Geert Kleinnibbelink

Post-Exercise Hypotension in Hypoxia 5 131 Limitations. A limitation is that we did not include a control group who either did not perform exercise or performed exercise under normoxic conditions across a 12-week period. Whilst this may have provided additional insight, this does not impact our primary finding of our study, in that PEH is strongly related to long-term declines in resting BP. In addition, our findings on PEH in hypoxia relate to a group of healthy young normotensive individuals and cannot be directly extrapolated to pre-hypertensive and hypertensive individuals, where PEH magnitude may be different. 36 Perspectives Hypoxia represents a relatively common stimulus that importantly alters the physiological demands of the cardiovascular system during exercise compared to normoxia. Nonetheless, we found that acute, high-intensity exercise under normoxia and hypoxia leads to a comparable post-exercise decline in BP in healthy volunteers (i.e. post-exercise hypotension), whilst the magnitude of post-exercise hypotension strongly relates to the anti-hypertensive effects of exercise training. Whilst this provides novel insight into the acute and chronic regulation of BP, the comparable effects of hypoxic and normoxic exercise may have potential clinical relevance. Whilst both types of exercise are linked to a similar subjective level of effort, absolute workloads with hypoxic endurance exercise are significantly lower. This makes hypoxic exercise a suitable alternative for sedentary and frail individuals as a non-drug antihypertensive treatment, since lower workloads will be linked to fewer injuries and risks of exercise. 31, 37, 38 Hypoxic exercise has already been used effectively to enhance vascular structure and function 39, 40 , adaptive responses in metabolic capacity 41 and glucose tolerance 42 , highlighting the potential of hypoxic exercise for health improvement. CONCLUSION Our findings show that hypoxia does not alter themagnitude of PEH in healthy individuals, whilst PEH relates to the BP-lowering effects of exercise. These data highlight the strong link between acute and chronic changes in BP.