Date of Completion

11-20-2018

Embargo Period

11-20-2019

Keywords

postexercise hypotension, self-efficacy, antihypertensive lifestyle therapy, positive outcome expectations, self-management

Major Advisor

Linda S. Pescatello, PhD

Co-Major Advisor

Beth A. Taylor, PhD

Associate Advisor

Crystal A. Park, PhD

Associate Advisor

na

Field of Study

Kinesiology

Degree

Doctor of Philosophy

Open Access

Open Access

Abstract

A single exercise session evokes blood pressure (BP) reductions that are immediate and persist for ≥24hr, termed postexercise hypotension (PEH). Self-monitoring of PEH may foster positive outcome expectations of exercise, and thus, enhance exercise adherence among adults with hypertension. PURPOSE: To compare the efficacy of self-monitoring of exercise (EXERCISE) versus exercise plus PEH (EXERCISE+PEH) to improve exercise adherence and BP control among adults with hypertension. METHODS: Adults with high BP were randomized to EXERCISE (n=12) or EXERCISE+PEH (n=12). Subjects underwent supervised, moderate intensity aerobic exercise training for 40-50min/session, 3d/wk for 12wk and were encouraged to exercise unsupervised at home ≥30min/d, 1-2d/wk. All subjects self-monitored exercise using a calendar recording method. EXERCISE+PEH also self-monitored BP before and after exercise. Adherence was calculated as [(# of exercise sessions performed ÷ # of possible exercise sessions) X 100%]. BP was measured pre- and post-training. RESULTS: Healthy, middle-aged (52.3±10.8y) men (n=11) and women (n=13) with hypertension (136.2±10.7/85.2±8.9mmHg) completed exercise training with 87.9±12.1% adherence. EXERCISE+PEH demonstrated greater adherence to supervised training (94.3±6.6%) than EXERCISE (81.6±13.2%; p=0.007). In addition, EXERCISE+PEH performed 32.6±22.5min/wk more unsupervised home exercise than EXERCISE (p=0.004), resulting in greater overall study exercise adherence (107.3±18.7%) than EXERCISE (82.7±12.2%; p=0.002). Post- versus pre-training, BP was reduced -7.4±11.3/-4.9±9.9mmHg (ps0.344). CONCLUSIONS: This study is the first to demonstrate that PEH self-monitoring is an efficacious tool to improve exercise adherence among adults with hypertension. Future research among a larger, more diverse sample is needed to confirm these novel findings and determine whether EXERCISE+PEH translates to better BP control relative to EXERCISE self-monitoring alone.

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