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Influence of breathing technique on arterial blood pressure during heavy weight lifting

Narloch JA, Brandstater ME.
Department of Physical Medicine and Rehabilitation, Loma Linda University
Arch Phys Med Rehabil. 1995 May;76(5):457-62.

Arterial hypertension occurring during heavy resistance exercise may be a risk factor for stroke in healthy young adults.


Two men were admitted to an inpatient rehabilitation unit after intracerebral hemorrhage. Both were recreational weight lifters who experienced an acute hemorrhage while performing vigorous resistance exercises at a fitness center.

One patient was 38 years old and sustained an intracerebral hemorrhage near the middle cerebral artery. The other was 23 years old and sustained an intracerebral hemorrhage near the anterior cerebral artery.

Neither patient had any predisposing medical conditions (such as hypertension) or took prescribed medications, illicit drugs, or anabolic steroids.

Several other case reports have related hemorrhagic stroke and weight training.

Tuxen and colleagues reported on a 33-year-old veteran weight lifter who sustained a brainstem infarction during training.

Hall-Jurkowski and associates described a spontaneous subarachnoid hemorrhage that occurred in a 16-year old girl during weight lifting.

Frankle and colleagues reported a 34-year-old male body builder who was actively taking anabolic steroids and sustained a middle cerebral artery infarction during training.

The incidence of acute stroke in otherwise healthy weight lifters is not known. In most cases identified in this review, including the patients in this study, no risk factors other than weight lifting were described.

It is assumed therefore that the physiological stress of vigorous weight lifting may, in certain individuals, evolve into a state that places them at risk for a stroke. It is the authors' hypothesis that the physiological response that becomes a risk factor for stroke in weight lifters is arterial hypertension. The authors' proposed to study the arterial BP response during heavy weight lifting and whether a change in training technique could ameliorate the pressor effect of exercise.

Any training method that ameliorates the pressor effect of exercise should reduce the risk of stroke. The objective of this study was to observe the influence of breathing technique on arterial blood pressure (BP) generated during heavy, dynamic weight lifting.

BP was recorded in 10 male athletes by radial artery catheterization. Each subject then performed double-leg press sets at 85% and 100% of maximum. Each exercise was performed twice, once with closed glottis Valsalva, and then with slow exhalation during concentric contraction.

Influence of breathing technique on arterial blood pressure during heavy weight lifting

The mean BP at 100% maximum with Valsalva was 311/284. The highest pressure recorded in an individual was 370/360. With slow exhalation, the mean BP was 198/175 when the same 100% maximum was lifted (p <0.005). [Tabel]

A reduced pressor response was also noted at 85% maximal lifting with slow exhalation. Arterial hypertension produced during heavy weight lifting with Valsalva is extreme and may be dramatically reduced when the exercise is performed with an open glottis (without Valsalva). It is concluded that heavy resistance exercise is safer when performed while the subject breathes with an open glottis.

PMID: 7741618




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