scholarly journals Sex differences in workload-indexed blood pressure response and vascular function among professional athletes and their utility for clinical exercise testing

2021 ◽  
Author(s):  
Pascal Bauer ◽  
Lutz Kraushaar ◽  
Oliver Dörr ◽  
Holger Nef ◽  
Christian W. Hamm ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sex Differences ◽  
Vascular Function ◽  
Blood Pressure Response ◽  
Pressure Response ◽  
Peak Exercise ◽  
Male Athletes ◽  
Relationship Of ◽  
Response To Exercise ◽  
The Relationship

Abstract Purpose Sex differences in blood pressure (BP) regulation at rest have been attributed to differences in vascular function. Further, arterial stiffness predicts an exaggerated blood pressure response to exercise (BPR) in healthy young adults. However, the relationship of vascular function to the workload-indexed BPR and potential sex differences in athletes are unknown. Methods We examined 47 male (21.6 ± 1.7 years) and 25 female (21.1 ± 2 years) athletes in this single-center pilot study. We assessed vascular function at rest, including systolic blood pressure (SBP). Further, we determined the SBP/W slope, the SBP/MET slope, and the SBP/W ratio at peak exercise during cycling ergometry. Results Male athletes had a lower central diastolic blood pressure (57 ± 9.5 vs. 67 ± 9.5 mmHg, p < 0.001) but a higher central pulse pressure (37 ± 6.5 vs. 29 ± 4.7 mmHg, p < 0.001), maximum SBP (202 ± 20 vs. 177 ± 15 mmHg, p < 0.001), and ΔSBP (78 ± 19 vs. 58 ± 14 mmHg, p < 0.001) than females. Total vascular resistance (1293 ± 318 vs. 1218 ± 341 dyn*s/cm5, p = 0.369), pulse wave velocity (6.2 ± 0.85 vs. 5.9 ± 0.58 m/s, p = 0.079), BP at rest (125 ± 10/76 ± 7 vs. 120 ± 11/73.5 ± 8 mmHg, p > 0.05), and the SBP/MET slope (5.7 ± 1.8 vs. 5.1 ± 1.6 mmHg/MET, p = 0.158) were not different. The SBP/W slope (0.34 ± 0.12 vs. 0.53 ± 0.19 mmHg/W) and the peak SBP/W ratio (0.61 ± 0.12 vs. 0.95 ± 0.17 mmHg/W) were markedly lower in males than in females (p < 0.001). Conclusion Male athletes displayed a lower SBP/W slope and peak SBP/W ratio than females, whereas the SBP/MET slope was not different between the sexes. Vascular functional parameters were not able to predict the workload-indexed BPR in males and females.

scholarly journals Lifestyle modifications to attenuate the exaggerated blood pressure response to exercise in men

2021 ◽  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Sex Differences ◽  
Blood Pressure Response ◽  
Pressure Response ◽  
Peak Exercise ◽  
Prior History ◽  
Lifestyle Modifications ◽  
Blood Pressure Elevation ◽  
Response To Exercise

The blood pressure response to physical activities is an essential contributor to ambulatory blood pressure and a risk factor for future cardiovascular disease. Peak exercise blood pressure and the blood pressure elevation from rest to peak exercise are higher in apparently healthy men without a prior history of hypertension than in their female peers. Lifestyle modifications can decrease blood pressure during aerobic and resistance exercise. However, there may be sex differences in the effects of lifestyle modifications on blood pressure responses to exercise. Additionally, the optimal blood pressure interventions probably differ between men and women due to sex differences in lifestyles. In men, hypertension not only increases the risk of cardiovascular disease but also worsens quality of life by contributing to erectile dysfunction. Further studies are warranted to attenuate the exaggerated blood pressure response to exercise in men.

Relationship of ambulatory arterial stiffness index with blood pressure response to exercise in the early stages of hypertension

2010 ◽  
Vol 15 (3) ◽  
pp. 132-138 ◽  
Author(s):  
Dimitris Tsiachris ◽  
Costas Tsioufis ◽  
Kyriakos Dimitriadis ◽  
Peter Kokkinos ◽  
Charles Faselis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Blood Pressure Response ◽  
Pressure Response ◽  
Stiffness Index ◽  
Early Stages ◽  
Arterial Stiffness Index ◽  
Relationship Of ◽  
Response To Exercise

Metabolic syndrome and exaggerated blood pressure response to exercise in newly diagnosed hypertensive patients

2011 ◽  
Vol 19 (3) ◽  
pp. 467-473 ◽  
Author(s):  
Costas Tsioufis ◽  
Alexandros Kasiakogias ◽  
Dimitris Tsiachris ◽  
Athanasios Kordalis ◽  
Costas Thomopoulos ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Blood Pressure Response ◽  
Pressure Response ◽  
Peak Exercise ◽  
Diabetic Patients ◽  
Newly Diagnosed ◽  
Hypertensive Patients ◽  
Response To Exercise ◽  
The Impact

Background: Running evidence supports a prognostic value of an exaggerated blood pressure response to exercise (EBPR). The impact of the metabolic syndrome (MS) on EBPR in hypertensive patients has not been investigated. Design: A cross-sectional study in the setting of an outpatient hypertension clinic. Methods: In total, 325 non-diabetic patients with newly diagnosed hypertension were divided into two groups based on the presence ( n = 95) or absence ( n = 230) of the MS as defined with NCEP-ATP III criteria. All subjects underwent ambulatory blood pressure monitoring, echocardiography and exercise treadmill testing. Results: Hypertensive patients with MS exhibited higher prevalence of EBPR (by 17%, p = 0.002) and peak exercise systolic BP (by 10.4 mmHg, p = 0.001) irrespectively of confounders. Metabolic equivalents were higher in hypertensives with MS (by 0.6 ml/kg/min, p = 0.048), but the difference lost significance after adjusting for confounders, including body mass index. Logistic regression analysis identified the MS as an independent predictor of an EBPR ( p = 0.016). Hypertensive patients with MS had a 2.3-fold risk of exhibiting EBPR compared to those without MS. However, individual components of MS altogether as well as each one separately failed to predict EBPR. Conclusions: Presence of MS in newly diagnosed hypertensive patients is associated with increased peak exercise BP and a higher frequency of EBPR over and above its separate elements.

6075Workload adjusted blood pressure response rather than peak systolic blood pressure is associated with increased all-cause mortality in males; results from 7097 treadmill exercise tests

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Hedman ◽  
N Cauwenberghs ◽  
J W Christle ◽  
A M Tun ◽  
T Kuznetsova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiac Output ◽  
Systolic Blood Pressure ◽  
Blood Pressure Response ◽  
Pressure Response ◽  
Peak Exercise ◽  
Exercise Tests ◽  
Hazard Ratios ◽  
All Cause Mortality ◽  
Response To Exercise

Abstract Background Systolic blood pressure (SBP) is routinely measured during exercise testing (ET) and is in part determined by cardiac output and peripheral vascular resistance. A frequently used threshold for defining hypertensive response to exercise is ≥210 mmHg but this does not account for the fact that SBP is related to workload, via cardiac output. Purpose To examine the prognostic implications of considering external workload (METs) adjusted SBP response to exercise. Methods We reviewed all symptom-limited treadmill ET in males between 1987 and 2007 at a single centre (inclusion/exclusion criteria detailed in figure 1A). SBP was measured standing at rest and at peak exercise. Workload adjusted BP response with exercise (SBP/MET slope) was calculated as ΔSBP/ΔMET. METs were calculated from peak speed and grade according to the standard American College of Sports Medicine (ACSM) formula. Age-predicted peak METs was calculated as: 18 - 0.15 × age. Ten-year Cox proportional hazard ratios (HR) with 95% confidence intervals were calculated and adjusted as outlined in figure 1B. Results 7097 subjects were included, of which 1559 (22%) died within 10 years. Survivors were younger (57.2±10.6 y vs. 64.5±10.3 y, p<0.001) and reached higher % of age-predicted METs (97±33% vs. 82±33%, p<0.001). Survivors had higher peak SBP (181±26 vs. 176±27 mmHg, p<0.001) as well as greater ΔSBP (49±22 vs. 42±22 mmHg, p<0.001), while they had lower SBP/MET slope (7.0±4.4 vs. 8.9±6.5 mmHg/MET, p<0.001). A peak SBP ≥210 mmHg was associated with better survival; 10-yr adjusted HR: 0.76 (0.64–0.88, p<0.001). In contrast, a higher SBP/MET slope was associated with increased mortality (table 1). Table 1. Ten year adjusted hazard ratios Variable HR (95% CI) P Variable HR (95% CI) P Variable HR (95% CI) P Peak SBP, Q1: 100–159 mmHg REF REF Delta SBP, Q1: 1–29 mmHg REF REF SBP/MET slope, Q1: 0.2–4.2 REF REF Peak SBP, Q2: 160–179 mmHg 0.81 (0.71–0.94) 0.006 Delta SBP, Q2: 30–46 mmHg 0.80 (0.70–0.91) 0.001 SBP/MET slope, Q2: 4.3–6.2 0.95 (0.81–1.12) 0.562 Peak SBP, Q3: 180–199 mmHg 0.68 (0.58–0.78) <0.001 Delta SBP, Q3: 47–61 mmHg 0.76 (0.66–0.88) <0.001 SBP/MET slope, Q3: 6.2–9.1 1.18 (1.01–1.37) 0.032 Peak SBP, Q4: ≥200 mmHg 0.60 (0.51–0.69) <0.001 Delta SBP, Q4: ≥62 mmHg 0.59 (0.50–0.69) <0.001 SBP/MET slope, Q4: ≥9.1 1.40 (1.22– 1.62) <0.001 HR, hazard ratio (adjusted according to figure 1B); SBP, systolic blood pressure; MET, metabolic equivalent of task; Q1–Q4, quartiles (Q1 as reference). Figure 1 Conclusion Workload adjusted blood pressure response to exercise in contrast to peak BP response was associated with increased mortality in male patients referred for ET. Of note, reaching a BP of at least 210 mmHg (suggested to define a hypertensive response to exercise) was associated with a 24% reduction in all-cause mortality. Acknowledgement/Funding K Hedman was supported by post-doc. grants from the Fulbright Commission, the Swedish Society of Medicine, County Council of Östergötland, Sweden

Exaggerated blood pressure response to exercise in athletes

2012 ◽  
Vol 17 (5) ◽  
pp. 184-192 ◽  
Author(s):  
Julie Turmel ◽  
Valérie Bougault ◽  
Louis-Philippe Boulet ◽  
Paul Poirier
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Response ◽  
Pressure Response ◽  
Response To Exercise

Physiological characteristics and hormonal profile of young normotensive men with exaggerated blood pressure response to exercise

1997 ◽  
Vol 17 (1) ◽  
pp. 1-18 ◽  
Author(s):  
K. Nazar ◽  
H. Kaciuba-Uscilko ◽  
W. Ziemba ◽  
H. Krysztofiak ◽  
E. Wójcik-Ziólkowska ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Response ◽  
Pressure Response ◽  
Physiological Characteristics ◽  
Hormonal Profile ◽  
Response To Exercise
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