Effects of submaximal test on heart rate recovery in hypertensive patients

Background: Hypertension is associated with impaired regulation of the autonomic nervous system, resulting in altered cardiovascular responses during and after physical activity. Heart rate recovery (HRR) following exercise is a simple, non-invasive, and reliable indicator of autonomic function and cardiovascular health. Delayed HRR is associated with increased cardiovascular morbidity and mortality in hypertensive individuals. Post-exercise recovery position may influence venous return, autonomic reactivation, and the speed of heart rate normalization; however, limited evidence exists regarding the most effective recovery posture following submaximal exercise in hypertensive patients. Aim: This study sought to determine the most effective recovery position for optimizing cardiovascular recovery in hypertensive individuals, supporting improved hypertension management strategies. Methodology: A cross-sectional study was conducted on 36 hypertensive patients aged 30–60 years. Participants performed the Queen College Step Test, and heart rate was measured immediately post-exercise and during recovery at 1, 5, and 10 minutes across three recovery positions—supine, trunk-forward leaning, and standing—assigned in a randomized, counterbalanced manner. Repeated-measures ANOVA (jamovi) compared heart rate recovery across positions and time intervals. Result: A significant effect of time on heart rate was found (p < 0.001), but no significant between-group effect (p = 0.647). A significant time × group interaction (p = 0.015) indicated differing recovery patterns across groups. Heart rate reductions from immediate post-exercise to 1 and 5 minutes were significant (p < 0.001), with near-complete recovery by 10 minutes. Trunk-forward leaning showed comparatively faster recovery. Conclusion: Body position during recovery influences HRR pattern and rate in hypertensive patients. Heart rate remained elevated at 1 and 5 minutes across groups, indicating delayed autonomic recovery. Trunk-forward leaning showed the fastest early decline, supine approached near-complete recovery by 10 minutes, and standing was slowest, suggesting recovery posture affects cardiovascular recovery post-exercise.