HIGH-INTENSITY INTERVAL TRAINING SELF-GUIDED BY PERCEIVED EXERTION IN OLDER ADULTS WITH HYPERTENSION: FEASIBILITY AND ANTIHYPERTENSIVE EFFECTS
High-intensity interval training, exercise, aging, arterial stiffness, cardiovascular disease.
This dissertation aimed to assess the feasibility of an outdoor, self-guided high-intensity interval training (HIIT) program based on perceived exertion, and its effects on 24-hour ambulatory blood pressure in older adults with hypertension. This pilot study randomized 31 participants (66±4 years; hypertension diagnosis: 14±9 years; HIIT, n=18; Control, n=13) to a six-week intervention. The HIIT group performed three weekly sessions on an outdoor track, progressing from four to eight 1-minute bouts (RPE 7-8) with active recovery (RPE 3-4). Heart rate (HR) and affective response (Feeling Scale, -5 to +5) were monitored during the sessions. The active control group attended weekly health education sessions. Feasibility outcomes included consent and retention rates, intervention adherence, and adverse events. BP outcomes: 24-hour, daytime, and nighttime ambulatory BP. In addition, office BP (central and brachial), augmentation index (AIx), and aortic pulse wave velocity (aPWV). Consent rate was 18.6%; retention (83.3%) and adherence (89%) rates were high. Musculoskeletal issues occurred in 11.1%. Participants trained at >75% HRreserve and >85% HRmax, with affective responses rated as “fairly good”. The HIIT group reduced 24-hour systolic (-3 mmHg), diastolic (-2 mmHg), and nighttime systolic BP (-5 mmHg) (p<0.05). Despite a nonsignificant group-by-time interaction, nighttime diastolic BP (-3 mmHg) and AIx (-5.6%) decreased in the HIIT group (p>0.05). No changes were found in the control group (p>0.05). RPE-based outdoor HIIT appears to be a feasible exercise training approach for older adults with hypertension and may promote clinically meaningful reductions in 24-hour ambulatory BP.