Physical exercise at low altitude as lifestyle change relationship with pulse pressure and rate–pressure product in hypertensive patients

Vasodilator drugs reduce peripheral vascular resistance but lead to a secondary baroreflex-mediated chronotropic effect. After angiotensin-converting enzyme inhibition, blood pressure falls without associated tachycardia. In a previous study it was observed that enalapril increased vagal tone in essential hypertensive patients. In order to evaluate the effect of enalapril on sympathetic stimulation 10 mild to moderate hypertensive patients were studied during static (hand grip) and dynamic exercise (bicycle ergometer), after 2 weeks of placebo and after 1 month of treatment with 20–40 mg enalapril once daily. Enalapril significantly reduced blood pressure and the rate–pressure product at rest and at peak dynamic exercise. There was no effect on supine and maximal heart rate. Enalapril also significantly reduced blood pressure during hand grip, but did not interfere with the rate of the increase. Thus, enalapril does not seem to interfere with sympathetic adaptation to stress.

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Parameters of arterial stiffness in hypertensive patients with and without subclinical carotid atherosclerosis

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2021-27-4-427-435 ◽

2021 ◽

Vol 27 (4) ◽

pp. 427-435

Author(s):

V. E. Gumerova ◽

S. A. Sayganov ◽

V. V. Gomonova

Keyword(s):

Arterial Stiffness ◽

Pulse Pressure ◽

Augmentation Index ◽

Subclinical Atherosclerosis ◽

Stiffness Index ◽

Control Group ◽

Hypertensive Patients ◽

Significant Difference ◽

Arterial Stiffness Index ◽

Plaque Detection

Objective. To assess the relationship between arterial stiffness parameters in hypertensive patients with and without atherosclerotic lesions.Design and methods. We included 127 subjects who were divided into 3 groups: patients with hypertension (HTN) without atherosclerosis (n = 42); patients with HTN and subclinical atherosclerosis (SА) (n = 52) and control group which consisted of individuals without HTN, SA, or coronary artery disease (n = 33). All groups matched by age and gender. All subjects underwent following examinations: ultrasonography of extracranial segments of carotid arteries, 24-hour blood pressure monitoring with the assessment of arterial stiffness parameters.Results. In subjects with HTN compared to controls, pulse wave velocity in aorta (PWVao) was significantly higher (11,3 ± 1,5; 12,3 ± 1,8 vs 10,4 ± 1,3 m/s; p < 0,05), as well as pulse pressure (PP) (46,4 ± 9,8; 45,6 ± 10,6 vs 39,9 ± 6,5 mmHg; p < 0,05), central pulse pressure (PPао) (35,5 ± 8,5; 34,9 ± 8,5 vs 30,9 ± 5,4 mmHg; p < 0,05), and arterial stiffness index (ASI) (141 (127, 159); 139 (128,5, 160,5) vs 126 (118, 138) mmHg; p < 0,05). In subjects with HTN and SA, PWVao was significantly higher compared to other groups (p < 0,05). No significant difference in augmentation index was found (–32,5 (–45, –12); –22 (–36, –12); –37 (–50, –17); p = 0,25). Аmbulatory arterial stiffness index was higher in controls (0,5 ± 0,2) compared to HTN group (0,4 ± 0,2; p = 0,05), while HTN and SA group did not differ significantly (0,5 ± 0,2; p = 0,3). PWVao above 11,15 m/s is associated with 4,3 (2,3–8,2) times higher rate of atherosclerosis plaque detection.Conclusions. In HTN patients, arterial stiffness is changed compared to healthy individuals. PWVao above 11,15 m/s is associated with 4,3 (2,3–8,2) times higher rate of atherosclerosis plaque detection. In patients with HTN and SA arterial stiffness is higher, which might have additional predictive value in risk stratification.

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Plasma cyclic nucleotides and plasma catecholamines before and after prolonged treatment with clonidine in hypertensive patients

Acta Endocrinologica ◽

10.1530/acta.0.0970405 ◽

1981 ◽

Vol 97 (3) ◽

pp. 405-411 ◽

Cited By ~ 3

Author(s):

Per Manhem ◽

Lise Heding ◽

Jörgen Malmquist ◽

Bernt Hökfelt

Keyword(s):

Physical Exercise ◽

Supine Position ◽

Cyclic Nucleotides ◽

Plasma Catecholamines ◽

Prolonged Treatment ◽

Hypertensive Patients ◽

Noradrenaline Concentration ◽

Before And After ◽

Plasma Camp ◽

Response To Exercise

Abstract. The effect of standing and physical exercise on catecholamines and cyclic nucleotides in plasma was measured in 8 patients with essential hypertension under standardized conditions before and after prolonged treatment with clonidine. Before clonidine medication noradrenaline, adrenaline and cyclic AMP (cAMP) increased in response to standing and bicycling for 20 min. No significant correlation was found between their absolute levels nor was the increase in cAMP following exercise correlated to the increase in noradrenaline. Standing and physical exercise were without effect on cyclic GMP (cGMP). Clonidine reduced the plasma noradrenaline concentration in supine position and the noradrenaline and the adrenaline response to standing and exercise. Plasma cAMP was uneffected by clonidine under basal conditions but the response to exercise was slightly reduced initially. During clonidine there was a positive correlation between the plasma levels of cAMP and noradrenaline following work. Clonidine produced an increase in plasma cGMP in supine position, immediately prior to bicycling and after 5 min of exercise.

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