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Ghidoni C, van der Stouwe JG, Würzburger L, Wiech P, Vontobel J, Bohm P, Moser G, Petrasch G, Rossi VA, Schmied CM, Caselli S, Niederseer D. Blood pressure response during exercise testing in individuals with and without hypertension: The value of the recovery phase. Eur J Clin Invest 2024:e14285. [PMID: 38994816 DOI: 10.1111/eci.14285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 06/28/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Hypertension and exercise testing are essential for cardiovascular risk assessment. However, an exact description of blood pressure (BP) in patients with a hypertensive response during exercise (HRE), especially in the recovery phase is lacking. Herein, we aimed to analyse BP and heart rate during exercise testing and recovery in patients with an HRE. METHODS 800 patients aged 17-90 with an HRE during a standardized bicycle ergometry test were recruited. The BP behaviour during exercise testing was correlated with clinical data. Furthermore, data were analysed according to the presence of pre-existent hypertension. RESULTS Of the 800 patients included in this study 497 (62%) were previously diagnosed with hypertension. Analysis of covariance showed a significantly faster systolic (β [95% CI] 8.0 [4.9-11.1]) and diastolic (2.4 [0.4-4.4]) BP recovery 3 min after maximal exercise in patients without hypertension in univariable models. These results remained robust in fully adjusted models taking into account age, sex, body mass index, cardiovascular disease, and antihypertensive treatment for systolic (5.3 [1.2-9.4]) and diastolic BP (4.5 [1.9-7.0]). Furthermore, patients with hypertension displayed higher systolic BP during maximal exercise in univariable (3.8 [0.1-7.5]) and fully adjusted (5.5 [1.1-10.0]) models. There was no difference in maximum diastolic BP between groups. CONCLUSION In this large cohort study, patients without hypertension showed a faster systolic and diastolic BP recovery and lower maximal systolic BP compared to patients with hypertension. Overall, this study provides new insights into cardiovascular health during recovery phase.
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Affiliation(s)
- Céline Ghidoni
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jan Gerrit van der Stouwe
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Cardiology, University Hospital Basel, Basel, Switzerland
| | - Laura Würzburger
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Patrick Wiech
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jan Vontobel
- Department of Cardiology, Hochgebirgsklinik Davos, Medicine Campus Davos, Davos, Switzerland
| | - Philipp Bohm
- Department of Cardiology, Hochgebirgsklinik Davos, Medicine Campus Davos, Davos, Switzerland
| | - Georg Moser
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Gloria Petrasch
- Department of Cardiology, Hochgebirgsklinik Davos, Medicine Campus Davos, Davos, Switzerland
| | - Valentina A Rossi
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christian M Schmied
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Herzgefaesszentrum Im Park, Hirslanden Klinik Im Park, Zurich, Switzerland
| | - Stefano Caselli
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Herzgefaesszentrum Im Park, Hirslanden Klinik Im Park, Zurich, Switzerland
| | - David Niederseer
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Cardiology, Hochgebirgsklinik Davos, Medicine Campus Davos, Davos, Switzerland
- Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
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Gaudron PD, Liu D, Scholz F, Hu K, Florescu C, Herrmann S, Bijnens B, Ertl G, Störk S, Weidemann F. The septal bulge--an early echocardiographic sign in hypertensive heart disease. ACTA ACUST UNITED AC 2015; 10:70-80. [PMID: 26850524 DOI: 10.1016/j.jash.2015.11.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 11/04/2015] [Accepted: 11/11/2015] [Indexed: 10/22/2022]
Abstract
Patients in the early stage of hypertensive heart disease tend to have normal echocardiographic findings. The aim of this study was to investigate whether pathology-specific echocardiographic morphologic and functional parameters can help to detect subclinical hypertensive heart disease. One hundred ten consecutive patients without a history and medication for arterial hypertension (AH) or other cardiac diseases were enrolled. Standard echocardiography and two-dimensional speckle-tracking-imaging analysis were performed. Resting blood pressure (BP) measurement, cycle ergometer test (CET), and 24-hour ambulatory BP monitoring (ABPM) were conducted. Patients were referred to "septal bulge (SB)" group (basal-septal wall thickness ≥ 2 mm thicker than mid-septal wall thickness) or "no-SB" group. Echocardiographic SB was found in 48 (43.6%) of 110 patients. In this SB group, 38 (79.2%) patients showed AH either by CET or ABPM. In contrast, in the no-SB group (n = 62), 59 (95.2%) patients had no positive test for AH by CET or ABPM. When AH was solely defined by resting BP, SB was a reasonable predictive sign for AH (sensitivity 73%, specificity 76%). However, when AH was confirmed by CET or ABPM the echocardiographic SB strongly predicted clinical AH (sensitivity 93%, specificity 86%). In addition, regional myocardial deformation of the basal-septum in SB group was significantly lower than in no-SB group (14 ± 4% vs. 17 ± 4%; P < .001). In conclusion, SB is a morphologic echocardiographic sign for early hypertensive heart disease. Sophisticated BP evaluation including resting BP, ABPM, and CET should be performed in all patients with an accidental finding of a SB in echocardiography.
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Affiliation(s)
- Philipp Daniel Gaudron
- Department of Internal Medicine I, University of Würzburg, Bavaria, Germany; Comprehensive Heart Failure Center, University of Würzburg, Bavaria, Germany
| | - Dan Liu
- Department of Internal Medicine I, University of Würzburg, Bavaria, Germany; Comprehensive Heart Failure Center, University of Würzburg, Bavaria, Germany
| | - Friederike Scholz
- Department of Internal Medicine I, University of Würzburg, Bavaria, Germany
| | - Kai Hu
- Department of Internal Medicine I, University of Würzburg, Bavaria, Germany; Comprehensive Heart Failure Center, University of Würzburg, Bavaria, Germany
| | | | - Sebastian Herrmann
- Department of Internal Medicine I, University of Würzburg, Bavaria, Germany; Comprehensive Heart Failure Center, University of Würzburg, Bavaria, Germany
| | - Bart Bijnens
- ICREA, Universitat Pompeu Fabra, Barcelona, Spain; Department of Cardiovascular Diseases, K.U. Leuven, Belgium
| | - Georg Ertl
- Department of Internal Medicine I, University of Würzburg, Bavaria, Germany; Comprehensive Heart Failure Center, University of Würzburg, Bavaria, Germany
| | - Stefan Störk
- Department of Internal Medicine I, University of Würzburg, Bavaria, Germany; Comprehensive Heart Failure Center, University of Würzburg, Bavaria, Germany
| | - Frank Weidemann
- Department of Internal Medicine I, University of Würzburg, Bavaria, Germany; Comprehensive Heart Failure Center, University of Würzburg, Bavaria, Germany; Medical Clinic II, Katharinen-Hospital, Unna, Germany.
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Liantonio A, Camerino GM, Scaramuzzi A, Cannone M, Pierno S, De Bellis M, Conte E, Fraysse B, Tricarico D, Conte Camerino D. Calcium homeostasis is altered in skeletal muscle of spontaneously hypertensive rats: cytofluorimetric and gene expression analysis. THE AMERICAN JOURNAL OF PATHOLOGY 2014; 184:2803-15. [PMID: 25084345 DOI: 10.1016/j.ajpath.2014.06.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 06/11/2014] [Accepted: 06/17/2014] [Indexed: 11/25/2022]
Abstract
Hypertension is often associated with skeletal muscle pathological conditions related to function and metabolism. The mechanisms underlying the development of these pathological conditions remain undefined. Because calcium homeostasis is a biomarker of muscle function, we assessed whether it is altered in hypertensive muscles. We measured resting intracellular calcium and store-operated calcium entry (SOCE) in fast- and slow-twitch muscle fibers from normotensive Wistar-Kyoto rats and spontaneously hypertensive rats (SHRs) by cytofluorimetric technique and determined the expression of SOCE gene machinery by real-time PCR. Hypertension caused a phenotype-dependent dysregulation of calcium homeostasis; the resting intracellular calcium of extensor digitorum longus and soleus muscles of SHRs were differently altered with respect to the related muscle of normotensive animals. In addition, soleus muscles of SHR showed reduced activity of the sarcoplasmic reticulum and decreased sarcolemmal calcium permeability at rest and after SOCE activation. Accordingly, we found an alteration of the expression levels of some SOCE components, such as stromal interaction molecule 1, calcium release-activated calcium modulator 1, and transient receptor potential canonical 1. The hypertension-induced alterations of calcium homeostasis in the soleus muscle of SHRs occurred with changes of some functional outcomes as excitability and resting chloride conductance. We provide suitable targets for therapeutic interventions aimed at counterbalancing muscle performance decline in hypertension, and propose the reported calcium-dependent parameters as indexes to predict how the antihypertensive drugs could influence muscle function.
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Affiliation(s)
- Antonella Liantonio
- Section of Pharmacology, Department of Pharmacy-Drug Sciences, University of Bari, Bari, Italy.
| | - Giulia M Camerino
- Section of Pharmacology, Department of Pharmacy-Drug Sciences, University of Bari, Bari, Italy
| | - Antonia Scaramuzzi
- Section of Pharmacology, Department of Pharmacy-Drug Sciences, University of Bari, Bari, Italy
| | - Maria Cannone
- Section of Pharmacology, Department of Pharmacy-Drug Sciences, University of Bari, Bari, Italy
| | - Sabata Pierno
- Section of Pharmacology, Department of Pharmacy-Drug Sciences, University of Bari, Bari, Italy
| | - Michela De Bellis
- Section of Pharmacology, Department of Pharmacy-Drug Sciences, University of Bari, Bari, Italy
| | - Elena Conte
- Section of Pharmacology, Department of Pharmacy-Drug Sciences, University of Bari, Bari, Italy
| | - Bodvael Fraysse
- INRA UMR703, LUNAM Université, Oniris, École Nationale Vétérinaire, Agro-Alimentaire et de l'Alimentation Nantes-Atlantique, Nantes, France
| | - Domenico Tricarico
- Section of Pharmacology, Department of Pharmacy-Drug Sciences, University of Bari, Bari, Italy
| | - Diana Conte Camerino
- Section of Pharmacology, Department of Pharmacy-Drug Sciences, University of Bari, Bari, Italy
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