Studies assessing acute response to HEx |
Cunha et al. (Brazil) / cross-over 2828. 28. Cunha RM, Arsa G, Neves EB, Lopes LC, Santana F, Noleto MV, et al. Water aerobics is followed by short- time and immediate systolic blood pressure reduction in overweight and obese hypertensive women. J Am Soc Hypertens. 2016;10(7):570-7.
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18 overweight (mean age 54.4 ± 7.9 yrs.) and obese hypertensive women (mean age 56.4±6.6 yrs.) were randomly assigned to HEx and CON intervention. |
The water aerobics exercise session consisted of a 45-minute training at the intensity of 70%-75% of maximum heart rate adjusted for the aquatic environment. |
NR |
The control group did not enter the pool and did not perform any exercise. |
28.5 ºC |
Systolic and diastolic BP was measured before, immediately after, and every 10 min up to 30 min after HEx and CON intervention, using a semiautomatic device (Omron 705-CP). |
Castro et al. (Brazil) / cross-over 66. Castro RE, Guimarães GV, Silva JM, Bocchi EA, Ciolac EG. Postexercise Hypotension after Heart Transplant: Water-versus Land-Based Exercise. Med Sci Sports Exerc. 2016;48(5):804-10.
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18 heart transplant patients (12 male/6 female, mean age 45.7 ± 2.7 yrs.) were randomly assigned to HEx, LEx and CON. |
30 min moderate-intensity (11-13 in the 6-20 RPE) aerobic exercise (walking inside the pool immersed up to the xiphoid process). |
30 min moderate-intensity (11-13 in the 6-20 RPE) aerobic exercise (walking on a motorized treadmill). |
30 min of resting quietly in the seated position. |
30-32 ºC |
Ambulatory BP (systolic and diastolic) was measured during 24h after HEx, LEx and CON intervention, using an automatic device (Dyna-Mapa ABP monitor). |
Garzon et al. (Canada) / cross-over 2323. Garzon M, Juneau M, Dupuy O, Nigam A, Bosquet L, Comtois A, et al. Cardiovascular and hemodynamic responses on dryland vs. immersed cycling. J Sci Med Sport. 2015;18(5):619-23.
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20 healthy normotensive (18 male/2 female, mean age (32 ± 7 yrs.) were randomly assigned to HEx and LEx. |
Pedaling immersed on immersible ergocycle (Hydrorider®)-(immersion to the chest level). External power output on immersible ergocycle was controlled by pedaling rate (rpm). Initial rpm was set at 40 rpm and was increased by 10 rpm until 70 rpm and thereafter by 5 rpm until exhaustion. |
Pedaling on dryland ergocycle (Ergoline 800S; Bitz, Germany). Initial external power output of dryland ergocycle protocol was set at 25W and increased by 25W every minute until exhaustion. |
NR |
30 ºC |
Central hemodynamic parameters were measured continuously during exercise and a 5-min recovery period using a sphygmomanometer (WelchAllyn, USA). Central hemodynamic was measured continuously at rest, during exercise and after exercise cessation using impedance cardiography. |
Luza et al. (Brazil) / cross-over 2626. Luza M, Siqueira LO, Paqualotti A, Reolão JBC, Schmidt R, Calegari L. Efeitos do repouso e do exercício no solo e na água em hipertensos e normotensos. Fisioter Pesqui. 2011;18(4):346-52.
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8 sedentary normotensive (1 male/7 female, mean age 62 ± 3.7 yrs.) and 12 sedentary hypertensive (3 male/9 female, mean age 59 ± 2.6 yrs.) were randomly assigned to HEx, LEx and CON intervention. |
Heating; aerobic exercises; fortification; And stretching and relaxation, lasting 45 minutes [moderate- intensity (83-85% of HRMAX)]. |
The exercise was performed in athletics track, where the subjects were instructed to walk for 45 minutes in the heart rate intensity measured at the intensity corresponding to the anaerobic threshold [moderate- intensity (83-85% of HRMAX)]. |
In the ground rest protocol, the participants remained sitting for 45 minutes. In the rest protocol in the water, participants were immersed for 45 minutes in the pool. (The immersion occurred up to shoulder height.) |
30-32 ºC |
Systolic and diastolic BP (standard mercury sphygmomanometer Sankey), and Heart Rate were measured before and after (30, 60 and 90 min) each intervention. |
Pugh et al. (Australia) / cross-over 2727. Pugh CJ, Sprung VS, Ono K, Spence AL, Thijssen DH, Carter HH, et al. The effect of water immersion during exercise on cerebral blood flow. Med Sci Sports Exerc. 2015;47(2):299-306.
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15 recreationally active healthy normotensive (8 male/7 female, mean age 26 ± 4 yrs.) were randomly assigned to HEx and LEx intervention. |
Once immersed in water, participants remained in the resting upright position for 5 min, which was followed by a 20- min bout of low- intensity exercise consisting of a repetitive stepping protocol (approximately 100 bpm). Upon completion of the exercise bout, participants remained in the resting upright position for a further 5 min, after which, the pumps were reversed to empty the tank-30 min low- intensity (HR = 100 bpm). |
Participants remained in the upright standing position and avoided movement for 5 min. This was followed by a 20- min bout of low- intensity exercise consisting of a repetitive stepping protocol (approximately 100 bpm). Upon completion of the exercise bout, participants remained in the resting upright position for a further 5 min. |
NR |
30 ºC |
Finometer PRO (Finapres Medical Systems, Amsterdam, the Netherlands) was used to monitor relative changes in mean BP, cardiac output, and stroke volume, before, during, and 20 min after HEx and LEx intervention. |
Sosner et al. (Canada) / cross-over 2121. Sosner P, Gayda M, Dupuy O, Garzon M, Lemasson C, Gremeaux V, et al. Ambulatory blood pressure reduction following high-intensity interval exercise performed in water or dryland condition. J Am Soc Hypertens. 2016;10(5):420-8.
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42 hypertensive adults (22 male/20 female, mean age 65 ± 7 yrs.) were randomly assigned to HEx, LEx and CON intervention. |
30 min High- intensity interval exercise in up-to-the-chest immersed condition was performed on a mechanically- braked cycle ergometer (Hydrorider, DIESSE, San Lazzaro di Savena, Italia). Each exercise session was preceded by a 5-min warm-up consisting in pedaling at 40 rpm and followed by a 5-min passive recovery period in a sitting position that began immediately after exercise cessation. |
Moderate- intensity continuous exercise in dry land were performed on a stationary bicycle ergometer -- 24- min at 50% peak power output. |
NR |
30 ºC |
The 24h Ambulatory BP (Systolic and Diastolic) was measured with a brachial cuff-based oscillometric device Mobil-O-Graph PWA Monitor (I.E.M. GmbH, Stolberg, Germany)- The monitor was programmed to measure BP every 20 min during the overall 24h. |
High-intensity interval exercise in dry land were performed on a stationary bicycle ergometer-- two sets of 10-min with phases of 15-sec 100% peak power output interspersed by 15-sec of passive recovery. |
Arterial stiffness was automatically assessed, using the same oscillometric device Mobil-O-Graph PWA Monitor (I.E.M. GmbH, Stolberg, Germany), at rest with the patient in supine position in a quiet atmosphere for the first measurement, and every 20 min during the following 24h. |
Studies assessing chronic adaptation to HEx |
Arca et al. (Brazil) / Parallel 2929. Arca EA, Martinelli B, Martin LC, Waisberg CB, Franco RJ. Aquatic exercise is as effective as dry land training to blood pressure reduction in postmenopausal hypertensive women. Physiother Res Int. 2014;19(2):93-8.
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52 hypertensive women (mean age 64 ± 7 yrs.) randomly assigned to HEx (n = 19), LEx (n = 19) or CON (n = 14) groups. |
50-minute sessions on a three-time per week basis during 12 weeks. The heart rate was maintained around 50% to 60% of heart rate reserve. |
50-minute sessions on a three-time per week basis during 12 weeks. Dry land exercise was performed in stationary bikes. In the land dry exercise program, the heart rate was maintained around 50% to 60% of heart rate reserve. |
Did not change his eating habits and remained withou practicing physical activity in the period |
33-33.5 ºC |
BP measurements were performed with a mercury sphygmomanometer Premium G-tech®, adequately calibrated. In every one of the 12 weeks of intervention in aquatic and land, BP and heart rate were measured before subjects begun exercising, so respectively before immersion in water or before they had a walk on land. |
Colado et al. (Spain) / Parallel 3333. Colado JC, Triplett NT, Tella V, Saucedo P, Abellán J. Effects of aquatic resistance training on health and fitness in postmenopausal women. Eur J Appl Physiol. 2009;106(1):113-22.
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46 postmenopausal women randomly assigned to HEx (n = 15, mean age 54.7 ± 2 yrs.), LEx (n = 21, mean age 54 ± 2.8 yrs.) or CON (n = 10, mean age 52.9 ± 1.9 yrs.) groups. |
Training was performed twice per week in the first 12 weeks and three times per week for weeks 13-24. The total duration of the training session ranged from 35 to 60 min depending on the phase of periodization of the training program. |
Training was performed twice per week in the first 12 weeks and three times per week for weeks 13-24. The total duration of the training session ranged from 35 to 60 min depending on the phase of periodization of the training program. |
Did not change his eating habits and remained without practicing physical activity in the period. |
NR |
BP were taken at the same physician’s office within 1 week prior to and after the physical pre and post-testing, respectively. A resting BP measurement was taken after 10 min of quiet sitting. The BP measurement was repeated in the same manner after 48 h to ensure reliability. |
Farahani et al. (Iran)/ Parallel 3434. Farahani AV, Mansournia MA, Asheri H, Fotouhi A, Yunesian M, Jamali M, et al. The effects of a 10-week water aerobic exercise on the resting blood pressure in patients with essential hypertension. Asian J Sports Med. 2010;1(3):159-67.
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40 men with stage 1 or 2 essential hypertension were assigned to HEx (n=12, mean age 48.33 ± 10.74 yrs.) or CON (n = 28, mean age 46.96 ± 11.58 yrs.) groups. |
Subjects in the intervention group participated in a supervised 10-week water aerobic training program of 55 min sessions, 3 days per week on alternate days. The exercise intensity was set at 60-65% of the maximal heart rate and increased gradually up to 70-75% during the program. |
NR |
The control group were not involved in any regular training program during this period. |
31-32 °C |
Blood pressures were measured using mercury sphygmomanometers (Richter, Germany). Blood pressure was measured at baseline and 48 hours after the last exercise session to avoid the acute effects of a single bout of exercise. |
Guimarães et al. (Brazil) / Parallel 1818. Guimaraes GV, Cruz LGB, Fernandes-Silva MM, Dorea EL, Bocchi EA. Heated water-based exercise training reduces 24-hour ambulatory blood pressure levels in resistant hypertensive patients: a randomized controlled trial (HEx trial). Int J Cardiol. 2014;172(2):434-41.
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32 patients with resistant hypertension (15 male/17 female, mean age 53.7 ± 6 yrs.) randomly assigned to HEx (n = 16, 8 male/8 female, mean age 55±5,9 yrs.) or CON (n = 16.6 male/10f emale, mean age 52.4 ± 5.9 yrs.) groups. |
60 min of moderate-intensity (11-13 in the 6-20 RPE) aerobic (walking inside the pool immersed up to the xiphoid process) and callisthenic exercise (immersed up to the xiphoid process) performed 3 times a week. |
NR |
The control group was asked to maintain habitual activities. |
32 ºC |
Systolic and diastolic BP were measured before, and after 2 and 12 weeks of HEx and CON intervention, using a standard mercury sphygmomanometer. Ambulatory BP (systolic and diastolic) was measured during 24 h before, and after 2 and 12 weeks of HEx and CON intervention, using an automatic device (Spacelabs model). |
Lambert et al. (USA) / Parallel 3030. Lambert BS, Greene NP, Carradine AT, Joubert DP, Fluckey JD, Riechman SE, et al. Aquatic treadmill training reduces blood pressure reactivity to physical stress. Med Sci Sports Exerc. 2014;46(4):809-16.
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60 normotensive subjects (30 male/30 female) randomly assigned to HEx (n = 36.19 male/17 female, mean age 41 ± 2 yrs.) or LEx (n = 24.11 male/13 female, mean age 42 ±2 yrs.) groups. |
Exercise training included three sessions per week for 12 weeks with sessions progressively increasing from 250 kcal per session, 60% V˙ O2max during the first week, to 500 kcal per session, 85% V˙ O2max during weeks 6-12. |
Exercise training included three sessions per week for 12 weeks with sessions progressively increasing from 250 kcal per session, 60% V˙ O2max during the first week, to 500 kcal per session, 85% V˙ O2max during weeks 6-12. |
NR |
33 ºC |
BP measured before, at the end of each stage, and for 5 min after exercise testing. Serial BP measurements were obtained using standard sphygmomanometric procedures with subjects resting in the supine position during the last 30 s of each 3-min stage of the graded exercise stress tests and at 1, 3, and 5 min during recovery. |
Silva et al. (Brazil) / Parallel 3131. Silva J, Geraldes A, Natali A, Pereira J, Vale R, Dantas E. Acute Effects of Swimming on the Arterial Pressure of Hypertensive Adults. Maced J Med Sci. 2009;2(4):330-4.
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26 hypertensive subjects (11 male/15 female) randomly assigned to HEx (n = 13.4 male/9 female, mean age 38.40 ± 8.24 yrs.) or CON (n = 13.7 male/6 female, mean age 38.36 ± 8.96 yrs.) groups. |
Regular swimming program consisting of three weekly fifty-minute sessions of training for 10 weeks. The initial sessions had an intensity of around 40% of HRmax. |
NR |
Did not change his eating habits and remained without practicing physical activity in the period. |
27-28 ºC |
BP was measured with a digital arterial pressure monitor (Omrom® HEM-741C model, Japan). The measurements were taken always at the same time of day. Before training, the subjects were at rest for at least 10 minutes prior to the measurement of BP. Soon after the training session, the subjects remained at rest again for about 10 minutes before measurement. |
Silva et al. (Portugal) / Parallel 3232. Silva JE, Teixeira AMB, Dantas EHM, Rama LMPL. Comportamento da pressão arterial em homens pré- hipertensos participantes em um programa regular de natação. Rev Bras Med Esporte. 2015;21(3):178-81.
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36 pre-hypertensive men randomly assigned to HEx (n = 24, mean age 40.60 ± 9.36 yrs.) or CON (n = 12, mean age 40.57 ± 8.05 yrs.) groups. |
A regular swimming program was conducted, with three weekly sessions of 45 minutes for 12 weeks. The initial sessions had an intensity of around 40% to 50% of HR max. |
NR |
Did not change his eating habits and remained without practicing physical activity in the period. |
27-29 °C |
BP was measured according to the recommendations of the ACSM hypertension diagnosis, and was measured using an oscillometric device (Omrom, model HEM-741C, Japan). |