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The effect of a short-term exercise programme on haemodynamic adaptability: a randomised controlled trial with newly diagnosed transient ischaemic attack patients [with consumer summary]
Faulkner J, McGonigal G, Woolley B, Stoner L, Wong L, Lambrick D
Journal of Human Hypertension 2013 Dec;27(12):736-743
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

This study assessed the effect of a short-term, 8-week exercise programme on resting and exercise blood pressure (systolic (SBP); diastolic (DBP)), and other haemodynamic responses (heart rate (HR), pulse pressure (PP), double product (DP)), of newly diagnosed transient ischaemic attack (TIA) patients. Sixty-eight TIA patients completed a continuous and incremental exercise test within 2 weeks of symptom diagnosis. HR, SBP and DBP were regularly measured at rest, during exercise and in recovery. Participants were then randomised to either an 8-week exercise programme or to a usual care control group prior to completing an identical post-intervention (PI) re-assessment. Individuals randomised to the exercise condition experienced a significantly greater reduction in resting HR (-5.4 +/- 10.2%), SBP (-6.7 +/- 8.1%) and DBP (-2.8 +/- 7.2%) than the control group at the PI assessment (all p < 0.05). Similar findings were demonstrated at the PI assessment when comparing haemodynamic responses during exercise (p < 0.05), with significantly larger decrements observed for SBP and HR (both 10 to 14%), PP (17 to 24%) and DP (26 to 32%) for those randomised to the exercise intervention (all p < 0.05). This study demonstrates that structured physical activity soon after TIA diagnosis will improve haemodynamic responses. The early implementation of exercise following TIA diagnosis may be an important secondary prevention strategy for this population.
Reprinted by permission from Journal of Human Hypertension, Macmillan Publishers Ltd.

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