The impact of Aerobic Exercise on blood pressure in older adults

INTERVENTION: This is a randomized controlled crossover clinical trial. The planned study sample will consist of 20 older adults diagnosed with hypertension. Participants will undergo three experimental conditions in a randomized order: (1) high‐intensity interval training (HIIT), (2) moderate‐intensity continuous training (MICT), and (3) a non‐exercise control condition. The study will be conducted without blinding. Due to the nature of the interventions, it will not be possible to blind either the participants or the researchers responsible for administering the exercise protocols and the control condition. In the HIIT condition, participants will perform a supervised 20‐minute exercise session consisting of 10 cycles of 1 minute at high intensity (rating of perceived exertion [RPE] 7–8), interspersed with 1 minute of active recovery (RPE 3–4). In the MICT condition, participants will perform a supervised continuous aerobic exercise session lasting 40 minutes at moderate intensity (RPE 5–6). In the control condition, participants will remain seated at rest for a period equivalent to that of the exercise conditions. All participants will complete the three experimental conditions, with the order of administration determined by randomization. The conditions will be separated by a washout period of at least seven days to minimize potential carryover effects from previous interventions. Before each session, resting blood pressure will be assessed. During the interventions, heart rate and affective responses will be monitored using the Feeling Scale. Immediately after each experimental condition, resting blood pressure will be reassessed, with additional measurements performed at 10, 20, and 30 minutes after the end of the session. Finally, participants will undergo 24‐hour ambulatory blood pressure monitoring and movement behavior assessment throughout the 24‐hour period following each experimental condition. CONDITION: Hypertension ; Cardiovascular diseases PRIMARY OUTCOME: A reduction in blood pressure levels is expected following the exercise sessions compared with the control condition. The outcome will be assessed using 24‐hour Ambulatory Blood Pressure Monitoring (ABPM) performed after each experimental condition. Mean systolic and diastolic blood pressure values over 24 hours, as well as during awake and sleep periods, will be evaluated and expressed in mmHg. The outcome will be determined by the absolute (mmHg) and relative (%) differences between the exercise conditions and the control condition. INCLUSION CRITERIA: Older adults; diagnosed with hypertension; receiving antihypertensive medication for at least three months SECONDARY OUTCOME: A reduction in resting blood pressure levels is expected following the exercise sessions compared with the control condition. The outcome will be assessed through resting blood pressure measurements using a validated device for clinical blood pressure assessment (Omron®, HEM‐742 INT, Brazil), following current recommendations. Resting systolic and diastolic blood pressure values, expressed in mmHg, will be evaluated. The outcome will be determined by the absolute (mmHg) and relative (%) differences between the values obtained before and after each experimental condition, as well as between the studied conditions. Differences in cardiovascular responses between exercise modalities are expected due to the distinct physiological demands imposed by each exercise protocol. The outcome will be assessed through continuous heart rate monitoring using a validated heart rate monitor (Polar, H10) throughout each experimental session. Heart rate values will be recorded in beats per minute (bpm), including mean heart rate, peak heart rate, and percentage of maximum heart rate (%HRmax) achieved during the exercise sessions. The outcome will be determined by differences in these parameters between experimental conditions and across the different phases of each exercise session. It is expected that movement behavior will be greater during the exercise sessions compared with the control condition. In addition, similar movement behavior is expected across conditions during the 24 hours following each experimental condition. Movement behaviors will be assessed using the activPAL3 micro (PAL Technologies Ltd, Glasgow, United Kingdom). The following outcomes will be evaluated: sleep, sedentary behavior, and physical activity (step count). More negative affective responses are expected following the exercise sessions compared with the control condition. The outcome will be assessed using the Feeling Scale at predetermined time points during and after the experimental sessions. Feeling Scale scores, ranging from ‐5 (very bad) to +5 (very good), will be recorded. The outcome will be determined by differences in affective scores across assessment time points and between experimental conditions.