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Relations of exercise blood pressure response to cardiovascular risk factors and vascular function in the Framingham Heart Study. Circulation 2012 Jun 12;125(23):2836-43

Date

05/11/2012

Pubmed ID

22572915

Pubmed Central ID

PMC3636551

DOI

10.1161/CIRCULATIONAHA.111.063933

Scopus ID

2-s2.0-84862131572   87 Citations

Abstract

BACKGROUND: Exercise blood pressure (BP) is an important marker of left ventricular hypertrophy, incident hypertension, and future cardiovascular events. Although impaired vascular function is hypothesized to influence the BP response during exercise, limited data exist on the association of vascular function with exercise BP in the community.

METHODS AND RESULTS: Framingham Offspring cohort participants (n=2115, 53% women, mean age 59 years) underwent a submaximal exercise test (first 2 stages of the Bruce protocol), applanation tonometry, and brachial artery flow-mediated dilation testing. We related exercise systolic and diastolic BP at second stage of the Bruce protocol to standard cardiovascular risk factors and to vascular function measures. In multivariable linear regression models, exercise systolic BP was positively related to age, standing BP, standing heart rate, smoking, body mass index, and the total cholesterol-to-high-density cholesterol ratio (P≤0.01 for all). Similar associations were observed for exercise diastolic BP. Carotid-femoral pulse wave velocity (P=0.02), central pulse pressure (P<0.0001), mean arterial pressure (P=0.04), and baseline brachial flow (P=0.002) were positively associated with exercise systolic BP, whereas flow-mediated dilation was negatively associated (P<0.001). For exercise diastolic BP, forward pressure wave amplitude was negatively related (P<0.0001), whereas mean arterial pressure was positively related (P<0.0001).

CONCLUSIONS: Increased arterial stiffness and impaired endothelial function are significant correlates of a higher exercise systolic BP response. Our findings suggest that impaired vascular function may contribute to exaggerated BP responses during daily living, resulting in repetitive increments in load on the heart and vessels and increased cardiovascular disease risk.

Author List

Thanassoulis G, Lyass A, Benjamin EJ, Larson MG, Vita JA, Levy D, Hamburg NM, Widlansky ME, O'Donnell CJ, Mitchell GF, Vasan RS

Author

Michael E. Widlansky MD Associate Director, Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Blood Flow Velocity
Blood Pressure
Brachial Artery
Cohort Studies
Exercise
Exercise Test
Female
Humans
Hypertension
Hypertrophy, Left Ventricular
Male
Manometry
Massachusetts
Middle Aged
Multivariate Analysis
Risk Factors
Ultrasonography
Vascular Stiffness
jenkins-FCD Prod-484 8aa07fc50b7f6d102f3dda2f4c7056ff84294d1d