Blood pressure (BP) reduction occurs after a single bout of exercise, referred to as postexercise hypotension (PEH). The clinical importance of PEH has been advocated owing to its potential contribution to chronic BP lowering, and as a predictor of responders to exercise training as an antihypertensive therapy. However, the mechanisms underlying PEH have not been well defined. This study undertook a scoping review of research on PEH mechanisms, as disclosed in literature reviews. We searched the PubMed, Web of Science, Scopus, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and Sport Discus databases until January 2023 to locate 21 reviews - 13 narrative, four systematic with 102 primary trials, and four meta-analyses with 75 primary trials involving 1566 participants. We classified PEH mechanisms according to major physiological systems, as central (autonomic nervous system, baroreflex, cardiac) or peripheral (vascular, hemodynamic, humoral, and renal). In general, PEH has been related to changes in autonomic control leading to reduced cardiac output and/or sustained vasodilation. However, the role of autonomic control in eliciting PEH has been challenged in favor of local vasodilator factors. The contribution of secondary physiological outcomes to changes in cardiac output and/or vascular resistance during PEH remains unclear, especially by exercise modality and population (normal vs. elevated BP, young vs. older adults). Further research adopting integrated approaches to investigate the potential mechanisms of PEH is warranted, particularly when the magnitude and duration of BP reductions are clinically relevant. (PROSPERO CRD42021256569).

中文翻译：

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运动后低血压的中枢和外周机制：范围审查。

单次运动后血压 (BP) 会降低，称为运动后低血压 (PEH)。 PEH 的临床重要性得到了提倡，因为它对慢性血压降低有潜在贡献，并且可以作为抗高血压治疗运动训练反应的预测指标。然而，PEH 的机制尚未明确。本研究对文献综述中披露的 PEH 机制研究进行了范围审查。我们检索了截至 2023 年 1 月的 PubMed、Web of Science、Scopus、护理和联合健康文献累积索引 (CINAHL)、Cochrane 图书馆和 Sport Discus 数据库，找到了 21 篇综述——13 篇叙述性综述、4 篇包含 102 项初步试验的系统综述和 4 篇综述对涉及 1566 名参与者的 75 项主要试验进行荟萃分析。我们根据主要生理系统将 PEH 机制分类为中枢（自主神经系统、压力反射、心脏）或外周（血管、血流动力学、体液和肾脏）。一般来说，PEH 与导致心输出量减少和/或持续血管舒张的自主控制变化有关。然而，自主控制在引发 PEH 中的作用受到局部血管舒张因素的挑战。 PEH 期间次要生理结果对心输出量和/或血管阻力变化的影响仍不清楚，特别是运动方式和人群（正常血压与升高血压、年轻人与老年人）。有必要采取综合方法进一步研究 PEH 的潜在机制，特别是当血压降低的幅度和持续时间与临床相关时。 （普罗斯佩罗 CRD42021256569）。