Postural influence on postexercise hypotension: a randomized crossover study of supine, seated, and standing recovery following high-intensity exercise.

BACKGROUND

Postexercise hypotension (PEH) is a well-established cardiovascular benefit of acute exercise, yet the influence of recovery posture on hemodynamic mechanisms remains understudied. This study investigated how different recovery positions affect postexercise cardiovascular responses.

METHODS

Ten healthy adults (23.1±6.8 years, Body Mass Index [BMI] 24.5±3.7 kg/m2) completed a randomized crossover trial comparing four conditions: control (no exercise), and high-intensity interval exercise followed by supine, seated, or standing recovery. Cardiovascular parameters of blood pressure, heart rate, stroke volume, and systemic vascular resistance were measured continuously for 60 minutes postexercise.

RESULTS

Standing recovery produced the greatest heart rate increase (61.5%) versus supine (18.5%, P<0.001). Stroke volume showed significant condition × pre-/postexercise interactions (F<inf>(3, 2097)</inf>=134.219, P<0.001), with standing recovery causing dramatic reductions (-69.6%) compared to supine (+0.1%) and seated (-20.3%). Cardiac output interactions were significant (F<inf>(3, 2097)</inf>=45.292, P<0.001), with standing decreasing (-21.4%) while supine increased (+19.0%). Systemic vascular resistance demonstrated significant interactions (F<inf>(3, 2097)</inf>=55.977, P<0.001), increasing markedly during standing (+31.9%) while decreasing during supine recovery (-17.7%). Diastolic blood pressure showed significant condition × pre-/postexercise interactions (F<inf>(3, 592)</inf>=4.512, P=0.004), with standing producing the highest increase (+8.9%).

CONCLUSIONS

Recovery posture significantly influences postexercise cardiovascular responses through gravitational effects on blood distribution. Standing recovery attenuates hypotensive benefits due to orthostatic stress, while supine recovery optimizes acute blood pressure reduction.