1
|
Çoner A, Öncel CR, Köseoğlu C, Dağaşan G. Multiple factors are related to the development of exaggerated blood pressure response to exercise. J Clin Hypertens (Greenwich) 2024. [PMID: 39344673 DOI: 10.1111/jch.14899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Accepted: 08/20/2024] [Indexed: 10/01/2024]
Affiliation(s)
- Ali Çoner
- Department of Cardiology, Alanya Alaaddin Keykubat University Faculty of Medicine, Alanya, Turkey
| | - Can Ramazan Öncel
- Department of Cardiology, Alanya Alaaddin Keykubat University Faculty of Medicine, Alanya, Turkey
| | - Cemal Köseoğlu
- Department of Cardiology, Alanya Alaaddin Keykubat University Faculty of Medicine, Alanya, Turkey
| | - Göksel Dağaşan
- Department of Cardiology, Alanya Alaaddin Keykubat University Faculty of Medicine, Alanya, Turkey
| |
Collapse
|
2
|
Glenning JP, Sandhu K, Harrington HA, Eastaugh L, Lane GK, Smolich JJ, Mynard JP. Accuracy of the WatchBP Office Central as a Type 2 device for non-invasive estimation of central aortic blood pressure in children and adolescents. J Hum Hypertens 2024:10.1038/s41371-024-00956-9. [PMID: 39271785 DOI: 10.1038/s41371-024-00956-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 09/02/2024] [Accepted: 09/05/2024] [Indexed: 09/15/2024]
Abstract
High blood pressure (BP) in childhood is a recognised precursor of elevated cardiovascular risk in adulthood. Brachial BP is normally used for clinical decision making, but central BP may be a better marker of pressure load on the heart. There is a paucity of validated non-invasive, automated devices for estimating central BP in children and adolescents. In this study, we compared the WatchBP Office Central (a Type 2 central pressure estimation device) against a high-fidelity micromanometer in the ascending aorta of anaesthetised patients undergoing clinically-indicated catheterisation (n = 15, age 4-16 years). As a secondary aim, central systolic BP (cSBP) was also compared to two non-invasive estimation methods in 34 awake patients undergoing routine cardiac MRI (age 10-18 years). WatchBP substantially overestimated cSBP compared to the intra-arterial gold-standard reference (26.1 ± 7.4 mmHg), and recruitment was terminated at n = 11 (included in the analysis) due to high statistical certainty that the device would not pass the validation criteria of 5±8 mmHg. WatchBP cSBP was also substantially higher than values obtained from a phase contrast MRI method (11.8 ± 7.9 mmHg) and the SphygmoCor XCEL (13.5 ± 8.9 mmHg) in the awake patient group, which translate to 21-23 mmHg on average after accounting for known/estimated biases in these non-invasive comparators. Compared with invasive central diastolic and systolic BPs, the brachial measures from WatchBP yielded errors of 0.1 ± 5.6 and 12.5 ± 6.0 mmHg respectively. We conclude that the WatchBP substantially overestimates cSBP in children and adolescents. These findings reinforce the need for central BP-measuring devices to be further developed and validated in this population.
Collapse
Affiliation(s)
- Jonathan P Glenning
- Heart Research, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Kieran Sandhu
- Heart Research, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Melbourne Medical School, University of Melbourne, Parkville, VIC, Australia
| | - Hilary A Harrington
- Heart Research, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Lucas Eastaugh
- Heart Research, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Cardiology, Royal Children's Hospital, Parkville, VIC, Australia
| | - Geoffrey K Lane
- Heart Research, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Cardiology, Royal Children's Hospital, Parkville, VIC, Australia
| | - Joseph J Smolich
- Heart Research, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Jonathan P Mynard
- Heart Research, Murdoch Children's Research Institute, Parkville, VIC, Australia.
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.
- Department of Biomedical Engineering, University of Melbourne, Parkville, VIC, Australia.
| |
Collapse
|
3
|
Martinez MA, Dillon KN, Kang Y, Maharaj A, Fischer SM, Figueroa A. Endothelial dysfunction influences augmented aortic hemodynamic responses to metaboreflex activation in postmenopausal women. Eur J Appl Physiol 2024; 124:2603-2613. [PMID: 38607608 DOI: 10.1007/s00421-024-05476-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/15/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE Postmenopausal women experience augmented aortic hemodynamic responses to isometric handgrip (IHG) exercise and metaboreflex activation post-exercise muscle ischemia (PEMI). Relationships between endothelial function brachial artery flow-mediated dilation (FMD) and aortic stiffness carotid-femoral pulse wave velocity (cfPWV) with aortic pulsatile hemodynamics during IHG and PEMI have not been determined. The relationships between aortic hemodynamic responses to PEMI were evaluated. METHODS Aortic blood pressure (BP), wave reflection, and pressure of forward (Pf) and backward (Pb) waves were measured using arterial tonometry at rest, IHG at 30% maximal force, and PEMI in 30 (15/group) postmenopausal women with low (≤ 4.5%) and normal (≥ 5.5%) FMD. Hemodynamic responses were analyzed as the change (Δ) from rest to the last minute of IHG and PEMI. RESULTS Brachial and aortic systolic BP (SBP) responses to IHG were higher in the low vs normal FMD group (P < 0.05). Aortic SBP (Δ20 ± 8 vs Δ11 ± 7 mmHg), pulse pressure (PP) (Δ12 ± 8 vs Δ6 ± 4 mmHg), augmented pressure (AP) (Δ5 ± 3 vs Δ2 ± 2 mmHg), and Pb (Δ6 ± 4 vs Δ3 ± 2 mmHg) responses to PEMI were greater (P < 0.05) in women with low vs. normal FMD. FMD was negatively correlated with aortic SBP, PP, AP, and Pb (P < 0.05) responses to PEMI. cfPWV was not correlated with responses to PEMI. CONCLUSION Endothelial dysfunction relates to augmented aortic pulsatile load during metaboreflex activation, which may increase cardiovascular risk in postmenopausal women.
Collapse
Affiliation(s)
- Mauricio A Martinez
- Department of Kinesiology and Sport Management, Texas Tech University, 3204 Main St, Lubbock, TX, 79409, USA
| | - Katherine N Dillon
- Department of Kinesiology and Sport Management, Texas Tech University, 3204 Main St, Lubbock, TX, 79409, USA
| | - Yejin Kang
- Department of Kinesiology and Sport Management, Texas Tech University, 3204 Main St, Lubbock, TX, 79409, USA
| | - Arun Maharaj
- Department of Kinesiology and Sport Management, Texas Tech University, 3204 Main St, Lubbock, TX, 79409, USA
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Stephen M Fischer
- Department of Kinesiology and Sport Management, Texas Tech University, 3204 Main St, Lubbock, TX, 79409, USA
| | - Arturo Figueroa
- Department of Kinesiology and Sport Management, Texas Tech University, 3204 Main St, Lubbock, TX, 79409, USA.
| |
Collapse
|
4
|
Gwag HB, Kim YJ, Park KM. Excessive Blood Pressure Rise and Cardiovascular Remodeling in Marathon Runners. Int J Sports Med 2024. [PMID: 38772403 DOI: 10.1055/a-2330-9869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2024]
Abstract
Exercise-induced hypertension (EIH) is thought to be associated with increased cardiovascular (CV) risks. However, no previous studies have investigated the effects of EIH on CV systems in marathon runners without CV risk factors using both 24-hr ambulatory blood pressure (BP) monitoring and exercise stress echocardiography (ESE). This study firstly described differences in CV adaptations according to EIH assessed by both exams. Marathon runners between 35 and 64 years of age without CV risk factors were eligible. All the participants underwent both 24-hr ambulatory BP monitoring and ESE. EIH was defined as a maximal exercise systolic BP≥210 mmHg. The EIH group (n=19) had shorter training history and higher exercise intensity compared to the non-EIH group (n=23). The average systolic BP was higher in the EIH group than in the non-EIH group. Left cardiac chamber size and left ventricular mass (LVM) were also higher in the EIH group compared to the non-EIH group. Maximal BP during ESE was positively correlated with both parameters. Exaggerated BP response during exercise needs to be monitored for pre-emptive measurements before it results in progressive cardiovascular maladaptation.
Collapse
Affiliation(s)
- Hye Bin Gwag
- Division of Cardiology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea (the Republic of)
| | - Young-Joo Kim
- Department of exercise rehabilitation & Welfare, Sungshin Women's University, Seongbuk-gu, Korea (the Republic of)
| | - Kyoung-Min Park
- Division of Cardiology, Department of Internal Medicine, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
| |
Collapse
|
5
|
Wuttichaipradit C, Yodwut C, Sukhum P, Hengrussamee K, Treesong M, Thiangtham S, Samut B, Tunhasiriwet A, Yingchoncharoen T. CAVI (Cardio-Ankle Vascular Index) as an independent predictor of hypertensive response to exercise. BMC Cardiovasc Disord 2024; 24:165. [PMID: 38504197 PMCID: PMC10949558 DOI: 10.1186/s12872-024-03807-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/21/2024] [Indexed: 03/21/2024] Open
Abstract
OBJECTIVES Hypertensive response to exercise (HRE) is related to the development of future hypertension, cardiovascular morbidity, and mortality, independent of resting blood pressure. We hypothesized that arterial stiffness as measured by cardio-ankle vascular index (CAVI) could be an independent predictor of HRE. MATERIALS AND METHODS Retrospective chart review of patients participated in the preventive health program at the Bangkok Heart Hospital who underwent both CAVI and treadmill stress testing on the same day between June and December 2018 were performed. Variables for the prediction of HRE were analyzed using univariate analysis, and significant variables were entered into multiple logistic regression. An ROC curve was created to test the sensitivity and specificity of CAVI as a predictor of HRE. RESULTS A total of 285 participants (55.1% female) were enrolled in this study. There were 58 patients (20.4%) who met the HRE definition (SBP > 210 mmHg in males, SBP > 190 mmHg in females, or DBP > 110 mmHg in both males and females), with a mean age of 46.4 12.8 years. In univariate analysis, age, systolic blood pressure at rest, diastolic blood pressure at rest, pulse pressure at rest, diabetes mellitus, hypertension, dyslipidemia, history of beta-blocker, and CAVI results were statistically significant. Multiple logistic regression revealed that CAVI and systolic blood pressure were statistically significant predictors of HRE with OR of 5.8, 95%CI: 2.9-11.7, P < 0.001 and OR 1.07, 95%CI: 1.03-1.10, P = 0.001 respectively. ROC curve analysis of the CAVI revealed an AUC of 0.827 (95%CI: 0.76-0.89, p < 0.001), and the sensitivity and specificity of cut-point CAVI > 8 were 53% and 92%, respectively. CONCLUSION This study demonstrated that CAVI is an independent predictor of hypertensive response to exercise. Additionally, the findings suggest that CAVI > 8 can be a valuable tool in identifying individuals at risk for hypertensive responses during exercise.
Collapse
Affiliation(s)
| | - C Yodwut
- Bangkok Heart Hospital, Bangkok, Thailand
| | - P Sukhum
- Bangkok Heart Hospital, Bangkok, Thailand
| | | | - M Treesong
- Bangkok Heart Hospital, Bangkok, Thailand
| | | | - B Samut
- Bangkok Heart Hospital, Bangkok, Thailand
| | | | - T Yingchoncharoen
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| |
Collapse
|
6
|
Zhang Y, Jiang X. The relationship between physical activity and stroke in middle-aged and elderly people after controlling demography variables, health status and lifestyle variables. Medicine (Baltimore) 2023; 102:e36646. [PMID: 38115280 PMCID: PMC10727543 DOI: 10.1097/md.0000000000036646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/20/2023] [Accepted: 11/22/2023] [Indexed: 12/21/2023] Open
Abstract
The increase in the number of stroke patients in China brain has led to the decline in quality of life and the burden of family economic conditions. This study explored the relationship between stroke and physical activity (PA) in middle-aged and elderly Chinese after controlling Demography, health status and lifestyle variables, providing a new basis for the prevention and treatment of stroke in the elderly. The data is from the 2018 China Health and Retirement Longitudinal study. Five thousand seventy people over 50 years old with complete information on PA, stroke, Demography, health status and lifestyle were included in the analysis. SPSS 27.0 software was used to conduct Z test, logistic regression analysis and linear hierarchical regression analysis on the collected data. The results showed that high-level physical exercise was significantly negatively correlated with stroke (P < .05). After adjusting Demographics characteristics (gender, registered residence type, education level, age, widowhood or not), health status characteristics and living habits (arthritis, bad mood, asthma, hyperlipidemia, disability, memory disease, health self-evaluation, hypertension, smoking, depression), There was still statistical significance (P < .05) between PA and stroke. This study concludes that middle-aged and elderly people with high PA have a lower risk of stroke. In the process of preventing and improving stroke symptoms in the elderly, it is important to maintain high PA while also paying attention to health management and a healthy lifestyle.
Collapse
Affiliation(s)
- Yaqun Zhang
- School of Sports Medicine, Anshan Normal University, Anshan, China
| | - Xin Jiang
- School of Physical Education, Dalian University, Dalian, China
| |
Collapse
|
7
|
Watso JC, Cuba JN, Boutwell SL, Moss JE, Bowerfind AK, Fernandez IM, Cassette JM, May AM, Kirk KF. Acute nasal breathing lowers diastolic blood pressure and increases parasympathetic contributions to heart rate variability in young adults. Am J Physiol Regul Integr Comp Physiol 2023; 325:R797-R808. [PMID: 37867476 PMCID: PMC11178300 DOI: 10.1152/ajpregu.00148.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 10/24/2023]
Abstract
There is growing interest in how breathing pace, pattern, and training (e.g., device-guided or -resisted breathing) affect cardiovascular health. It is unknown whether the route of breathing (nasal vs. oral) affects prognostic cardiovascular variables. Because nasal breathing can improve other physiological variables (e.g., airway dilation), we hypothesized that nasal compared with oral breathing would acutely lower blood pressure (BP) and improve heart rate variability (HRV) metrics. We tested 20 adults in this study [13 females/7 males; age: 18(1) years, median (IQR); body mass index: 23 ± 2 kg·m-2, means ± SD]. We compared variables between nasal- and oral-only breathing (random order, five min each) using paired, two-tailed t tests or Wilcoxon signed-rank paired tests with significance set to P < 0.05. We report the median (interquartile range) for diastolic BP and means ± SD for all other variables. We found that nasal breathing was associated with a lower mean BP (nasal: 84 ± 7 vs. oral: 86 ± 5 mmHg, P = 0.006, Cohen's d = 0.70) and diastolic BP [nasal: 68(8) vs. oral: 72(5) mmHg, P < 0.001, Rank-biserial correlation = 0.89] but not systolic BP (nasal: 116 ± 11 vs. oral: 117 ± 9 mmHg, P = 0.48, Cohen's d = 0.16) or heart rate (HR; nasal: 74 ± 10 vs. oral: 75 ± 8 beats·min-1, P = 0.90, Cohen's d = 0.03). We also found that nasal breathing was associated with a higher high-frequency (HF) contribution to HRV (nasal: 59 ± 19 vs. oral: 52 ± 21%, P = 0.04, Cohen's d = 0.50) and a lower low frequency-to-HF ratio at rest (nasal: 0.9 ± 0.8 vs. oral: 1.2 ± 0.9, P = 0.04, Cohen's d = 0.49). These data suggest that nasal compared with oral breathing acutely 1) lowers mean and diastolic BP, 2) does not affect systolic BP or heart rate, and 3) increases parasympathetic contributions to HRV.NEW & NOTEWORTHY There is growing interest in how breathing pace, pattern, and training (e.g., device-guided or -resisted breathing) affect prognostic cardiovascular variables. However, the potential effects of the breathing route on prognostic cardiovascular variables are unclear. These data suggest that nasal compared with oral breathing 1) lowers mean and diastolic blood pressure (BP), 2) does not affect systolic BP or heart rate (HR), and 3) increases parasympathetic contributions to heart rate variability (HRV). These data suggest that acute nasal breathing improves several prognostic cardiovascular variables.
Collapse
Affiliation(s)
- Joseph C Watso
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, & Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Jens N Cuba
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, & Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Savannah L Boutwell
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, & Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Justine E Moss
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, & Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Allison K Bowerfind
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, & Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Isabela M Fernandez
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, & Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Jessica M Cassette
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, & Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Allyson M May
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, & Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Katherine F Kirk
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, & Food Sciences, Florida State University, Tallahassee, Florida, United States
| |
Collapse
|
8
|
Remchak MME, Dosik JK, Pappas G, Gow AJ, Shah AM, Malin SK. Exercise blood pressure and heart rate responses to graded exercise testing in intermediate versus morning chronotypes with obesity. Am J Physiol Heart Circ Physiol 2023; 325:H635-H644. [PMID: 37505468 PMCID: PMC10642995 DOI: 10.1152/ajpheart.00149.2023] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 07/29/2023]
Abstract
Exaggerated exercise blood pressure (BP) is linked to cardiovascular disease (CVD). Although evening chronotypes have greater CVD risk than morning (Morn) types, it is unknown if exercise BP differs in intermediate (Int) types. Adults with obesity were classified as either Morn [n = 23 (18 females), Morning-Eveningness Questionnaire (MEQ) = 63.96 ± 1.0, 54.74 ± 1.4 yr, 33.7 ± 0.6 kg/m2] or Int [n = 23 (19 females), MEQ = 51.36 ± 1.1, 55.96 ± 1.8 yr, 37.2 ± 1.2 kg/m2] chronotype per MEQ. A graded, incremental treadmill test to maximal aerobic capacity (V̇o2max) was conducted. Systolic (SBP) and diastolic (DBP) blood pressure and mean arterial pressure (MAP), rate pressure product (RPP), heart rate (HR), and rate of perceived intensity (RPE) were determined at baseline, 4 min, 6 min, and maximal stages. HR recovery (HRR; maximum postexercise) was determined at 1 and 2 min postexercise. Preexercise fasted aortic waveforms (applanation tonometry), plasma leptin, nitrate/nitrite (nitric oxide bioavailability), and body composition (dual X-ray, DXA) were also collected. Int had lower V̇o2max and plasma nitrate (both P ≤ 0.02) than Morn. No difference in preexercise BP, aortic waveforms, or body composition were noted between groups, although higher plasma leptin was seen in Int compared with Morn (P = 0.04). Although Int had higher brachial DBP and MAP across exercise stages (both P ≤ 0.05) and higher HR, RPE, and RPP at 6 min of exercise (all P ≤ 0.05), covarying for V̇o2max nullified the BP, but not HR or RPE, difference. HRR was greater in Morn independent of V̇o2max (P = 0.046). Fasted leptin correlated with HR at exercise stage 4 (r = 0.421, P = 0.041) and 6 min (r = 0.593, P = 0.002). This observational study suggests that Int has exaggerated BP and HR responses to exercise compared with Morn, although fitness abolished BP differences.NEW & NOTEWORTHY This study compares blood pressure and heart rate responses with graded, incremental exercise between morning and intermediate chronotype adults with obesity. Herein, blood pressure responses to exercise were elevated in intermediate compared with morning chronotype, although V̇o2max abolished this observation. However, heart rate responses to exercise were higher in intermediate vs. morning chronotypes independent of fitness. Collectively, this exercise hemodynamic response among intermediate chronotype may be related to reduced aerobic fitness, altered nitric oxide metabolism, and/or elevated aortic waveforms.
Collapse
Affiliation(s)
- Mary-Margaret E Remchak
- Department of Kinesiology and Health, Rutgers University, New Brunswick, New Jersey, United States
| | - Jaclyn K Dosik
- Department of Kinesiology and Health, Rutgers University, New Brunswick, New Jersey, United States
| | - Gregory Pappas
- Department of Kinesiology and Health, Rutgers University, New Brunswick, New Jersey, United States
- Ernest Mario School of Pharmacy, Pharmacology and Toxicology, Rutgers University, New Brunswick, New Jersey, United States
| | - Andrew J Gow
- Ernest Mario School of Pharmacy, Pharmacology and Toxicology, Rutgers University, New Brunswick, New Jersey, United States
| | - Ankit M Shah
- Division of Endocrinology, Metabolism & Nutrition, Rutgers University, New Brunswick, New Jersey, United States
| | - Steven K Malin
- Department of Kinesiology and Health, Rutgers University, New Brunswick, New Jersey, United States
- Division of Endocrinology, Metabolism & Nutrition, Rutgers University, New Brunswick, New Jersey, United States
- New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, New Jersey, United States
- Institute of Translational Medicine and Science, Rutgers University, New Brunswick, New Jersey, United States
| |
Collapse
|
9
|
Tian Y, Zhang Y. The relationship between hypertension and physical activity in middle-aged and older adults controlling for demographic, chronic disease, and mental health variables. Medicine (Baltimore) 2022; 101:e32092. [PMID: 36451488 PMCID: PMC9704945 DOI: 10.1097/md.0000000000032092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
To explore the relationship between hypertension and physical activity (PA) in the middle-aged and elderly after controlling demographic characteristics, chronic diseases and mental health variables. The 2018 China Health and Retirement Longitudinal Study (CHARLS) was used to collect the data. A baseline survey of middle-aged and older people was carried out nationally using the PPS sample method to look into their demographic, health state, and other information. The investigation included 4593 adults over 50 with complete data on PA level and hypertension prevalence. Z-test, logistic regression analysis, and linear hierarchical regression analysis were performed on the gathered data using the SPSS 27.0 program. The prevalence of hypertension among middle-aged and senior persons was 12.2%, and the percentage of those who did not have it was 87.8%. Males were more likely than females to have hypertension. Participants who reported high levels of PA made up 49.2% of the total, while those who reported low levels of PA made up 50.8% of the total. High levels of PA were significantly inversely correlated with hypertension (P < .05). There was still a statistically significant relationship between PA and hypertension (P < .05) after controlling demographic factors (gender, age, household registration type, education level, widowhood), chronic disease (arthritis, diabetes, disability, asthma, self-assessment of health, memory disease, stroke, hyperlipidemia) and mental health variables (bad mood and depression). High-level PA is significantly related to the low risk of hypertension. After controlling demographic characteristics, chronic diseases and mental health variables, this correlation is still significant.
Collapse
Affiliation(s)
- Ying Tian
- College of Sports Science, Shenyang Normal University, Shenyang, China
| | - Yaqun Zhang
- College of Sports Science, Anshan Normal University, Anshan, China
- *Correspondence: Yaqun Zhang, College of Sports Science, Anshan Normal University, No.43, Tiedong District, Anshan, Liaoning, China (e-mail: )
| |
Collapse
|
10
|
Watso JC, Romero SA, Moralez G, Huang M, Cramer MN, Johnson E, Crandall CG. Six months of unsupervised exercise training lowers blood pressure during moderate, but not vigorous, aerobic exercise in adults with well-healed burn injuries. J Appl Physiol (1985) 2022; 133:742-754. [PMID: 35952345 PMCID: PMC9484988 DOI: 10.1152/japplphysiol.00181.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 07/18/2022] [Accepted: 08/08/2022] [Indexed: 11/22/2022] Open
Abstract
Exercise training reduces cardiovascular disease risk, partly due to arterial blood pressure (BP) lowering at rest and during fixed-load exercise. However, it is unclear whether exercise training can reduce BP at rest and during exercise in adults with well-healed burn injuries. Therefore, the purpose of this investigation was to test the hypothesis that 6 mo of unsupervised exercise training reduces BP at rest and during lower-body cycle ergometry in adults with well-healed burn injuries. Thirty-nine adults (28 with well-healed burn injuries and 11 controls) completed 6 mo of unsupervised, progressive exercise training including endurance, resistance, and high-intensity interval components. Before and after exercise training, we measured BP at rest, during fixed-load submaximal exercise (50 and 75 W), during fixed-intensity submaximal exercise (40% and 70% of V̇o2peak), and during maximal exercise on a lower-body cycle ergometer. We compared cardiovascular variables using two-way ANOVA (group × pre/postexercise training [repeated factor]). Adults with well-healed burn injuries had higher diastolic BP at rest (P = 0.04), which was unchanged by exercise training (P = 0.26). Exercise training reduced systolic, mean, and diastolic BP during fixed-load cycling exercise at 75 W in adults with well-healed burn injuries (P ≤ 0.03 for all), but not controls (P ≥ 0.67 for all). Exercise training also reduced mean and diastolic BP during exercise at 40% (P ≤ 0.02 for both), but not at 70% (P ≥ 0.18 for both), of V̇o2peak. These data suggest that a 6-mo unsupervised exercise training program lowers BP during moderate, but not vigorous, aerobic exercise in adults with well-healed burn injuries.NEW & NOTEWORTHY Adults with well-healed burn injuries have greater cardiovascular disease morbidity and all-cause mortality compared with nonburn-injured adults. We found that exercise training reduced blood pressure (BP) during fixed-load cycling at 75 W and during moderate, but not vigorous, intensity cycling exercise in adults with well-healed burn injuries. These data suggest that 6 mo of unsupervised exercise training provides some degree of cardioprotection by reducing BP responses during submaximal exercise in well-healed burn-injured adults.
Collapse
Affiliation(s)
- Joseph C Watso
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Department of Applied Clinical Research, School of Health Professions, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Nutrition & Integrative Physiology, Florida State University, Tallahassee, Florida
| | - Steven A Romero
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Department of Physiology & Anatomy, University of North Texas Health Science Center, Fort Worth, Texas
| | - Gilbert Moralez
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Department of Applied Clinical Research, School of Health Professions, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Mu Huang
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Department of Applied Clinical Research, School of Health Professions, University of Texas Southwestern Medical Center, Dallas, Texas
- Office of Science, Medicine, and Health, American Heart Association, Dallas, Texas
| | - Matthew N Cramer
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
| | - Elias Johnson
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
| | - Craig G Crandall
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Department of Applied Clinical Research, School of Health Professions, University of Texas Southwestern Medical Center, Dallas, Texas
| |
Collapse
|
11
|
Costa EC, Browne RAV, Câmara M, Macêdo GAD, Lucena BEB, Vianna LC, Duhamel TA. Immediate post-exercise blood pressure and arterial stiffness in hypertensive and normotensive older females. J Clin Hypertens (Greenwich) 2022; 24:704-712. [PMID: 35582956 PMCID: PMC9180321 DOI: 10.1111/jch.14490] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/14/2022] [Accepted: 03/28/2022] [Indexed: 12/04/2022]
Abstract
Although it has been suggested that increased arterial stiffness is linked to exaggerated blood pressure (BP) from brief moderate exercise, it is not clear whether this occurs in older adults with and without hypertension. This study investigates whether the immediate post‐exercise systolic BP following brief moderate exercise is associated with arterial stiffness in older females with different BP status. This cross‐sectional study included 191 older females aged 60–80 years without known cardiovascular disease (CVD). Arterial stiffness was determined by aortic pulse wave velocity (aPWV). Systolic BP was measured before and immediately following a 3‐min moderate walking test (stage 1 Bruce protocol). Specific quartile‐based thresholds were used to define an exaggerated immediate post‐exercise systolic BP for hypertensive and normotensive older females (quartile 4 as an exaggerated response). Traditional CVD risk factors were assessed (covariates). Older females from the highest quartile of immediate post‐exercise absolute systolic BP showed higher aPWV compared to their peers from the lowest quartile (β = .22 m/s, p = .018). The quartile‐based threshold to define the exaggerated post‐exercise systolic BP was higher in hypertensive than in normotensive older females (174 vs. 172 mmHg). In summary, exaggerated immediate post‐exercise systolic BP following a brief moderate exercise is associated with higher arterial stiffness in older females with different BP status.
Collapse
Affiliation(s)
- Eduardo C Costa
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal, Brazil.,Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Rodrigo A V Browne
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Marcyo Câmara
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Geovani A D Macêdo
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Bruno E B Lucena
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Lauro C Vianna
- NeuroV̇ASQ̇ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, Brazil
| | - Todd A Duhamel
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Canada.,Institute of Cardiovascular Sciences, St. Boniface General Hospital Albrechtsen Research Centre, Winnipeg, Canada
| |
Collapse
|
12
|
Maharaj A, Fischer SM, Dillon KN, Kang Y, Martinez MA, Figueroa A. Acute Citrulline Blunts Aortic Systolic Pressure during Exercise and Sympathoactivation in Hypertensive Postmenopausal Women. Med Sci Sports Exerc 2022; 54:761-768. [PMID: 34974502 DOI: 10.1249/mss.0000000000002848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Hypertensive postmenopausal women (PMW) have exaggerated exercise systolic blood pressure (SBP) due to impaired functional sympatholysis. l-Citrulline (CIT) supplementation attenuates aortic SBP responses to cold pressor test (CPT)-induced vasoconstriction in young men. We hypothesized that acute CIT ingestion would attenuate aortic SBP and leg hemodynamic responses during exercise and CPT (EX + CPT). METHODS Fifteen hypertensive PMW (61 ± 7 yr) were randomly assigned to consume either 6 g of CIT or placebo (PL) separated by a minimum 3-d washout phase. Brachial and aortic blood pressure, femoral artery blood flow (FBF), and vascular conductance (FVC) were measured at rest and during 5 min of unilateral plantarflexion exercise with a CPT applied during minutes 4 and 5. RESULTS No differences between conditions were found in FBF, FVC, and brachial and aortic blood pressure at rest and during exercise alone. Changes in brachial SBP (CIT vs PL, 29 ± 12 vs 40 ± 10 mm Hg) and mean arterial pressure (CIT vs PL, 21 ± 10 vs 33 ± 11 mm Hg), and aortic SBP (CIT vs PL, 27 ± 11 vs 38 ± 9 mm Hg) and mean arterial pressure (CIT vs PL, 23 ± 9 vs 33 ± 11 mm Hg) to EX + CPT were lower in the CIT versus PL condition (P < 0.05). FBF, FVC, and functional sympatholysis (%ΔFVC) were not significantly different between conditions. CONCLUSIONS Acute CIT ingestion attenuated aortic SBP response to exercise and cold-induced sympathetic activation that may prevent left ventricle overload in hypertensive PMW.
Collapse
Affiliation(s)
- Arun Maharaj
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX
| | | | | | | | | | | |
Collapse
|
13
|
Blood pressure measurements during treadmill exercise testing and the risk for the future development of atrial fibrillation. Hypertens Res 2022; 45:1496-1504. [PMID: 35444293 DOI: 10.1038/s41440-022-00920-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/11/2022] [Accepted: 03/22/2022] [Indexed: 02/06/2023]
Abstract
Hypertension is a well-established risk factor for the onset and progression of atrial fibrillation (AF). Blood pressure (BP) measurements during routine exercise stress testing (EST) may identify subjects at increased risk for developing AF. We performed a retrospective analysis of treadmill EST carried out using the Bruce protocol in patients aged ≥40 years without a history of AF (n = 17,617; 42% women). BP was measured at rest, peak exercise, and 2-min recovery and analyzed for its association with the risk for developing AF. During a mean follow-up of 7 years, AF was documented in 4.5% of the patients. The incidence rate of AF per 1000 person-years increased with the rise in CHA2DS2VASc scores (3.26 for a Score=0 to 19.78 for scores ≥6). In a multivariate analysis, adjusting for risk score components and exercise capacity, systolic BP measurements taken at rest (≥130 vs. ≤110 mmHg), peak exercise (>170 vs. ≤150 mmHg), and recovery (>150 vs. ≤130 mmHg) were associated with an increased risk for AF: the hazard ratios (HRs) were 1.56 (95% CI, 1.30-1.87), 1.21 (1.01-1.45), and 1.33 (1.10-1.62), respectively. Similarly, diastolic BP measurements taken at rest (≥90 vs. <80 mmHg), peak exercise (≥100 vs. <90 mmHg), and recovery (>90 vs. ≤80 mmHg) were associated with an increased risk for AF: the HRs were 1.80 (1.36-2.38), 2.08 (1.28-3.37), and 1.56 (0.81-3.02), respectively. The association of exercise BP with AF was further observed when the BPs were analyzed as continuous variables and in subjects without a baseline diagnosis of hypertension. In conclusion, systolic and diastolic BP taken at the rest, peak exercise and recovery phases of EST may provide independent predictive information regarding future risk for developing AF.
Collapse
|
14
|
Sprick JD, Mammino K, Jeong J, DaCosta DR, Hu Y, Morison DG, Nocera JR, Park J. Aerobic exercise training improves endothelial function and attenuates blood pressure reactivity during maximal exercise in chronic kidney disease. J Appl Physiol (1985) 2022; 132:785-793. [PMID: 35142559 PMCID: PMC8917938 DOI: 10.1152/japplphysiol.00808.2021] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Patients with chronic kidney disease (CKD) have exaggerated increases in blood pressure during exercise that are associated with endothelial dysfunction. We hypothesized that aerobic exercise training would improve endothelial function and attenuate blood pressure reactivity during exercise in CKD. Sedentary individuals with CKD stages III-IV underwent 12 wk of aerobic cycling exercise (n = 26) or nonaerobic exercise (n = 22, control). Both interventions were performed 3 days/wk and matched for duration. Endothelial function was measured via peripheral arterial tonometry and quantified as reactive hyperemia index (RHI). Peak oxygen uptake (V̇o2peak) was assessed via maximal treadmill exercise testing with concomitant blood pressure monitoring. All measurements were performed at baseline and after the 12-wk intervention. A linear mixed model was used to compare the rate of increase in blood pressure during the test. RHI improved with exercise (Pre = 1.78 ± 0.10 vs. Post = 2.01 ± 0.13, P = 0.03) with no change following stretching (Pre = 1.73 ± 0.08 vs. Post = 1.67 ± 0.10, P = 0.69). Peak systolic blood pressure during the maximal treadmill exercise test was lower after exercise training (Pre = 186 ± 5 mmHg, Post = 174 ± 4 mmHg, P = 0.003) with no change after stretching (Pre = 190 ± 6 mmHg, Post = 190 ± 4 mmHg, P = 0.12). The rate of increase in systolic blood pressure during the V̇o2peak test tended to decrease after training for both groups (-2 mmHg/stage) with no differences between groups (P = 0.97). There was no change in V̇o2peak after either intervention. In conclusion, aerobic exercise training improves endothelial function and attenuates peak blood pressure reactivity during exercise in CKD.NEW & NOTEWORTHY Patients with chronic kidney disease (CKD) exhibit increased blood pressure reactivity during exercise that is associated with endothelial dysfunction. Twelve weeks of structured, aerobic, exercise training improves endothelial function and attenuates peak blood pressure responses during exercise in CKD stages III-IV.
Collapse
Affiliation(s)
- Justin D. Sprick
- 1Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia,2Department of Veterans Affairs Health Care System, Decatur, Georgia,3Department of Veterans Affairs Health Care System, Center for Visual and Neurocognitive Rehabilitation, Decatur, Georgia
| | - Kevin Mammino
- 2Department of Veterans Affairs Health Care System, Decatur, Georgia,3Department of Veterans Affairs Health Care System, Center for Visual and Neurocognitive Rehabilitation, Decatur, Georgia
| | - Jinhee Jeong
- 1Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia,2Department of Veterans Affairs Health Care System, Decatur, Georgia,3Department of Veterans Affairs Health Care System, Center for Visual and Neurocognitive Rehabilitation, Decatur, Georgia
| | - Dana R. DaCosta
- 1Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia,2Department of Veterans Affairs Health Care System, Decatur, Georgia,3Department of Veterans Affairs Health Care System, Center for Visual and Neurocognitive Rehabilitation, Decatur, Georgia
| | - Yingtian Hu
- 4Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Doree G. Morison
- 1Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia,2Department of Veterans Affairs Health Care System, Decatur, Georgia
| | - Joe R. Nocera
- 2Department of Veterans Affairs Health Care System, Decatur, Georgia,3Department of Veterans Affairs Health Care System, Center for Visual and Neurocognitive Rehabilitation, Decatur, Georgia,5Departments of Neurology and Rehabilitative Medicine, Emory University Department of Medicine, Atlanta, Georgia
| | - Jeanie Park
- 1Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia,2Department of Veterans Affairs Health Care System, Decatur, Georgia,3Department of Veterans Affairs Health Care System, Center for Visual and Neurocognitive Rehabilitation, Decatur, Georgia
| |
Collapse
|
15
|
Lee BA, Kim YJ. Effect of regular endurance exercises on management of cardiovascular health in middle-aged men. J Exerc Rehabil 2022; 18:50-56. [PMID: 35356140 PMCID: PMC8934609 DOI: 10.12965/jer.2142674.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/27/2021] [Indexed: 11/30/2022] Open
Abstract
This study was conducted to investigate the effect of regular endurance exercises on the management of cardiovascular health in middle-aged men. The following conclusions were drawn as the result of comparatively analyzing middle-aged men who regularly performed triathlon and cycling exercises for more than 5 years. The effect of regular endurance exercises on cardiovascular health management in middle-aged men was found to be relatively positive. However, prolonged endurance exercises can cause cardiovascular disease which can adversely affect the cardiac function, and to date, no defining limit is known about the amount of exercise that improves the cardiovascular function while reducing the cardiovascular events. Therefore, aiming for exercises at moderate intensity that befit the individual’s fitness level as well as conducting regular examinations to predict and manage the risk of sudden cardiac death from exercising were considered as the more effective method of cardiovascular health management.
Collapse
Affiliation(s)
- Bo-Ae Lee
- Department of Anti-aging Healthcare Education, College of Education, Changwon National University, Changwon,
Korea
- Department of Physical Education, College of Education, Pusan National University, Busan,
Korea
| | - Young-Joo Kim
- Department of Exercise Rehabilitation, Welfare Soojung Campus, Sungshin University, Seoul,
Korea
- Corresponding author: Young-Joo Kim, Department of Exercise Rehabilitation, Welfare Soojung Campus, Sungshin University, 2 Bomun-ro 34da-gil, Seoungbuk-gu, Seoul 02844, Korea,
| |
Collapse
|
16
|
Motiejunaite J, Vidal-Petiot E. Does exercise stress testing carry an incremental prognostic value beyond resting office blood pressure? J Hypertens 2022; 40:24-26. [PMID: 34857701 DOI: 10.1097/hjh.0000000000003016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Justina Motiejunaite
- Service de Physiologie - Explorations Fonctionnelles, Assistance Publique Hôpitaux de Paris, Hôpital Bichat-Claude Bernard.,Université de Paris
| | - Emmanuelle Vidal-Petiot
- Service de Physiologie - Explorations Fonctionnelles, Assistance Publique Hôpitaux de Paris, Hôpital Bichat-Claude Bernard.,Université de Paris.,Inserm U1149, Paris, France
| |
Collapse
|
17
|
Blood pressure response during treadmill exercise testing and the risk for future cardiovascular events and new-onset hypertension. J Hypertens 2022; 40:143-152. [PMID: 34857707 DOI: 10.1097/hjh.0000000000002991] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The physiologic response to exercise may provide valuable prognostic information. We investigated the association of blood pressure (BP) measurements during exercise stress testing (EST) with long-term risk of myocardial infarction, stroke or death (major adverse cardiovascular event, MACE), as well as the development of new-onset hypertension. METHODS A retrospective analysis of treadmill ESTs (years 2005-2019) performed by the Bruce protocol in patients aged 35-75 years without a history of cardiovascular disease (n = 14 792; 48% women). BP was documented at rest, submaximal exercise (Bruce stage-2), peak exercise and recovery (2 min). Association of SBP measures with study outcomes during median follow-up of 6.5 years was investigated. RESULTS Highest vs. lowest SBP quartile at rest (≥140 vs. <120 mmHg), submaximal-exercise (≥170 vs. <130 mmHg), peak-exercise (≥180 vs. ≤145 mmHg) and recovery (≥160 vs. <130 mmHg) was associated with an increase in the adjusted hazard ratio and 95% confidence interval (CI) for MACE: 1.53 (1.23-1.88), 1.33 (1.01-1.76), 1.30 (1.05-1.61), 1.35 (1.09-1.68), respectively. The association between SBP at submaximal exercise and recovery with MACE displayed a J-shaped pattern. Among nonhypertensive patients (n = 8529), excessive SBP response to peak exercise (≥190 mmHg in women and ≥210 mmHg in men) was an independent predictor of hypertension [hazard ratio (95% CI)]: 1.87 (1.41-2.48), as were SBPs during submaximal exercise [>160 vs. ≤130 mmHg: 2.44 (1.97-3.03)] and recovery [≥140 vs. ≤120 mmHg: 1.65 (1.37-1.98)]. CONCLUSION BP measurement during rest, exercise and recovery phases of EST provides incremental prognostic information regarding long-term risk for cardiovascular events and the probability for developing hypertension.
Collapse
|
18
|
Left ventricular hypertrophy in athletes, a case-control analysis of interindividual variability. Int J Cardiol 2021; 348:157-162. [PMID: 34896409 DOI: 10.1016/j.ijcard.2021.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/16/2021] [Accepted: 12/06/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND A variability in cardiac remodeling is observed in athletes regardless of age, sex, body size and sport participated. We sought to investigate whether other individual characteristics could affect the extent of Left ventricular hypertrophy (LVH). METHODS From 2120 consecutive Olympic athletes, those with LVH (defined as LV Wall thickness ≥ 13 mm) were matched 1:1 by age, gender, body surface area and type of sport with non-LVH Athletes. Clinical and Echocardiographic variables were compared. RESULTS 48 athletes with LVH (2.3%) and 48 matched non-LVH athletes were identified. LVH Athletes had higher body weight (90 ± 18 vs 81 ± 11Kg; p = 0.006) body mass index (26 ± 2 vs 24 ± 2 Kg/m2; p < 0.001) and body fat percentage (15 ± 7% vs 12 ± 4%; p = 0.016) compared to non-LVH Athletes. They also had higher systolic (123 ± 1 vs 116 ± 11 mmHg; p = 0.002) and diastolic blood pressure (76 ± 8 vs 71 ± 9 mmHg; p = 0.002). On exercise testing, LVH Athletes reached a lower index workload (3.7 ± 0.9 vs 4.1 ± 0.8 W/Kg; p = 0.013) and a higher peak diastolic blood pressure (79 ± 10 vs 74 ± 11 mmHg; p = 0.012) than those without LVH. Binary logistic regression analysis showed that diastolic blood pressure (OR 1.052; 95% CI from 1.011 to 1.130; p = 0.020) and BMI (OR 1.220; 95% CI from 1.016 to 1.465; p = 0.033) had the strongest association with LVH as categorical variable. CONCLUSIONS Our study showed that increased blood pressure at rest and during exercise, together with larger body weight, body mass and fat percentage are associated with a higher degree of LVH, which is not associated with a greater physical performance and therefore possibly disproportionate to the sport activity.
Collapse
|
19
|
Biffi A, Gallo G, Fernando F, Sirico F, Signorello MG, De Martino L, Manole GE, Palermi S, Volpe M. Relationship Between Cardiorespiratory Fitness, Baseline Blood Pressure and Hypertensive Response to Exercise in the Ferrari Corporate Population. High Blood Press Cardiovasc Prev 2021; 29:81-88. [PMID: 34822139 DOI: 10.1007/s40292-021-00491-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022] Open
Abstract
AIM To evaluate the incidence and clinical significance of impaired cardiorespiratory fitness (CRF) and the association with baseline blood pressure (BP) levels and hypertensive response to exercise (HRE). METHODS A cross-sectional study was conducted on a total sample of 2058 individuals with a mean age of 38 ± 9 years, enrolled for the first time at the Ferrari corporate wellness program "Formula Benessere", including a maximal exercise stress testing (EST). BP and heart rate (HR) values were obtained from EST at rest, during exercise and recovery time. CRF was arbitrarily classified according to estimated VO2 max in optimal, normal, mildly and moderately reduced. RESULTS One-hundred and thirty-nine individuals of 2058 (6.7%) showed a moderate CRF reduction assessed by EST. Subjects with elevated resting and/or exercise BP showed a worse CRF than those with normal BP levels, also after the adjustment for age, sex, body mass index, smoking habits, peak SBP and DBP. Seventy-seven individuals (3.7%) showed an HRE during EST, with normal baseline BP levels. CONCLUSION About 7% of a corporate population showed a significantly reduced CRF, assessed by EST. Individuals with lower levels of CRF have higher resting and/or peak exercising BP values after adjusting for co-variables. This study expands the role of EST outside of traditional ischemic CVD evaluation, towards the assessment of reduced CRF and HRE in the general population, as a possible not evaluated CV risk factor.
Collapse
Affiliation(s)
- Alessandro Biffi
- Med-Ex, Medicine and Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy
| | - Giovanna Gallo
- Cardiology Unit, Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
| | - Fredrick Fernando
- Med-Ex, Medicine and Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy
| | - Felice Sirico
- Med-Ex, Medicine and Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy
| | | | - Lorena De Martino
- Med-Ex, Medicine and Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy
| | - George Emil Manole
- Med-Ex, Medicine and Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy
| | - Stefano Palermi
- Med-Ex, Medicine and Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy
| | - Massimo Volpe
- Cardiology Unit, Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
20
|
Dutra-Marques AC, Rodrigues S, Cepeda FX, Toschi-Dias E, Rondon E, Carvalho JC, Alves MJNN, Braga AMFW, Rondon MUPB, Trombetta IC. Exaggerated Exercise Blood Pressure as a Marker of Baroreflex Dysfunction in Normotensive Metabolic Syndrome Patients. Front Neurosci 2021; 15:680195. [PMID: 34177456 PMCID: PMC8219920 DOI: 10.3389/fnins.2021.680195] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 05/03/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction Exaggerated blood pressure response to exercise (EEBP = SBP ≥ 190 mmHg for women and ≥210 mmHg for men) during cardiopulmonary exercise test (CPET) is a predictor of cardiovascular risk. Sympathetic hyperactivation and decreased baroreflex sensitivity (BRS) seem to be involved in the progression of metabolic syndrome (MetS) to cardiovascular disease. Objective To test the hypotheses: (1) MetS patients within normal clinical blood pressure (BP) may present EEBP response to maximal exercise and (2) increased muscle sympathetic nerve activity (MSNA) and reduced BRS are associated with this impairment. Methods We selected MetS (ATP III) patients with normal BP (MetS_NT, n = 27, 59.3% males, 46.1 ± 7.2 years) and a control group without MetS (C, n = 19, 48.4 ± 7.4 years). We evaluated BRS for increases (BRS+) and decreases (BRS−) in spontaneous BP and HR fluctuations, MSNA (microneurography), BP from ambulatory blood pressure monitoring (ABPM), and auscultatory BP during CPET. Results Normotensive MetS (MetS_NT) had higher body mass index and impairment in all MetS risk factors when compared to the C group. MetS_NT had higher peak systolic BP (SBP) (195 ± 17 vs. 177 ± 24 mmHg, P = 0.007) and diastolic BP (91 ± 11 vs. 79 ± 10 mmHg, P = 0.001) during CPET than C. Additionally, we found that MetS patients with normal BP had lower spontaneous BRS− (9.6 ± 3.3 vs. 12.2 ± 4.9 ms/mmHg, P = 0.044) and higher levels of MSNA (29 ± 6 vs. 18 ± 4 bursts/min, P < 0.001) compared to C. Interestingly, 10 out of 27 MetS_NT (37%) showed EEBP (MetS_NT+), whereas 2 out of 19 C (10.5%) presented (P = 0.044). The subgroup of MetS_NT with EEBP (MetS_NT+, n = 10) had similar MSNA (P = 0.437), but lower BRS+ (P = 0.039) and BRS− (P = 0.039) compared with the subgroup without EEBP (MetS_NT−, n = 17). Either office BP or BP from ABPM was similar between subgroups MetS_NT+ and MetS_NT−, regardless of EEBP response. In the MetS_NT+ subgroup, there was an association of peak SBP with BRS− (R = −0.70; P = 0.02), triglycerides with peak SBP during CPET (R = 0.66; P = 0.039), and of triglycerides with BRS− (R = 0.71; P = 0.022). Conclusion Normotensive MetS patients already presented higher peak systolic and diastolic BP during maximal exercise, in addition to sympathetic hyperactivation and decreased baroreflex sensitivity. The EEBP in MetS_NT with apparent well-controlled BP may indicate a potential depressed neural baroreflex function, predisposing these patients to increased cardiovascular risk.
Collapse
Affiliation(s)
- Akothirene C Dutra-Marques
- Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Sara Rodrigues
- Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Felipe X Cepeda
- Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Edgar Toschi-Dias
- Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.,Universidade Metodista de São Paulo, São Paulo, Brazil
| | - Eduardo Rondon
- Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Jefferson C Carvalho
- Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Maria Janieire N N Alves
- Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Ana Maria F W Braga
- Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | - Ivani C Trombetta
- Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
21
|
Mohammed LLM, Dhavale M, Abdelaal MK, Alam ABMN, Blazin T, Prajapati D, Mostafa JA. Exercise-Induced Hypertension in Healthy Individuals and Athletes: Is it an Alarming Sign? Cureus 2020; 12:e11988. [PMID: 33437543 PMCID: PMC7793423 DOI: 10.7759/cureus.11988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Exercise-induced hypertension (EIH) is defined as elevated blood pressure (BP) > 190mm Hg for females and > 210 mmHg for males during exercise. EIH is prevalent among athletes and healthy individuals with no cardiovascular (CV) risk factors. While previous data corroborates exercise in reducing hypertension and cardiovascular risk, the development of EIH and its attendant cardiovascular risk necessitates a review of the pathophysiological mechanisms resulting in EIH. To date, these mechanisms causing EIH are not fully understood, nor are there any established guidelines on the management of EIH. In this article, we discuss in detail the pathophysiological mechanisms, the prognostic value, clinical implications, possible treatment, and future directions in managing EIH.
Collapse
Affiliation(s)
- Linha Lina M Mohammed
- Miscellaneous, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Meera Dhavale
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mohamed K Abdelaal
- Surgery/General and Visceral Surgery, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - A B M Nasibul Alam
- Miscellaneous, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Tatjana Blazin
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Dhruvil Prajapati
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Jihan A Mostafa
- Psychiatry/Psychotherapy, California Institute of Behavorial Neurosciences & Psychology, Fairfield, USA
| |
Collapse
|
22
|
Kerber E, Bukowska S, Mancol F, Kosowski B, Lee SR, Teelucksingh S, Del Corral P. Increased vasoconstrictor sensitivity to glucocorticoids is associated with the exaggerated systolic blood pressure during submaximal exercise in young healthy adults. Eur J Prev Cardiol 2020; 28:e28-e31. [PMID: 33624050 DOI: 10.1093/eurjpc/zwaa055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/27/2020] [Accepted: 08/11/2020] [Indexed: 11/14/2022]
Affiliation(s)
- Erik Kerber
- Department of Biological Sciences, Benedictine University, 5700 College Rd, Lisle, IL 60532, USA
| | - Sabina Bukowska
- Department of Biological Sciences, Benedictine University, 5700 College Rd, Lisle, IL 60532, USA
| | - Faith Mancol
- Department of Biological Sciences, Benedictine University, 5700 College Rd, Lisle, IL 60532, USA
| | - Brett Kosowski
- Department of Biological Sciences, Benedictine University, 5700 College Rd, Lisle, IL 60532, USA
| | - Sang-Rok Lee
- Department of Kinesiology and Dance, New Mexico State University, 600 Stewart St, Activity Center 214, Las Cruces, NM 88003, USA
| | - Surujpal Teelucksingh
- Department of Clinical Medical Sciences, The University of The West Indies, Building 67, 2nd Floor. Eric Williams Medical Sciences Complex. Mt Hope. Trinidad. W.I
| | - Pedro Del Corral
- Department of Biological Sciences, Benedictine University, 5700 College Rd, Lisle, IL 60532, USA.,Department of Physiology and Pathology, Burrell College of Osteopathic Medicine, 3501 Arrowhead Dr., Las Cruces, NM 88001, USA
| |
Collapse
|
23
|
Watso JC, Robinson AT, Babcock MC, Migdal KU, Witman MAH, Wenner MM, Stocker SD, Farquhar WB. Short-term water deprivation attenuates the exercise pressor reflex in older female adults. Physiol Rep 2020; 8:e14581. [PMID: 32965797 PMCID: PMC7510566 DOI: 10.14814/phy2.14581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/24/2020] [Accepted: 08/28/2020] [Indexed: 12/28/2022] Open
Abstract
Older adults have reduced fluid intake and impaired body fluid and electrolyte regulation. Older female adults exhibit exaggerated exercise blood pressure (BP) responses, which is associated with an increased risk of adverse cardiovascular events. However, it is unclear if dysregulated body fluid homeostasis contributes to altered exercise BP responses in older female adults. We tested the hypothesis that short-term water deprivation (WD) increases exercise BP responses in older female adults. Fifteen female adults (eight young [25 ± 6 years] and seven older [65 ± 6 years]) completed two experimental conditions in random crossover fashion; a euhydration control condition and a stepwise reduction in water intake over three days concluding with a 16-hr WD period. During both trials, beat-to-beat BP (photoplethysmography) and heart rate (electrocardiogram) were continuously assessed during rest, handgrip exercise (30% MVC), and post-exercise ischemia (metaboreflex isolation). At screening, older compared to young female adults had greater systolic and diastolic BP (p ≤ .02). Accelerometer-assessed habitual physical activity was not different between groups (p = .65). Following WD, 24-hr urine flow rate decreased, whereas thirst, urine specific gravity, and plasma osmolality increased (condition: p < .05 for all), but these WD-induced changes were not different between age groups (interaction: p ≥ .31 for all). Resting systolic and diastolic BP values were higher in older compared to young adults (p < .01 for both), but were not different between experimental conditions (p ≥ .20). In contrast to our hypothesis, WD was associated with attenuated systolic BP responses during handgrip exercise (post hoc: p < .01) and post-exercise ischemia (post hoc: p = .03) in older, but not young, female adults. These data suggest that reduced water intake-induced challenges to body fluid homeostasis do not contribute to exaggerated exercise BP responses in post-menopausal female adults.
Collapse
Affiliation(s)
- Joseph C. Watso
- Department of Kinesiology and Applied PhysiologyUniversity of DelawareNewarkDEUSA
| | - Austin T. Robinson
- Department of Kinesiology and Applied PhysiologyUniversity of DelawareNewarkDEUSA
- School of KinesiologyNeurovascular Physiology LaboratoryAuburn UniversityAuburnALUSA
| | - Matthew C. Babcock
- Department of Kinesiology and Applied PhysiologyUniversity of DelawareNewarkDEUSA
| | - Kamila U. Migdal
- Department of Kinesiology and Applied PhysiologyUniversity of DelawareNewarkDEUSA
| | - Melissa A. H. Witman
- Department of Kinesiology and Applied PhysiologyUniversity of DelawareNewarkDEUSA
| | - Megan M. Wenner
- Department of Kinesiology and Applied PhysiologyUniversity of DelawareNewarkDEUSA
| | - Sean D. Stocker
- Department of MedicineUniversity of PittsburghPittsburghPAUSA
| | - William B. Farquhar
- Department of Kinesiology and Applied PhysiologyUniversity of DelawareNewarkDEUSA
| |
Collapse
|
24
|
Bauer P, Kraushaar L, Dörr O, Bauer T, Nef H, Hamm CW, Most A. Association of 25-hydroxy vitamin D level with the blood pressure response to a maximum exercise test among professional indoor athletes. Eur J Appl Physiol 2020; 120:1931-1941. [PMID: 32588193 PMCID: PMC7340632 DOI: 10.1007/s00421-020-04421-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 06/13/2020] [Indexed: 12/17/2022]
Abstract
Purpose Low vitamin D levels have been associated with elevated blood pressure (BP) in the general population. However, whether there is an association of vitamin D insufficiency with BP changes during maximum exercise in athletes is currently unclear.
Methods A total of 120 male professional indoor athletes (age 26 ± 5 years) were examined. BP was measured at rest and during a graded cycling test. We assessed the BP response (BPR) during maximum exercise and the respective load. BP and BPR (peak-baseline BP) were analysed with respect to 25-OH vitamin D levels, with levels < 30 ng/mL defining vitamin D insufficiency.
Results 35 athletes were classified as being vitamin D insufficient. BP was not different between sufficient and insufficient vitamin D groups (122 ± 10/75 ± 7 vs. 120 ± 12/77 ± 9 mmHg). At maximum exercise, however, systolic BP (198 ± 17 vs. 189 ± 19, p = 0.026) and the pulse pressure (118 ± 18 vs. 109 ± 21 mmHg, p = 0.021) were higher in the sufficient group; the BPR was not different between groups (76 ± 20/5 ± 6 vs. 69 ± 22/3 ± 6 mmHg, p = 0.103). Athletes with sufficient levels had a higher maximum power output (3.99 ± 0.82 vs. 3.58 ± 0.78 W/kg, p = 0.015) and achieved higher workloads (367 ± 78 vs. 333 ± 80 W, p = 0.003). The workload-adjusted BPR (maximum systolic BP/MPO) was not different between athletes with sufficient and insufficient vitamin D levels (51 ± 10 vs. 56 ± 14 mmHg × kg/W, p = 0.079).
Conclusion Athletes with sufficient vitamin D achieved a higher maximum systolic BP and a higher maximum power output. The workload-adjusted BPR was not different between groups, which suggests that this finding reflects a better performance of athletes with sufficient vitamin D.
Collapse
Affiliation(s)
- Pascal Bauer
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Giessen, Germany.
| | | | - Oliver Dörr
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Giessen, Germany
| | - Timm Bauer
- Department of Cardiology and Intensive Care Medicine, Sana Clinic Offenbach, Offenbach, Germany
| | - Holger Nef
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Giessen, Germany
| | - Christian W Hamm
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Giessen, Germany.,Department of Cardiology, Kerckhoff Clinic GmbH, Bad Nauheim, Germany
| | - Astrid Most
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Giessen, Germany
| |
Collapse
|
25
|
Costa EC, Boreskie KF, Scott Kehler D, Kent DE, Hay JL, Arora RC, Browne RAV, Duhamel TA. Immediate post-exercise blood pressure and arterial compliance in middle-aged and older normotensive females: A cross-sectional study. Sci Rep 2020; 10:9205. [PMID: 32514128 PMCID: PMC7280524 DOI: 10.1038/s41598-020-66104-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/06/2020] [Indexed: 11/16/2022] Open
Abstract
This study examined whether immediate post-exercise systolic blood pressure (SBP) is associated with arterial compliance in middle-aged and older normotensive females. A total of 548 normotensive, non-frail females aged 55 years and older with no previous history of cardiovascular disease (CVD) participated in this cross-sectional study. Large and small arterial compliance were assessed by pulse wave analysis. Reduced arterial compliance was defined based on age and sex cutoffs. SBP was measured at rest and immediately following a 3-min moderate step-test. CVD risk factors were also assessed (e.g. resting systolic and diastolic BP, fasting glucose, triglycerides, cholesterol, body mass index). A total of 15.1% and 44.0% of the participants showed reduced large and small artery compliance, respectively. Immediate post-exercise SBP was associated with reduced large (OR 1.02 per 1 mmHg increase in post-exercise SBP, 95%CI 1.01–1.04; p = 0.010) and small (OR 1.02 per 1 mmHg increase in post-exercise SBP, 95%CI 1.00–1.03; p = 0.008) arterial compliance. Participants with highest immediate post-exercise SBP (quartile 4; i.e. ≥ 165 mmHg) showed increased odds ratios for reduced large (2.67, 95%CI 1.03–6.94; p = 0.043) and small (2.27, 95%CI 1.22–4.21; p = 0.010) arterial compliance compared to those with the lowest immediate post-exercise SBP (quartile 1; i.e. ≤ 140 mmHg), independent of other established CVD risk factors. Immediate post-exercise SBP following a brief moderate step-test seems to be able to discriminate reduced arterial compliance in middle-aged and older normotensive females.
Collapse
Affiliation(s)
- Eduardo C Costa
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal, Brazil.
| | - Kevin F Boreskie
- Faculty of Kinesiology & Recreation Management, University of Manitoba, Winnipeg, Canada.,Institute of Cardiovascular Sciences, St-Boniface Hospital Albrechtsen Research Centre, Winnipeg, Canada
| | - D Scott Kehler
- Faculty of Kinesiology & Recreation Management, University of Manitoba, Winnipeg, Canada.,Institute of Cardiovascular Sciences, St-Boniface Hospital Albrechtsen Research Centre, Winnipeg, Canada.,Division of Geriatric Medicine, Dalhousie University, Halifax, Canada
| | - David E Kent
- Faculty of Kinesiology & Recreation Management, University of Manitoba, Winnipeg, Canada.,Institute of Cardiovascular Sciences, St-Boniface Hospital Albrechtsen Research Centre, Winnipeg, Canada
| | - Jacqueline L Hay
- Faculty of Kinesiology & Recreation Management, University of Manitoba, Winnipeg, Canada.,Institute of Cardiovascular Sciences, St-Boniface Hospital Albrechtsen Research Centre, Winnipeg, Canada
| | - Rakesh C Arora
- Institute of Cardiovascular Sciences, St-Boniface Hospital Albrechtsen Research Centre, Winnipeg, Canada.,Cardiac Sciences Program, St-Boniface Hospital Albrechtsen Research Centre, Winnipeg, Canada.,Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Rodrigo A V Browne
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Todd A Duhamel
- Faculty of Kinesiology & Recreation Management, University of Manitoba, Winnipeg, Canada.,Institute of Cardiovascular Sciences, St-Boniface Hospital Albrechtsen Research Centre, Winnipeg, Canada.,Cardiac Sciences Program, St-Boniface Hospital Albrechtsen Research Centre, Winnipeg, Canada
| |
Collapse
|
26
|
Delgado-Floody P, Alvarez C, Caamaño-Navarrete F, Jerez-Mayorga D, Latorre-Román P. Influence of Mediterranean diet adherence, physical activity patterns, and weight status on cardiovascular response to cardiorespiratory fitness test in Chilean school children. Nutrition 2019; 71:110621. [PMID: 31874334 DOI: 10.1016/j.nut.2019.110621] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 09/27/2019] [Accepted: 10/06/2019] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The aim of this study was to determine the association between Mediterranean diet adherence, physical activity (PA) patterns (i.e., screen time and PA after school), and weight status with the cardiovascular response following a cardiorespiratory fitness test. METHODS Participants were 605 school children: 272 girls (11.79 ± 0.93 y old) and 333 boys (12.06 ± 1.03 y old). Body mass index, waist circumference (WC), food habits, and PA patterns were evaluated. Heart rate (HR), and systolic (SBP) and diastolic (DBP) blood pressures were assessed before and immediately after the 20-m shuttle run test and the changes induced were calculated (Δ = post/pretest). RESULTS The cardiovascular response was higher in obese than normal weight and overweight children in terms of HR (P = 0.007) and SBP (P < 0.001). The ΔSBP presented inverse association with WC (β = -0.09; 95% confidence interval [CI], -0.17 to -0.01; P = 0.026), food habits (β = -0.65; 95% CI, -0.81 to -0.49; P < 0.001), PA after school (β = -7.03; 95% CI, -7.84 to -6.22; P < 0.001) and PA patterns (β = -5.96; 95% CI, -6.40 to -5.52, P < 0.001). ΔDBP was not associated with food habits or PA patterns (P > 0.005). Finally, ΔHR reported inverse association with PA patterns (β = -1.67; 95% CI, -3.18 to -0.17; P = 0.029). CONCLUSION School children with obesity showed a higher cardiovascular response in HR and SBP than normal weight and overweight peers. Moreover, the increment of the SBP presented inverse association with food habits and PA patterns.
Collapse
Affiliation(s)
- Pedro Delgado-Floody
- Department of Physical Education, Sport and Recreation, Universidad de La Frontera, Temuco, Chile.
| | - Cristian Alvarez
- Quality of Life and Wellness Research Group, Department of Physical Activity Sciences, Unniverisidad de Los Lagos, Osorno, Chile
| | - Felipe Caamaño-Navarrete
- Physical Education Pedagogy, Faculty of Education, Universidad Católica de Temuco, Temuco, Chile
| | | | - Pedro Latorre-Román
- Department of Didactics of Corporal Expression, Universidad de Jaén, Jaén, Spain
| |
Collapse
|
27
|
Kennedy CD, van Schalkwyk MCI, McKee M, Pisinger C. The cardiovascular effects of electronic cigarettes: A systematic review of experimental studies. Prev Med 2019; 127:105770. [PMID: 31344384 DOI: 10.1016/j.ypmed.2019.105770] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 06/18/2019] [Accepted: 07/12/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Smoking is responsible for substantial cardiovascular morbidity and mortality. Electronic cigarettes have been advocated as a means to reduce this disease burden; by reducing exposure to harmful substances in smokers who are unable to quit. Concerns have been raised however, about cardiovascular effects of their use, with inhalants containing carbonyls and fine particulate matter. We systematically reviewed experimental studies of in vitro, animal, and human cardiovascular effects associated with electronic cigarette use. METHODS A literature search was conducted using Ovid MEDLINE & Embase databases, identifying experimental studies investigating cardiovascular effects of electronic cigarette use. Subsequently, Cochrane Risk of Bias tools were used to assess study quality. Any differences in outcomes by conflict of interest and risk of bias status were sought. RESULTS 38 studies were included, investigating animals (n=6), humans (n=24) and human cardiovascular cells in vitro (n=8). 74.3% of studies found potentially harmful effects. Increased sympathetic nerve activity was observed in human studies, whilst platelet haemostatic processes, reactive oxygen species production and endothelial dysfunction were reported across all study types. Studies with conflicts of interest or median-high risk of bias were less likely to identify potentially harmful effects (p=0.0007, p=0.04 respectively). DISCUSSION Most studies suggest potential for cardiovascular harm from electronic cigarette use, through mechanisms that increase risk of thrombosis and atherosclerosis. Notably, studies with conflicts of interest are significantly less likely to identify concerning cardiovascular effects. Included studies examine healthy, adult participants, limiting generalisation to potential high-risk groups including individuals with established cardiovascular disease or young, non-smokers.
Collapse
Affiliation(s)
- Ciaran D Kennedy
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - May C I van Schalkwyk
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Martin McKee
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Charlotta Pisinger
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Capital Region of Denmark, Denmark; Danish Heart Foundation, Copenhagen, Denmark; University of Copenhagen, Faculty of Health and Medical Science, Denmark.
| |
Collapse
|
28
|
Currie KD, Sasson Z, Goodman JM. Vascular-ventricular coupling during exercise is not affected by exaggerated blood pressures in endurance-trained athletes. J Appl Physiol (1985) 2019; 127:753-759. [DOI: 10.1152/japplphysiol.00108.2019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
This study sought to examine whether cardiovascular performance during exercise, assessed using the vascular-ventricular coupling index (VVC), was affected by exaggerated blood pressure (EBP) responses in endurance-trained athletes. Subjects were middle-aged endurance-trained men and women. Blood pressure measurements and left ventricular echocardiography were performed in a semiupright position at rest and during steady-state cycling at workloads that elicited 100–110 beats/min ( stage 1) and 130–140 beats/min ( stage 2). These data were used to calculate effective arterial elastance index ( EaI), left ventricular end-systolic elastance index ( ELVI), and their ratio (VVC). Additional measurements of left ventricular volumes and function (i.e., stroke volume, cardiac output, and longitudinal strain) and indirect assessments of peripheral vascular function (i.e., total arterial compliance and peripheral vascular resistance) were examined. Fourteen subjects with EBP (EBP+, 50% men) and 14 sex-matched subjects without EBP (EBP−) participated, with results presented as EBP+ versus EBP−. EaI and ELVI increased from rest to exercise while VVC decreased, but only ELVI was different between groups at stage 1 [7.6 (1.8) vs. 6.4 (1.0) mmHg·ml−1·m−2, P = 0.045] and stage 2 [10.3 (1.6) vs. 8.0 (1.7) mmHg·ml−1·m−2, P < 0.001]. Additional comparisons revealed no group difference in the contribution of the Frank-Starling mechanism or left ventricular and peripheral vascular function during exercise. The cardiovascular adjustment to exercise in athletes with EBP is achieved through a matched increase in both EaI and ELVI, and the absence of between-group differences in left ventricular or peripheral vascular function suggests that other factors may contribute to the EBP response. NEW & NOTEWORTHY Cardiovascular performance during submaximal exercise, assessed using vascular-ventricular coupling, is unaffected by exaggerated blood pressure (EBP) responses in endurance-trained athletes. The underlying mechanisms of EBP in athletes remain unknown as changes in left ventricular and peripheral vascular function during exercise were similar in athletes with and without EBP.
Collapse
Affiliation(s)
- Katharine D. Currie
- Department of Kinesiology, Michigan State University, East Lansing, Michigan
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Zion Sasson
- University Health Network and Mount Sinai Hospital Division of Cardiology, Toronto, Canada
| | - Jack M. Goodman
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
- University Health Network and Mount Sinai Hospital Division of Cardiology, Toronto, Canada
| |
Collapse
|
29
|
Hydration Status and Cardiovascular Function. Nutrients 2019; 11:nu11081866. [PMID: 31405195 PMCID: PMC6723555 DOI: 10.3390/nu11081866] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 07/30/2019] [Accepted: 08/08/2019] [Indexed: 02/07/2023] Open
Abstract
Hypohydration, defined as a state of low body water, increases thirst sensations, arginine vasopressin release, and elicits renin–angiotensin–aldosterone system activation to replenish intra- and extra-cellular fluid stores. Hypohydration impairs mental and physical performance, but new evidence suggests hypohydration may also have deleterious effects on cardiovascular health. This is alarming because cardiovascular disease is the leading cause of death in the United States. Observational studies have linked habitual low water intake with increased future risk for adverse cardiovascular events. While it is currently unclear how chronic reductions in water intake may predispose individuals to greater future risk for adverse cardiovascular events, there is evidence that acute hypohydration impairs vascular function and blood pressure (BP) regulation. Specifically, acute hypohydration may reduce endothelial function, increase sympathetic nervous system activity, and worsen orthostatic tolerance. Therefore, the purpose of this review is to present the currently available evidence linking acute hypohydration with altered vascular function and BP regulation.
Collapse
|
30
|
Watso JC, Babcock MC, Robinson AT, Migdal KU, Wenner MM, Stocker SD, Farquhar WB. Water deprivation does not augment sympathetic or pressor responses to sciatic afferent nerve stimulation in rats or to static exercise in humans. J Appl Physiol (1985) 2019; 127:235-245. [PMID: 31070954 DOI: 10.1152/japplphysiol.00005.2019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Excess dietary salt intake excites central sympathetic networks, which may be related to plasma hypernatremia. Plasma hypernatremia also occurs following water deprivation (WD). The purpose of this study was to test the hypothesis that WD induces hypernatremia and consequently augments sympathetic and pressor responses to sympathoexcitatory stimuli in rats and humans. Sympathetic nerve activity (SNA) and arterial blood pressure (ABP) responses to sciatic afferent nerve stimulation (2-20 Hz) and chemical stimulation of the rostral ventrolateral medulla (RVLM) were assessed in rats after 48 h of WD and compared with normally hydrated control rats (CON). In a parallel randomized-crossover human experiment (n = 13 healthy young adults), sympathetic (microneurography) and pressor (photoplethysmography) responses to static exercise were compared between 16-h WD and CON conditions. In rats, plasma [Na+] was significantly higher in WD versus CON [136 ± 2 vs. 144 ± 2 (SD) mM, P < 0.01], but sciatic afferent nerve stimulation produced similar increases in renal SNA [5 Hz, 174 ± 34 vs. 169 ± 49% (SD), n = 6-8] and mean ABP [5 Hz, 21 ± 6 vs. 18 ± 7 (SD mmHg, n = 6-8]. RVLM injection of l-glutamate also produced similar increases in SNA and ABP in WD versus CON rats. In humans, WD increased serum [Na+] [140.6 ± 2.1 vs. 142.1 ± 1.9 mM (SD), P = 0.02] but did not augment sympathetic [muscle SNA: change from baseline (Δ) 6 ± 7 vs. 5 ± 7 (SD) bursts/min, P = 0.83] or mean ABP [Δ 12 ± 5 vs. 11 ± 8 (SD) mmHg, P = 0.73; WD vs. CON for all results] responses during the final minute of exercise. These findings suggest that despite eliciting relative hypernatremia, WD does not augment sympathetic or pressor responses to sciatic afferent stimulation in rats or to static exercise in humans. NEW & NOTEWORTHY Excess dietary salt intake excites central sympathetic networks, which may be related to plasma hypernatremia. Plasma hypernatremia also occurs following water deprivation (WD). We sought to determine whether plasma hypernatremia/hyperosmolality induced by WD augments sympathetic and pressor responses to sympathoexcitatory stimuli. Our findings suggest that WD does not augment sympathetic or pressor responses to sciatic afferent nerve stimulation in rats or to static exercise in humans.
Collapse
Affiliation(s)
- Joseph C Watso
- Department of Kinesiology and Applied Physiology, University of Delaware , Newark, Delaware
| | - Matthew C Babcock
- Department of Kinesiology and Applied Physiology, University of Delaware , Newark, Delaware
| | - Austin T Robinson
- Department of Kinesiology and Applied Physiology, University of Delaware , Newark, Delaware
| | - Kamila U Migdal
- Department of Kinesiology and Applied Physiology, University of Delaware , Newark, Delaware
| | - Megan M Wenner
- Department of Kinesiology and Applied Physiology, University of Delaware , Newark, Delaware
| | - Sean D Stocker
- Department of Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - William B Farquhar
- Department of Kinesiology and Applied Physiology, University of Delaware , Newark, Delaware
| |
Collapse
|
31
|
Migdal KU, Robinson AT, Watso JC, Babcock MC, Serrador JM, Farquhar WB. A high-salt meal does not augment blood pressure responses during maximal exercise. Appl Physiol Nutr Metab 2019; 45:123-128. [PMID: 31238011 DOI: 10.1139/apnm-2019-0217] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Augmented blood pressure (BP) responses during exercise are predictive of future cardiovascular disease. High dietary sodium (Na+) increases BP responses during static exercise. It remains unclear if high dietary Na+ augments BP responses during dynamic exercise. The purpose of this study was to test the hypothesis that an acute high-Na+ meal would augment BP responses during dynamic exercise. Twenty adults (10 male/10 female; age, 26 ± 5 years; BP, 105 ± 10/57 ± 6 mm Hg) were given a high-Na+ meal (HSM; 1495 mg Na+) and a low-Na+ meal (LSM; 138 mg Na+) separated by at least 1 week, in random order. Serum Na+ and plasma osmolality were measured. Eighty minutes following the meal, participants completed a graded-maximal exercise protocol on a cycle ergometer. Heart rate, beat-by-beat BP, cardiac output, total peripheral resistance, and manual BP were measured at rest and during exercise. Both serum Na+ (HSM: Δ1.6 ± 2.0 vs LSM: Δ1.1 ± 1.8 mmol/L, P = 0.0002) and plasma osmolality (HSM: Δ3.0 ± 4.5 vs LSM: Δ2.0 ± 4.2 mOsm/(kg·H2O), P = 0.01) were higher following the HSM. However, the HSM did not augment BP during peak exercise (systolic BP: HSM: 170 ± 23 vs LSM: 171 ± 21 mm Hg, P = 0.81). These findings suggest that an acute high-salt meal does not augment BP responses during dynamic exercise in adults. Novelty The high-salt meal increased serum sodium and plasma osmolality compared with the low-salt meal. The high-salt meal did not augment blood pressure responses during maximal dynamic exercise. This is important as augmented blood pressure responses during exercise put individuals at greater risk for development of cardiovascular disease.
Collapse
Affiliation(s)
- Kamila U Migdal
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19713, USA
| | - Austin T Robinson
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19713, USA
| | - Joseph C Watso
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19713, USA
| | - Matthew C Babcock
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19713, USA
| | - Jorge M Serrador
- Department of Pharmacology, Physiology and Neuroscience, Rutgers University, Newark, NJ 07103, USA
| | - William B Farquhar
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19713, USA
| |
Collapse
|
32
|
The Effect of 1 Week of a Multi-ingredient Dietary Preworkout Supplement on Resting and Postacute Resistance Exercise Vascular Function. Int J Sport Nutr Exerc Metab 2018; 28:611-618. [PMID: 29485323 DOI: 10.1123/ijsnem.2018-0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Dietary preworkout supplements are popular among recreational exercisers and athletes. However, the effects of these supplements on the vasculature, both at rest and during exercise, are not well studied. Therefore, the purpose of this study was to determine the effect of 1 week of supplementation with a multi-ingredient dietary preworkout supplement on measures of vascular function at rest and immediately following acute resistance exercise in young, recreationally active adults. Twelve participants (9 males and 3 females; mean ± SD: age = 24.5 ± 3.4 years and body mass index = 24.3 ± 4.7 kg/m2) completed this double-blind, randomized, crossover design study. After familiarization, participants were randomized to either a taste-matched placebo or the preworkout supplement for 1 week preceding the testing visits. Participants underwent measures of vascular function, including brachial artery flow-mediated dilation, measures of central and peripheral blood pressure, and measures of arterial stiffness via pulse wave analysis and pulse wave velocity. All measures were taken at rest and immediately following an acute bilateral leg press exercise session. Resting and postacute exercise flow-mediated dilation, blood pressure, and arterial stiffness were similar between the placebo and the preworkout supplement visits. One week of multi-ingredient preworkout supplementation does not affect vascular function at rest or in response to an acute bout of resistance exercise in young, healthy, recreationally active individuals.
Collapse
|
33
|
Mulè G, Nardi E, Lattuca L, Cottone S. Hyperuricemia and high blood pressure at rest and during exercise: Guilty or innocent? The jury is still out. J Clin Hypertens (Greenwich) 2018; 20:557-559. [PMID: 29457338 DOI: 10.1111/jch.13227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Giuseppe Mulè
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Emilio Nardi
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Luigi Lattuca
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Santina Cottone
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| |
Collapse
|
34
|
Somani YB, Baross AW, Brook RD, Milne KJ, McGowan CL, Swaine IL. Acute Response to a 2-Minute Isometric Exercise Test Predicts the Blood Pressure-Lowering Efficacy of Isometric Resistance Training in Young Adults. Am J Hypertens 2018; 31:362-368. [PMID: 29036548 DOI: 10.1093/ajh/hpx173] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 09/25/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This work aimed to explore whether different forms of a simple isometric exercise test could be used to predict the blood pressure (BP)-lowering efficacy of different types of isometric resistance training (IRT) in healthy young adults. In light of the emphasis on primary prevention of hypertension, identifying those with normal BP who will respond to IRT is important. Also, heightened BP reactivity increases hypertension risk, and as IRT reduces BP reactivity in patients with hypertension, it warrants further investigation in a healthy population. METHODS Forty-six young men and women (24 ± 5 years; 116 ± 10/ 68 ± 8 mm Hg) were recruited from 2 study sites: Windsor, Canada (n = 26; 13 women), and Northampton, United Kingdom (n = 20; 10 women). Resting BP and BP reactivity to an isometric exercise test were assessed prior to and following 10 weeks of thrice weekly IRT. Canadian participants trained on a handgrip dynamometer (isometric handgrip, IHG), while participants in the UK trained on an isometric leg extension dynamometer (ILE). RESULTS Men and women enrolled in both interventions demonstrated significant reductions in systolic BP (P < 0.001) and pulse pressure (P < 0.05). Additionally, test-induced systolic BP changes to IHG and ILE tests were associated with IHG and ILE training-induced reductions in systolic BP after 10 weeks of training, respectively (r = 0.58 and r = 0.77; for IHG and ILE; P < 0.05). CONCLUSIONS The acute BP response to an isometric exercise test appears to be a viable tool to identify individuals who may respond to traditional IRT prescription.
Collapse
Affiliation(s)
- Yasina B Somani
- Department of Kinesiology, University of Windsor, University of Windsor, Windsor, Ontario, Canada
| | - Anthony W Baross
- Department of Sport and Exercise, University of Northampton, Northampton, United Kingdom
| | - Robert D Brook
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Kevin J Milne
- Department of Kinesiology, University of Windsor, University of Windsor, Windsor, Ontario, Canada
| | - Cheri L McGowan
- Department of Kinesiology, University of Windsor, University of Windsor, Windsor, Ontario, Canada
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Ian L Swaine
- Department of Kinesiology, University of Windsor, University of Windsor, Windsor, Ontario, Canada
- Department of Life and Sport Sciences, University of Greenwich, Medway Campus, London, United Kingdom
| |
Collapse
|
35
|
Chung H, Kim JY, Lee BK, Min PK, Yoon YW, Hong BK, Rim SJ, Kwon HM, Choi EY. Arterial stiffness, sex, and age difference on hypertensive response to supine bicycle exercise. J Clin Hypertens (Greenwich) 2017; 19:1260-1268. [PMID: 29067771 DOI: 10.1111/jch.13106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/15/2017] [Accepted: 07/23/2017] [Indexed: 01/01/2023]
Abstract
Contributors to a hypertensive response to exercise (HTR) according to sex and age have not been fully evaluated. The authors analyzed a database of supine bicycle exercise stress echocardiography findings. HTR was defined as peak systolic blood pressure ≥210 mmHg for men and ≥190 mmHg for women during exercise. A total of 797 patients (306 [38%] women) were analyzed, with a mean age of 64 ± 10 years. Female sex, hypertension; higher left ventricular ejection fraction, effective arterial elastance, and pulse wave velocity; and lower total arterial compliance were significantly related to HTR. Patients with HTR had higher relative wall thickness, ratio of early diastolic mitral inflow and annular velocity, and diastolic elastance (all P ≤ .05). In multivariable analysis, indices of arterial stiffness such as pulse wave velocity, arterial elastance, total arterial compliance, and systemic vascular resistance were more strongly related in women, while in men, index of sympathetic activation was additionally related to HTR (all P ≤ .05). Female sex and lower total arterial compliance in older patients (≥65 years) and higher systemic vascular resistance and left ventricular relative wall thickness in younger patients were more strongly related to HTR. In conclusion, HTR was related to arterial stiffness, sympathetic activation, and diastolic dysfunction; however, the associations were different according to sex and age, which might guide individualized therapy.
Collapse
Affiliation(s)
- Hyemoon Chung
- Division of Cardiology, Kyung Hee University School of Medicine, Seoul, Korea.,Division of Medicine, Yonsei University Graduate School, Seoul, Korea
| | - Jong-Youn Kim
- Division of Cardiology, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Byoung Kwon Lee
- Division of Cardiology, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Pil-Ki Min
- Division of Cardiology, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young Won Yoon
- Division of Cardiology, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Bum-Kee Hong
- Division of Cardiology, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Se-Joong Rim
- Division of Cardiology, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyuck Moon Kwon
- Division of Cardiology, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eui-Young Choi
- Division of Cardiology, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
36
|
Incognito AV, Doherty CJ, Lee JB, Burns MJ, Millar PJ. Interindividual variability in muscle sympathetic responses to static handgrip in young men: evidence for sympathetic responder types? Am J Physiol Regul Integr Comp Physiol 2017; 314:R114-R121. [PMID: 29070505 DOI: 10.1152/ajpregu.00266.2017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Negative and positive muscle sympathetic nerve activity (MSNA) responders have been observed during mental stress. We hypothesized that similar MSNA response patterns could be identified during the first minute of static handgrip and contribute to the interindividual variability throughout exercise. Supine measurements of multiunit MSNA (microneurography) and continuous blood pressure (Finometer) were recorded in 29 young healthy men during the first (HG1) and second (HG2) minute of static handgrip (30% maximal voluntary contraction) and subsequent postexercise circulatory occlusion (PECO). Responders were identified on the basis of differences from the typical error of baseline total MSNA: 7 negative, 12 positive, and 10 nonresponse patterns. Positive responders demonstrated larger total MSNA responses during HG1 ( P < 0.01) and HG2 ( P < 0.0001); however, the increases in blood pressure throughout handgrip exercise were similar between all groups, as were the changes in heart rate, stroke volume, cardiac output, total vascular conductance, and respiration (all P > 0.05). Comparing negative and positive responders, total MSNA responses were similar during PECO ( P = 0.17) but opposite from HG2 to PECO (∆40 ± 46 vs. ∆-21 ± 62%, P = 0.04). Negative responders also had a shorter time-to-peak diastolic blood pressure during HG1 (20 ± 20 vs. 44 ± 14 s, P < 0.001). Total MSNA responses during HG1 were associated with responses to PECO ( r = 0.39, P < 0.05), the change from HG2 to PECO ( r = -0.49, P < 0.01), and diastolic blood pressure time to peak ( r = 0.50, P < 0.01). Overall, MSNA response patterns during the first minute of static handgrip contribute to interindividual variability and appear to be influenced by differences in central command, muscle metaboreflex activation, and rate of loading of the arterial baroreflex.
Collapse
Affiliation(s)
- Anthony V Incognito
- Department of Human Health and Nutritional Sciences, University of Guelph , Guelph, Ontario , Canada
| | - Connor J Doherty
- Department of Human Health and Nutritional Sciences, University of Guelph , Guelph, Ontario , Canada
| | - Jordan B Lee
- Department of Kinesiology, University of Guelph-Humber , Toronto, Ontario , Canada
| | - Matthew J Burns
- Department of Human Health and Nutritional Sciences, University of Guelph , Guelph, Ontario , Canada
| | - Philip J Millar
- Department of Human Health and Nutritional Sciences, University of Guelph , Guelph, Ontario , Canada.,Toronto General Research Institute , Toronto, Ontario , Canada
| |
Collapse
|
37
|
Schultz MG, La Gerche A, Sharman JE. Blood Pressure Response to Exercise and Cardiovascular Disease. Curr Hypertens Rep 2017; 19:89. [DOI: 10.1007/s11906-017-0787-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|
38
|
Keller K, Stelzer K, Ostad MA, Post F. Impact of exaggerated blood pressure response in normotensive individuals on future hypertension and prognosis: Systematic review according to PRISMA guideline. Adv Med Sci 2017; 62:317-329. [PMID: 28511070 DOI: 10.1016/j.advms.2016.11.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 09/09/2016] [Accepted: 11/29/2016] [Indexed: 11/25/2022]
Abstract
PURPOSE Arterial hypertension (aHT) is the leading risk factor for morbidity and mortality worldwide. Blood pressure (BP) deviation at rest is well defined and accompanies risk for cardiovascular events and cardiovascular mortality. A growing body of evidence emphasises that an exaggerated blood pressure response (EBPR) in cardiopulmonary exercise testing (CPET) could help to identify seemingly cardiovascular healthy and normotensive subjects, who have an increased risk of developing aHT and cardiovascular events in the future. MATERIALS AND METHODS The PubMed online database was searched for published studies reporting exercise-related BP and both the risk of aHT and cardiovascular events in the future. RESULTS We identified 18 original studies about EBPR in CPET, which included a total of 35,151 normotensive individuals for prediction of new onset of aHT in the future and 11 original studies with 43,012 enrolled subjects with the endpoint of cardiovascular events in the future. Although an EBPR under CPET is not well defined, a large number of studies emphasise that EBPR in CPET is associated with both new-onset aHT and cardiovascular events in the future. CONCLUSIONS A growing number of studies support the hypothesis that EBPR in CPET may be a diagnostic tool to identify subjects with an elevated risk of developing aHT and cardiovascular events in the future.
Collapse
|
39
|
Caldarone E, Severi P, Lombardi M, D'Emidio S, Mazza A, Bendini MG, Leggio M. Hypertensive response to exercise and exercise training in hypertension: odd couple no more. Clin Hypertens 2017; 23:11. [PMID: 28588902 PMCID: PMC5455108 DOI: 10.1186/s40885-017-0067-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 01/21/2017] [Indexed: 11/29/2022] Open
Abstract
The diagnostic and prognostic implication of exaggerated blood pressure response to exercise has been controversial, with opinions ranging from a benign process to a harbinger of potential cardiovascular morbidity. Nonetheless, lowering of blood pressure and prevention of hypertension is in first instance preferable by lifestyle changes, and many studies have shown the inverse association between physical activity level and the incidence of cardiovascular diseases suggesting low aerobic fitness as a strong predictor for future cardiovascular disease and all-cause mortality in both healthy and cardiovascular disease patients, including those with hypertension. Endothelial function, large artery stiffness and neurohormonal response are surely implicated both in the development of exaggerated blood pressure response to exercise and in the positive effect of physical exercise in the prevention and management of hypertension and cardiovascular disease in general. In their interesting and well documented review published in this issue Kim and Ha broadly described the possible pathophysiologic mechanisms of exaggerated blood pressure response to exercise and its clinical implications: in this regard, a very interesting issue could be represented by the role of exercise training. In fact, there is an the ample evidence in the literature that physical activity could positively affect endothelial function, arterial stiffness, neurohormonal response and finally blood pressure levels both in healthy men and in hypertensive patients and so should be considered a very important element in the prevention and management of cardiovascular disease.
Collapse
Affiliation(s)
- Elisa Caldarone
- Physical Medicine and Neurorehabilitation Operative Unit, Salus Infirmorum Clinic, Rome, Italy
| | - Paolo Severi
- Physical Medicine and Neurorehabilitation Operative Unit, Salus Infirmorum Clinic, Rome, Italy.,Department of Medicine and Rehabilitation, Cardiac Rehabilitation Operative Unit, San Filippo Neri Hospital - Salus Infirmorum Clinic, Via della Lucchina 41, 00135 Rome, Italy
| | - Mario Lombardi
- Physical Medicine and Neurorehabilitation Operative Unit, Salus Infirmorum Clinic, Rome, Italy
| | - Stefania D'Emidio
- Physical Medicine and Neurorehabilitation Operative Unit, Salus Infirmorum Clinic, Rome, Italy
| | - Andrea Mazza
- Cardiology Division, Santa Maria della Stella Hospital, Orvieto, Italy
| | | | - Massimo Leggio
- Department of Medicine and Rehabilitation, Cardiac Rehabilitation Operative Unit, San Filippo Neri Hospital - Salus Infirmorum Clinic, Via della Lucchina 41, 00135 Rome, Italy
| |
Collapse
|
40
|
Exaggerated blood pressure response to early stages of exercise stress testing and presence of hypertension. J Sci Med Sport 2016; 19:1039-1042. [DOI: 10.1016/j.jsams.2016.04.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 03/23/2016] [Accepted: 04/12/2016] [Indexed: 12/22/2022]
|
41
|
Hypertensive response to exercise: mechanisms and clinical implication. Clin Hypertens 2016; 22:17. [PMID: 27468357 PMCID: PMC4962449 DOI: 10.1186/s40885-016-0052-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 07/20/2016] [Indexed: 11/24/2022] Open
Abstract
A hypertensive response to exercise (HRE) is frequently observed in individuals without hypertension or other cardiovascular disease. However, mechanisms and clinical implication of HRE is not fully elucidated. Endothelial dysfunction and increased stiffness of large artery contribute to development of HRE. From neurohormonal aspects, excess stimulation of sympathetic nervous system and augmented rise of angiotensin II seems to be important mechanism in HRE. Increasing evidences indicates that a HRE is associated with functional and structural abnormalities of left ventricle, especially when accompanied by increased central blood pressure. A HRE harbors prognostic significance in future development of hypertension and increased cardiovascular events, particularly if a HRE is documented in moderate intensity of exercise. As supported by previous studies, a HRE is not a benign phenomenon, however, currently, whether to treat a HRE is controversial with uncertain treatment strategy. Considering underlying mechanisms, angiotensin receptor blockers and beta blockers can be suggested in individuals with HRE, however, evidences for efficacy and outcomes of treatment of HRE in individuals without hypertension is scarce and therefore warrants further studies.
Collapse
|
42
|
Assessment of 25-OH vitamin D levels and abnormal blood pressure response in female patients with cardiac syndrome X. Anatol J Cardiol 2016; 16:961-966. [PMID: 27271477 PMCID: PMC5324918 DOI: 10.14744/anatoljcardiol.2016.6862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objective: Vitamin D deficiency is associated with coronary artery disease, hypertension, heart failure, endothelial dysfunction, and metabolic syndrome. The pathophysiology of cardiac syndrome X (CSX) involves many pathways that are influenced by vitamin D levels. This study aimed to investigate the relationship between vitamin D deficiency and abnormal blood pressure response to exercise in patients with CSX. Methods: This was a cross-sectional and observational study. Fifty females with normal epicardial coronary arteries who presented with typical symptoms of rest or effort angina and 41 healthy age-matched female controls, were included. Patients with cardiomyopathy, severe valvular disease, congenital heart disease, and left ventricular hypertrophy were excluded. All patients underwent stress electrocardiography examination and 25-hydroxy (OH) vitamin D level measurements. Results: Levels of 25-OH vitamin D were significantly lower in CSX patients (9.8±7.3 ng/mL vs. 18.1±7.9 ng/mL; p<0.001). Systolic blood pressure (SBP) (188±15 mm Hg vs. 179±17 mm Hg; p=0.013) and diastolic blood pressure (DBP) (98±9 mm Hg vs. 88±9 mm Hg; p<0.001) during peak exercise were higher in CSX patients. Levels of 25-OH vitamin D were negatively correlated with peak SBP (r=–0.310, p=0.004) and peak DBP (r=–0.535, p<0.001) during exercise. To discard the multicollinearity problem, two different models were used for multivariate analyses. In the first model, metabolic equivalents (METs) (p=0.003) and 25-OH vitamin D levels (p=0.001) were independent predictors. METs (p=0.007), 25-OH vitamin D levels (p=0.008), and peak DBP were determined as independent predictors in the second multivariate model. Conclusion: In patients with CSX, 25-OH vitamin D levels were lower than those in controls; moreover, 25-OH vitamin D deficiency was also associated with higher levels of peak DBP during exercise. (Anatol J Cardiol 2016; 16: 961-6)
Collapse
|
43
|
Oh DJ, Hong HO, Lee BA. The effects of strenuous exercises on resting heart rate, blood pressure, and maximal oxygen uptake. J Exerc Rehabil 2016; 12:42-6. [PMID: 26933659 PMCID: PMC4771152 DOI: 10.12965/jer.150258] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 02/02/2016] [Indexed: 01/01/2023] Open
Abstract
The purpose of this study is to investigate the effects of strenuous exercises on resting heart rate, blood pressure, and maximal oxygen uptake. To achieve the purpose of the study, a total of 30 subjects were selected, including 15 people who performed continued regular exercises and 15 people as the control group. With regard to data processing, the IBM SPSS Statistics ver. 21.0 was used to calculate the mean and standard deviation. The difference of mean change between groups was verified through an independent t-test. As a result, there were significant differences in resting heart rate, maximal heart rate, maximal systolic blood pressure, and maximal oxygen uptake. However, the maximal systolic blood pressure was found to be an exercise-induced high blood pressure. Thus, it is thought that a risk diagnosis for it through a regular exercise stress test is necessary.
Collapse
Affiliation(s)
- Deuk-Ja Oh
- Department of Physical Education, College of Education, Pusan National University, Busan, Korea
| | - Hyeon-Ok Hong
- Department of Social Sports, Dong Eui Institute of Technology, Busan, Korea
| | - Bo-Ae Lee
- Department of Physical Education, College of Education, Pusan National University, Busan, Korea
| |
Collapse
|
44
|
Doumas M, Faselis C, Kokkinos P. Exaggerated Blood Pressure Response to Exercise: Will It Ever Be Ready for Prime Time? J Clin Hypertens (Greenwich) 2015; 17:845-7. [PMID: 26234157 DOI: 10.1111/jch.12630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Michael Doumas
- Department of Veterans Affairs and George Washington University, Washington, DC
| | - Charles Faselis
- Department of Veterans Affairs and George Washington University, Washington, DC
| | - Peter Kokkinos
- Department of Veterans Affairs and George Washington University, Washington, DC
| |
Collapse
|