OBJECTIVE: In this randomised two-period crossover trial, the objective was to compare acute changes in arterial distensibility between high-intensity interval physical exercise (HIIPE) and moderate-intensity continuous physical exercise (MICPE) sessions in subjects with elevated blood pressure (BP). METHODS AND ANALYSIS: Participants underwent either MICPE-HIIPE or HIIPE-MICPE sequences with intensity based on cardiopulmonary exercise testing. The main outcome measures included arterial stiffness (by pulse wave velocity (PWV)) at baseline, until 30 min and 24 hours after each physical exercise session. Other measures include office BP, 24-hour ambulatory blood pressure monitoring (ABPM) and applanation tonometry. RESULTS: The study involved 29 subjects with elevated BP (76% female, 48 +/- 7 years, body mass index 28.3 +/- 4.3 kg/m2, systolic Bp 126 +/- 9 mm Hg and diastolic Bp 84 +/- 4 mm Hg). They presented lower PWV 24 hours after MICPE compared with baseline and to 24-hour HIIPE ((-0.83 (-1.29 to -0.37) p = 0.001) and (-0.98 (-1.84 to -0.12), p = 0.021), respectively). Despite no differences in office BP, aortic systolic BP was lower after HIIPE compared with baseline and to 24-hour MICPE (113 +/- 19; 118 +/- 10 and 117 +/- 10 mm Hg; p = 0.013). CONCLUSION: In subjects with elevated BP, arterial distensibility is greater 24 hours after MICPE, while aortic systolic BP is lower after HIIPE. The particularities of each method and each exercise intensity can provide specific mechanisms of vascular response to exercise and detect vascular damage early in these subjects. TRIAL REGISTRATION NUMBER: NCT04200716.

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