Acute and Chronic Effects of Combined Training on BP in Hypertensives

Dynamic strength training (DST) is widely recognized for promoting neuromuscular adaptations such as increased strength and hypertrophy. It is currently endorsed by treatment and prevention guidelines for systemic arterial hypertension (SAH) due to its significant effect on lowering blood pressure (BP). However, when comparing BP reduction values, isometric strength training (IST) stands out with greater magnitudes of BP reduction, although without the neuromuscular adaptations seen in DST. Given their similarities, a combination of these strategies through combined strength training (CST) is possible but has not yet been evaluated. The researchers hypothesized that CST may have an additive effect compared with DST and IST alone in reducing ambulatory BP. Therefore, the objective of the present thesis was to evaluate and compare the effects of CST, DST, and IST on regulatory variables of ambulatory BP in medicated middle-aged hypertensive patients. This thesis is structured in two parts: (1) a crossover study with medicated middle-aged hypertensive patients to identify autonomic, endothelial, and vascular responses related to ambulatory BP after a single session of CST, DST, and IST; and (2) a randomized clinical trial to assess the chronic effects of CST, DST, and IST on regulatory variables of ambulatory BP in medicated middle-aged hypertensive patients.

Inclusion Criteria: Clinical diagnosis of stage 1 or stage 2 hypertension, according to current guidelines. Sedentary lifestyle (no participation in structured exercise training for at least 6 months). Age between 18 and 60 years. Stable antihypertensive pharmacological treatment for at least 4 weeks before enrollment. Ability to perform resistance exercise. Exclusion Criteria: Symptomatic cardiovascular disease. Heart failure. Unstable angina. Uncontrolled diabetes mellitus (HbA1c \> 8%). Renal insufficiency. Musculoskeletal disorders or physical limitations that contraindicate resistance exercise. Changes in antihypertensive medication within the 4 weeks prior to enrollment or during the study protocol. Current smoking. Excessive alcohol consumption.