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Exaggerated exercise blood pressure is related to impaired endothelial vasodilator function.
Am J Hypertens. 2004 Apr; 17(4):314-20.AJ

Abstract

BACKGROUND

Persons with high normal blood pressure (BP) or mild hypertension who also have an exaggerated BP response to exercise are at risk for worsening hypertension. The mechanisms that explain this relationship are unknown. We examined the relationships of endothelial vasodilator function and of aortic stiffness with exercise BP.

METHODS

Subjects were 38 men and 44 women, aged 55 to 75 years, with untreated high normal BP or mild hypertension but otherwise healthy. Exercise was performed on a treadmill. Endothelial vasodilator function was assessed as brachial artery flow-mediated vasodilation (FMD) during reactive hyperemia. Aortic stiffness was measured as pulse wave velocity (PWV).

RESULTS

Among men, resting systolic BP explained 34% of the variance (P < .01) in maximal exercise systolic BP and FMD explained an additional 11% (P < .01); resting systolic BP explained 23% of the variance in maximal pulse pressure (PP) (P < .01), and FMD explained an additional 10% (P < .01). Among women, resting systolic BP was the only independent correlate of maximal systolic BP (R2 = 0.12, P < .03) and FMD correlated negatively with maximal PP (R2 = 0.12, P < .03). Among men, FMD was the only independent correlate of the difference between resting and maximal systolic BP (R2 = 0.20, P < .02). The FMD was the only independent correlate of the difference between resting and maximal PP among men (R2 = 0.17, P < .03) and among women (R2 = 0.12, P < .03). The PWV did not correlate with exercise BP responses.

CONCLUSIONS

These results suggest that impaired endothelial vasodilator function may be a mechanism contributing to exercise hypertension and may also be one link between exaggerated exercise BP and worsening hypertension.

Authors+Show Affiliations

Department of Medicine, Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland 21224, USA. kstewart@mail.jhmi.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15062884

Citation

Stewart, Kerry J., et al. "Exaggerated Exercise Blood Pressure Is Related to Impaired Endothelial Vasodilator Function." American Journal of Hypertension, vol. 17, no. 4, 2004, pp. 314-20.
Stewart KJ, Sung J, Silber HA, et al. Exaggerated exercise blood pressure is related to impaired endothelial vasodilator function. Am J Hypertens. 2004;17(4):314-20.
Stewart, K. J., Sung, J., Silber, H. A., Fleg, J. L., Kelemen, M. D., Turner, K. L., Bacher, A. C., Dobrosielski, D. A., DeRegis, J. R., Shapiro, E. P., & Ouyang, P. (2004). Exaggerated exercise blood pressure is related to impaired endothelial vasodilator function. American Journal of Hypertension, 17(4), 314-20.
Stewart KJ, et al. Exaggerated Exercise Blood Pressure Is Related to Impaired Endothelial Vasodilator Function. Am J Hypertens. 2004;17(4):314-20. PubMed PMID: 15062884.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exaggerated exercise blood pressure is related to impaired endothelial vasodilator function. AU - Stewart,Kerry J, AU - Sung,Jidong, AU - Silber,Harry A, AU - Fleg,Jerome L, AU - Kelemen,Mark D, AU - Turner,Katherine L, AU - Bacher,Anita C, AU - Dobrosielski,Devon A, AU - DeRegis,James R, AU - Shapiro,Edward P, AU - Ouyang,Pamela, PY - 2003/01/13/received PY - 2003/02/20/revised PY - 2003/06/11/accepted PY - 2004/4/6/pubmed PY - 2004/11/9/medline PY - 2004/4/6/entrez SP - 314 EP - 20 JF - American journal of hypertension JO - Am. J. Hypertens. VL - 17 IS - 4 N2 - BACKGROUND: Persons with high normal blood pressure (BP) or mild hypertension who also have an exaggerated BP response to exercise are at risk for worsening hypertension. The mechanisms that explain this relationship are unknown. We examined the relationships of endothelial vasodilator function and of aortic stiffness with exercise BP. METHODS: Subjects were 38 men and 44 women, aged 55 to 75 years, with untreated high normal BP or mild hypertension but otherwise healthy. Exercise was performed on a treadmill. Endothelial vasodilator function was assessed as brachial artery flow-mediated vasodilation (FMD) during reactive hyperemia. Aortic stiffness was measured as pulse wave velocity (PWV). RESULTS: Among men, resting systolic BP explained 34% of the variance (P < .01) in maximal exercise systolic BP and FMD explained an additional 11% (P < .01); resting systolic BP explained 23% of the variance in maximal pulse pressure (PP) (P < .01), and FMD explained an additional 10% (P < .01). Among women, resting systolic BP was the only independent correlate of maximal systolic BP (R2 = 0.12, P < .03) and FMD correlated negatively with maximal PP (R2 = 0.12, P < .03). Among men, FMD was the only independent correlate of the difference between resting and maximal systolic BP (R2 = 0.20, P < .02). The FMD was the only independent correlate of the difference between resting and maximal PP among men (R2 = 0.17, P < .03) and among women (R2 = 0.12, P < .03). The PWV did not correlate with exercise BP responses. CONCLUSIONS: These results suggest that impaired endothelial vasodilator function may be a mechanism contributing to exercise hypertension and may also be one link between exaggerated exercise BP and worsening hypertension. SN - 0895-7061 UR - https://www.unboundmedicine.com/medline/citation/15062884/Exaggerated_exercise_blood_pressure_is_related_to_impaired_endothelial_vasodilator_function_ L2 - https://academic.oup.com/ajh/article-lookup/doi/10.1016/S0895-7061(03)01003-3 DB - PRIME DP - Unbound Medicine ER -