The cool-down should consist of pulse-lowering exercises, which aim to reduce the heart rate and blood pressure gradually. The time period recommended by SIGN (2002) for a cool-down session is 10 minutes and should consist of exercises of steadily diminishing intensity. Cool-down exercises should predominantly involve large muscle groups. Arm exercises should be kept to minimum and below shoulder height, to avoid increases in SBP and therefore RPP.

The cool-down component is the reverse of the warm-up component. A gradual reduction in intensity allows the muscular pumping action against the veins to assist venous return. This will prevent venous pooling, which can occur if exercise is stopped suddenly (ACSM, 2001).

Post-exercise hypotension is more common in cardiac patients as a result of the side effects of certain cardiac medications, and also due to the age-related slower reaction of the baroreceptors that detect changes in BP. In addition, after high-intensity exercise there is a risk of arrhythmias, due to the increased sympathetic activity (ACSM, 1995). A gradual cool-down will reduce the likelihood of these occurring.

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