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Page 4 of 10 Toy et al. Vessel Plus 2024;8:22 https://dx.doi.org/10.20517/2574-1209.2023.149

Figure 1. Clinical trial design and workflow for guided exercise and usual care groups. Guided exercise participants returned surveys
about their routine activities and/or exercise diaries at each study visit.

5-, 8-, or 10-pound weights. Wall sits were maintained with a ninety-degree angle between the back and
lower legs. Hand grip resistance level was calculated as 40% of maximal exertion using the dominant hand.
Leg raises were performed in a supine position, with both heels elevated six inches above ground level.
Stationary cycling was performed at a target of 100 Watts. The treadmill was performed once at 3 mph at a
14% grade incline. Cardiac rehabilitation facility staff and trained study personnel supervised all exercises.
Participants maintained exercises at moderate intensity (50%-80% of age-adjusted maximum heart rate)
long enough to acquire one brachial cuff reading (1-2 min). Blood pressure measurements during exercise
were manually triggered using the ABPMs and supervisors ensured that the measurement arm was
immobilized while the cuff inflated as recommended in the AHA scientific statement on blood pressure
measurement . All exercises were initiated for 15 s prior to triggering the ABPM and maintained until the
[16]
readings were completed. Post-exercise blood pressure measurements were taken following each exercise.
Exertional hypertension was defined as any systolic blood pressure > 180 mmHg or diastolic blood pressure
> 100 mmHg on more than 1 exercise. Exercises were promptly terminated if any of the following occurred:
persistent systolic pressure > 160 mmHg persisting after 3 min of recovery, any single systolic pressure
> 210 mmHg, or any single diastolic blood pressure > 120 mmHg; chest pain, dyspnea, or significant fatigue;
or a request to stop. Perceived exertion during each exercise was measured using the Borg CR-10 scale, with
a score of one representing minimal exertion and a score of ten indicating maximal exertion . Participants
[17]