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CLINICAL TRIAL
JOURNAL ARTICLE
RESEARCH SUPPORT, NON-U.S. GOV'T
Syncope is unrelated to supine and postural hypotension following prolonged exercise.
European Journal of Applied Physiology 2011 March
Syncope is widely reported following prolonged exercise. It is often assumed that the magnitude of exercise-induced hypotension (post-exercise hypotension; PEH), and the hypotensive response to postural change (initial orthostatic hypotension; IOH) are predictors of syncope post-exercise. The aim of this study was to determine the relationship between PEH, IOH, the residual IOH and syncope following prolonged exercise. Blood pressure (BP; Finometer) was measured continuously in 19 athletes (47 ± 20 years; BMI: 23.2 ± 2.2 kg m(2); VO(2) max: 51.3 ± 10.8 mL kg(-1) min(-1)) whilst supine and during head-up tilt (HUT) to 60° for 15 min (or to syncope), prior to and following 4 h of running at 70-80% maximal heart rate. Syncope developed in 15 of 19 athletes post-exercise [HUT-time completed, Pre: 14:39 (min:s) ± 0:55; Post: 5:59 ± 4:53; P < 0.01]. PEH was apparent (-7 ± 7 mmHg; -8 ± 8%), but was unrelated to HUT-time completed (r (2) = 0.09; P > 0.05). Although the magnitude of IOH was similar to post-exercise [-28 ± 12 vs. -20 ± 14% (pre-exercise); P > 0.05], the BP recovery following IOH was incomplete [-9 ± 9 vs. -1 ± 11 (pre-exercise); P < 0.05]; however, neither showed a relation to HUT-time completed (r(2) = 0.18, r (2) = 0.01; P > 0.05, respectively). Although an inability to maintain BP is a common feature of syncope post-exercise, the magnitude of PEH, IOH and residual IOH do not predict time to syncope. Practically, endurance athletes who present with greater hypotension are not necessarily at a greater risk of syncope than those who present with lesser reductions in BP.
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