONT) exercise, high-intensity interval (HIIE) training, isometric exercise and resistance-based exercise can lead to a PEH. Studies comparing CONT and HIIE showed that the magnitude of PEH was slightly superior following HIIE compared with CONT exercise.^, However, in these studies, the exercise protocols were not matched by volume. This is important because longer exercise duration and higher-intensity exercise results in greater decreases in arterial blood pressure and longer PEH duration when compared with a short bout of low-intensity exercise.^,

[…]