Team sport reduces hypertension in postmenopausal women

Postmenopausal women with elevated hypertension who participated in the high-intensity team sport of floorball, a form of indoor hockey, achieved a significant decrease in their blood pressure, according to a study from the Center for Team Sports and Health at the University of Copenhagen in Denmark.¹

The authors of the study, published in the American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, said that, although hypertension is associated with vascular dysfunction, it is unknown whether hypertensive postmenopausal women have blunted nitric oxide (NO)-mediated leg vasodilator responsiveness, and whether this is reversible by high-intensity training.

To bring clarity, the investigators examined the leg vascular conductance (LVC) in response to femoral-infusion of acetylcholine (ACh) and sodium nitroprusside (SNP), plus skeletal muscle markers of oxidative stress and NO bioavailability, before and after high-intensity training in postmenopausal women.

“We hypothesized that ACh- and SNP-induced LVC responsiveness was reduced in hypertensive compared to normotensive postmenopausal women and that 10 weeks of high-intensity training would reverse the blunted LVC response and decrease blood pressure,” wrote the authors.

The study evaluated nine postmenopausal women with high blood pressure and a control group of eight postmenopausal with normal blood pressure, all of whom had their last menstrual cycle at least 6 years before study enrollment.

All the women participated in twice-weekly floorball training for 10 weeks. Matches were played from 2 versus 2 to 5 versus 5.

Women with high blood pressure achieved a reduction in vascular stiffness that led to a decrease in blood pressure by 15 (systolic) and 9 (diastolic) mmHg, which corresponds to a 40% lower risk of death by heart attack and a 30% reduction for coronary artery disease.

However, because 4 of the 9 hypertensive women were on anti-hypertensive medication, vascular outcomes could be comprised. Nonetheless, when comparing the results of the medicated versus the non-medicated hypertensive women, no difference was observed in training-induced changes in leg vasodilator responsiveness.

The group of women with normal blood pressure had slightly elevated blood pressure at the beginning of the study, which is common among inactive postmenopausal women. But they too attained an impressive 10 mmHg decrease in systolic blood pressure.

Also, all study participants achieved on average a 10% reduction in visceral fat mass. Total fat mass also decreased by half a kilogram.

The authors noted the study results as particularly noteworthy because none of the women had previously played floorball and they were able to achieve excellent health results within a relatively short time.

The study also contradicts the notion that vascular smooth muscle in postmenopausal women cannot change with exercise. Vascular smooth muscle cell function was reduced by 30% to 40% in the women with high blood pressure compared to the control group.

After training, there was no difference in the vascular function between the two groups.

The study sheds light on the types of exercise that can effectively counteract the negative consequences of loss of estrogen during the postmenopausal state.

“Based on the study outcomes, we suggest floorball training as an efficient and motivating exercise modality that is suitable as a treatment-strategy for essential hypertension, even in postmenopausal women with no prior experience with floorball,” the authors concluded.

However, due to the low number of subjects, caution may be warranted in interpreting results.

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Reference

1. Gunnarsson T, Ehlers T, Baasch-Skytte T, et al. Hypertension is associated with blunted NO-mediated leg vasodilator responsiveness that is reversed by high-intensity training in postmenopausal women. Am J Physiol Regul. Published online October 14, 2020. doi:org/10.1152/ajpregu.00170.2020