The Influence of Aqua Aerobic Exercise on Cardiac Autonomic Function and Blood Pressure in College Male Students

Document Type: Original research papers


1 Department of Physical Education and Sport Science, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran

2 Department of Physical Education and Sport Science, Azarbaijan Shahid Madani University, Tabriz, Iran


Cardiac autonomic function may have beneficial adaptive changes from performing regular aqua aerobic exercise. We examined the effects of regular aqua aerobic exercise on heart rate variability and blood pressure in college male students. One hundred forty-eight subjects were randomly assigned to the aqua aerobic exercise (n = 74) and control (n = 74) groups. The aqua aerobic exercise group received training (65 to 75% of heart rate reserve) for three weeks. Blood pressure and heart rate variability were measured before and after intervention protocol in study groups. Dependent and independent t-test was used to analyze within and between group differences. The correlation between blood pressure and heart rate variability was calculated via Pearson’s correlation. Within and between groups analysis showed significant effects on blood pressure and heart rate variability (p < 0.001) and sympathetic and parasympathetic ratio (p < 0.05) after performing regular aqua aerobic exercise. Also, after performing aqua aerobic exercise, the result showed a significant negative correlation between root mean square of the differences in successive R-R intervals (after r=-0.348, p≤0.003; before r=0.139, p≤0.23) and systolic blood pressure, positive correlation between very low frequency(after r=0.300, p≤0.010; before r=0.00, p≤0.99 ) and diastolic blood pressure, positive correlation between very low frequency (after r=0.269, p≤0.021; before r=-0.050, p≤0.67) and mean blood pressure and negative correlation between root mean square of the differences in successive R-R intervals (after r=-0.232, p≤0.048; before r=0.037, p≤0.75) and mean blood pressure. Performing the aqua aerobic exercise improved cardiac autonomic function and blood pressure levels in college male students. Also, blood pressure levels control due to aqua aerobic exercise associated with some of the heart rate variability parameters.


Main Subjects

1.         Members: ATF, Perk J, De Backer G, Gohlke H, Graham I, Reiner Ž, et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). European heart journal. 2012;33(13):1635-701.

2.         Taylor F, Ward K, Moore TH, Burke M, Smith GD, Casas JP, et al. Statins for the primary prevention of cardiovascular disease. Cochrane database of systematic reviews. 2011(1).

3.         Hillebrand S, Gast KB, de Mutsert R, Swenne CA, Jukema JW, Middeldorp S, et al. Heart rate variability and first cardiovascular event in populations without known cardiovascular disease: meta-analysis and dose–response meta-regression. Europace. 2013;15(5):742-9.

4.         Pop-Busui R, Evans GW, Gerstein HC, Fonseca V, Fleg JL, Hoogwerf BJ, et al. Effects of cardiac autonomic dysfunction on mortality risk in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Diabetes care. 2010;33(7):1578-84.

5.         Ziegler D, Zentai CP, Perz S, Rathmann W, Haastert B, Döring A, et al. Prediction of mortality using measures of cardiac autonomic dysfunction in the diabetic and nondiabetic population: the MONICA/KORA Augsburg Cohort Study. Diabetes care. 2008;31(3):556-61.

6.         Kop WJ, Stein PK, Tracy RP, Barzilay JI, Schulz R, Gottdiener JS. Autonomic nervous system dysfunction and inflammation contribute to the increased cardiovascular mortality risk associated with depression. Psychosomatic medicine. 2010;72(7):626.

7.         Pik-Shan Kong A, Chan NN, Chung-Ngor Chan J. The role of adipocytokines and neurohormonal dysregulation in metabolic syndrome. Current Diabetes Reviews. 2006;2(4):397-407.

8.         Okada Y, Galbreath MM, Shibata S, Jarvis SS, VanGundy TB, Meier RL, et al. Relationship between sympathetic baroreflex sensitivity and arterial stiffness in elderly men and women. Hypertension. 2012;59(1):98-104.

9.         Carthy ER. Autonomic dysfunction in essential hypertension: a systematic review. Annals of medicine and surgery. 2014;3(1):2-7.

10.       Johnson RJ, Feig DI, Nakagawa T, Sanchez-Lozada LG, Rodriguez-Iturbe B. Pathogenesis of essential hypertension: historical paradigms and modern insights. Journal of hypertension. 2008;26(3):381.

11.       Stauss HM, Persson PB. Role of nitric oxide in buffering short-term blood pressure fluctuations. Physiology. 2000;15(5):229-33.

12.       Bond V, Stephens Q, Adams RG, Vaccaro P, Demeersman R, Williams D, et al. Aerobic exercise attenuates an exaggerated exercise blood pressure response in normotensive young adult African-American men. Blood pressure. 2002;11(4):229-34.

13.       Portela N, Amaral JF, Mira PAdC, Souza LVd, Martinez DG, Laterza MC. Peripheral Vascular Resistance Impairment during Isometric Physical Exercise in Normotensive Offspring of Hypertensive Parents. Arquivos brasileiros de cardiologia. 2017;109(2):110-6.

14.       Bond JV, Franks BD, Tearney RJ, Wood B, Melendez MA, Johnson L, et al. Exercise blood pressure response and skeletal muscle vasodilator capacity in normotensives with positive and negative family history of hypertension. Journal of hypertension. 1994;12(3):285-90.

15.       Prasad VK, Hand GA, Sui X, Shrestha D, Lee D-c, Lavie CJ, et al., editors. Association of exercise heart rate response and incidence of hypertension in men. Mayo Clinic Proceedings; 2014: Elsevier.

16.       Al Haddad H, Laursen PB, Chollet D, Lemaitre F, Ahmaidi S, Buchheit M. Effect of cold or thermoneutral water immersion on post-exercise heart rate recovery and heart rate variability indices. Autonomic Neuroscience. 2010;156(1-2):111-6.

17.       Eckberg DL, Harkins SW, Fritsch JM, Musgrave G, Gardner D. Baroreflex control of plasma norepinephrine and heart period in healthy subjects and diabetic patients. The Journal of clinical investigation. 1986;78(2):366-74.

18.       Goldstein DS. Arterial baroreflex sensitivity, plasma catecholamines, and pressor responsiveness in essential hypertension. Circulation. 1983;68(2):234-40.

19.       Vanderlei LCM, Pastre CM, Hoshi RA, Carvalho TDd, Godoy MFd. Basic notions of heart rate variability and its clinical applicability. Brazilian Journal of Cardiovascular Surgery. 2009;24(2):205-17.

20.       Acharya UR, Joseph KP, Kannathal N, Lim CM, Suri JS. Heart rate variability: a review. Medical and biological engineering and computing. 2006;44(12):1031-51.

21.       Silveri G, Accardo A, Pascazio L, editors. Relationship Between Blood Pressure and Heart Rate Circadian Rhythms in Normotensive and Hypertensive Subjects. 2018 Computing in Cardiology Conference (CinC); 2018: IEEE.

22.       Huang S-C, Dai Y-WE, Lee Y-H, Chiou L-C, Hwang L-L. Orexins depolarize rostral ventrolateral medulla neurons and increase arterial pressure and heart rate in rats mainly via orexin 2 receptors. Journal of Pharmacology and Experimental Therapeutics. 2010;334(2):522-9.

23.       Kumagai H, Oshima N, Matsuura T, Iigaya K, Imai M, Onimaru H, et al. Importance of rostral ventrolateral medulla neurons in determining efferent sympathetic nerve activity and blood pressure. Hypertension Research. 2012;35(2):132-41.

24.       Dampney R, Coleman M, Fontes M, Hirooka Y, Horiuchi J, Li YW, et al. Central mechanisms underlying short‐and long‐term regulation of the cardiovascular system. Clinical and experimental pharmacology and physiology. 2002;29(4):261-8.

25.       Hoppe UC, Brandt M-C, Wachter R, Beige J, Rump LC, Kroon AA, et al. Minimally invasive system for baroreflex activation therapy chronically lowers blood pressure with pacemaker-like safety profile: results from the Barostim neo trial. Journal of the American Society of Hypertension. 2012;6(4):270-6.

26.       Christofaro DGD, Casonatto J, Vanderlei LCM, Cucato GG, Dias RMR. Relationship between resting heart rate, blood pressure and pulse pressure in adolescents. Arquivos brasileiros de cardiologia. 2017;108(5):405-10.

27.       Fleisher LA, Frank SM, Sessler DI, Cheng C, Matsukawa T, Vannier CA. Thermoregulation and heart rate variability. Clinical science. 1996;90(2):97-103.

28.       Bolboli L, Nikbakht H, Rajabi H. Effects of physical activity in warm and normal water on plasma electerolytes (na+, k+) in middle aged men. 2005.

29.       Danieli A, Lusa L, Potočnik N, Meglič B, Grad A, Bajrović FF. Resting heart rate variability and heart rate recovery after submaximal exercise. Clinical Autonomic Research. 2014;24(2):53-61.

30.       Xie G-L, Wang J-h, Zhou Y, Xu H, Sun J-H, Yang S-R. Association of high blood pressure with heart rate variability in children. Iranian journal of pediatrics. 2013;23(1):37.

31.       Lovato NS, Anunciacao PG, Polito MD. Blood pressure and heart rate variability after aerobic and weight exercises performed in the same session. Revista Brasileira de Medicina do Esporte. 2012;18(1):22-5.

32.       Konarska M, Stewart RE, McCarty R. Sensitization of sympathetic-adrenal medullary responses to a novel stressor in chronically stressed laboratory rats. Physiology & behavior. 1989;46(2):129-35.

33.       Li M-H, Chen P-H, Ho S-T, Tung C-S, Lin T-C, Tseng C-J, et al. Lower Body Negative Pressure–Induced Vagal Reaction: Role for the Osmopressor Response? American journal of hypertension. 2013;26(1):5-12.

34.       Franke W, Taylor K. Exercise training mode affects the hemodynamic responses to lower body negative pressure in women. European journal of applied physiology and occupational physiology. 1996;73(1-2):169-74.

35.       Saito I, Takata Y, Maruyama K, Eguchi E, Kato T, Shirahama R, et al. Association between heart rate variability and home blood pressure: The Toon Health Study. American journal of hypertension. 2018;31(10):1120-6.

36.       Lutfi MF, Sukkar MY. Effect of blood pressure on heart rate variability. Khartoum Medical Journal. 2012;4(1).

37.       Hausswirth C, Schaal K, Le Meur Y, Bieuzen F, Filliard J-R, Volondat M, et al. Parasympathetic activity and blood catecholamine responses following a single partial-body cryostimulation and a whole-body cryostimulation. PloS one. 2013;8(8):e72658.

38.       Yoshimoto T, Eguchi K, Sakurai H, Ohmichi Y, Hashimoto T, Ohmichi M, et al. Frequency components of systolic blood pressure variability reflect vasomotor and cardiac sympathetic functions in conscious rats. The Journal of Physiological Sciences. 2011;61(5):373-83.

39.       Di Daniele N, Tesauro M, Mascali A, Rovella V, Scuteri A. Lower heart rate variability is associated with lower pulse pressure amplification: role of obesity. Pulse. 2017;5(1-4):99-105.

40.       Liakos CI, Karpanou EA, Markou MI, Grassos CA, Vyssoulis GP. Correlation of 24‐Hour Blood Pressure and Heart Rate Variability to Renal Function Parameters in Hypertensive Patients. The Effect of Smoking. The Journal of Clinical Hypertension. 2015;17(12):938-43.

41.       Furlan R, Porta A, Costa F, Tank J, Baker L, Schiavi R, et al. Oscillatory patterns in sympathetic neural discharge and cardiovascular variables during orthostatic stimulus. Circulation. 2000;101(8):886-92.

42.       Graff B, Szyndler A, Czechowicz K, Kucharska W, Graff G, Boutouyrie P, et al. Relationship between heart rate variability, blood pressure and arterial wall properties during air and oxygen breathing in healthy subjects. Autonomic Neuroscience. 2013;178(1-2):60-6.

43. Majlesi M, Azadian E, Farahpour N, Jafarnezhad AA, Rashedi H. Lower limb muscle activity during gait in individuals with hearing loss. Australasian physical & engineering sciences in medicine. 2017;40(3):659-65.

44. Anbarian M, Jafarnezhad AA. Knee malalignment influences the electromyographic activity of selected lower limb muscles during gait in boy adolescents. Gait & Posture. 2015;1(42):S39-40.