ABSTRACT
The Joint National Committee (National Institutes of Health, USA) denes hypertension, or the chronic elevation of resting arterial blood pressure (BP), as a resting systolic blood pressure (SBP) of ≥140 mmHg and/or a diastolic blood pressure (DBP) of ≥90 mmHg (Chobanian et al., 2003). Hypertension is estimated to af¬ict nearly 1 billion adults worldwide, and the lifetime risk of developing the disease may be as high as 90% in some populations (Chobanian et al., 2003). The overall severity of these statistics is compounded by a relatively low disease awareness and a poor rate of targeted BP control (Chobanian et al., 2003; Fields et al., 2004; Hajjar and Kotchen, 2003). Hypertension increases the risk of developing cardiovascular disease (CVD), with specic long-term complications including increased incidence of coronary artery disease, peripheral vascular disease, stroke, renal failure and both systolic and diastolic heart failure (Bonow et al., 2012; Leite-Moreira, 2006; Pescatello et al., 2004). Hypertension is a signicant health concern for both sexes (Mathers et al., 2009), although women, particularly those in their sixth decade of life, display an elevated risk of hypertension and hypertension-related CVD (American Heart Association, 2011). The weight of evidence currently suggests that the risk of death from ischemic heart disease and stroke increases in a linear fashion with an increasing resting arterial BP of greater than 140 mmHg SBP and 90 mmHg DBP (Arguedas et al., 2009), although highnormal and prehypertensive values may also increase the risk (Chobanian et al., 2003; Vasan et al., 2001). However, while the deleterious clinical implications of hypertension
CONTENTS
9.1 Introduction ........................................................................................................................ 165 9.2 Autonomic Dysfunction in Hypertension ..................................................................... 166 9.3 Effects of Hypertension on HRV ..................................................................................... 168 9.4 Effects of Aerobic and Resistance Training on Blood Pressure and HRV in
Hypertension Patients ....................................................................................................... 171 9.5 Effects of Isometric (Static) Training on Blood Pressure and HRV in
Hypertension Patients ....................................................................................................... 175 9.6 HRV-Based Exercise Training .......................................................................................... 175 9.7 Conclusions ......................................................................................................................... 176 Abbreviations .............................................................................................................................. 176 References ..................................................................................................................................... 177
are well known, the underlying etiology that is responsible for the increases in resting BP still remains unclear. Of the hypothesized pathways involved in the disease initiation and progression, changes in the neural control of BP are well studied and considered to be responsible for at least 50% of all hypertension cases (Esler, 2009). These alterations primarily manifest as excessive sympathoexcitation and parasympathetic inhibition and have been conrmed in studies measuring muscle sympathetic nerve activity (MSNA), norepinephrine spillover, baroreceptor re¬ex sensitivity and heart rate variability (HRV).
