Differences in blood pressure and heart rate response to exercise stress test between white coat and established hypertensives

AbstractBackground and Aims: Autonomic dysfunction in type 2 diabetes mellitus (DM) patients may translate into an increased cardiovascular morbidity and mortality. Autonomic system regulates ‘heart rate recovery’ (HRR), an important predictor of cardiovascular mortality, which can be assessed using the exercise electrocardiogram (ECG). Hence, utilizing HRR, this study assessed the autonomic function of the cardiovascular system after one minute of exercise stress test in both, patients with and without type 2 DM.Materials and Methods: A prospective case control study involving 50 patients with type 2 DM and 50 without type 2 DM, matched for age and sex, was carried out. Each subject underwent an exercise stress test by treadmill using the Bruce protocol. Cardiovascular parameters like heart rate was recorded using a 12 lead ECG along with blood pressure.Results: Patients with T2DM had lesser HRR after exercise (p < 0.001). Exercise capacity was significantly reduced among patients with T2DM when compared to controls (p = 0.01). A multiple linear regression analysis (R2=0.26) revealed that duration of diabetes (β=−0.02, p=0.048) and resting systolic blood pressure (SBP) (β=−010, p=0.048) are independent predictors of HRR.Conclusion: The study revealed HRR to be significantly reduced among patients with type 2 DM. HRR may hint at the presence of cardiac autonomic dysfunction and predict the cardiovascular mortality.

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Non-Hypertensive Patients with Prolonged P-Wave Indices Have Higher Blood Pressure Response to Exercise Stress Test

Journal of Arrhythmia ◽

10.4020/jhrs.27.pe3_002 ◽

2011 ◽

Vol 27 (Supplement) ◽

pp. PE3_002

Author(s):

Regina C. Yao ◽

Jansen R. Mancera ◽

Marcellus Francis Ramirez

Keyword(s):

Blood Pressure ◽

Blood Pressure Response ◽

Stress Test ◽

Exercise Stress Test ◽

Pressure Response ◽

P Wave ◽

Exercise Stress ◽

Hypertensive Patients ◽

Response To Exercise

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Safety and feasibility of regadenoson use for suboptimal heart rate response during symptom-limited standard Bruce exercise stress test

Journal of Nuclear Cardiology ◽

10.1007/s12350-012-9562-5 ◽

2012 ◽

Vol 19 (5) ◽

pp. 970-978 ◽

Cited By ~ 25

Author(s):

Sara L. Partington ◽

Viswanatha Lanka ◽

Jon Hainer ◽

Ron Blankstein ◽

Hicham Skali ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Response ◽

Stress Test ◽

Exercise Stress Test ◽

Exercise Stress

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Exercise Hypertension – A Review

Swiss Sports & Exercise Medicine ◽

10.34045/ssem/2019/14 ◽

2019 ◽

Vol 67 (2) ◽

Keyword(s):

Blood Pressure ◽

Maximal Exercise ◽

Blood Pressure Response ◽

Stress Test ◽

Prognostic Significance ◽

Exercise Stress Test ◽

Exercise Stress ◽

Different Populations ◽

Definition Of ◽

Response To Exercise

The actual significance and definition of hypertensive response to exercise (HRE) is still debated. Up to now, there is consensus in defining it as a systolic blood pressure value of either ≥ 210 mmHg in men and ≥ 190 mmHg in women or a diastolic blood pressure ≥ 110 mmHg during maximal exercise stress test. The mechanisms underlying an exaggerated blood pressure response to exercise are poorly understood; however, there are studies suggesting that HRE may represent a preclinical stadium of essential hypertension, which shares several common pathological mechanisms mostly related to an endothelial dysfunction and vascular stiffness. In this article we review the present knowledge with particular respect to prognostic significance and diagnostic and therapeutic strategies in different populations. A separate section is dedicated to athletes with HRE.

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Associations of the work duration, sleep duration and number of holidays with an exaggerated blood pressure response during an exercise stress test among workers

SANGYO EISEIGAKU ZASSHI ◽

10.1539/sangyoeisei.b15021 ◽

2016 ◽

Vol 58 (1) ◽

pp. 11-20 ◽

Cited By ~ 2

Author(s):

Ryoma Michishita ◽

Masanori Ohta ◽

Masaharu Ikeda ◽

Ying Jiang ◽

Hiroshi Yamato

Keyword(s):

Blood Pressure ◽

Sleep Duration ◽

Blood Pressure Response ◽

Stress Test ◽

Exercise Stress Test ◽

Pressure Response ◽

Exercise Stress ◽

Work Duration

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Effects of Atorvastatin on Resting and Peak Exercise Blood Pressure among Normotensive Men and Women

Cholesterol ◽

10.1155/2014/720507 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Amanda L. Zaleski ◽

Marianne L. Mentch ◽

Linda S. Pescatello ◽

Beth A. Taylor ◽

Jeffrey A. Capizzi ◽

...

Keyword(s):

Blood Pressure ◽

Stress Test ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Exercise Stress Test ◽

Total Sample ◽

Exercise Stress ◽

Peak Exercise ◽

Exercise Blood Pressure ◽

Double Blinded

Statins are the most widely prescribed and effective medication for reducing low density lipoprotein cholesterol. Statins may also lower resting blood pressure (BP); however, results are inconsistent. We sought to determine if the maximum dose of atorvastatin reduces resting BP and the peak systolic BP (SBP) achieved on a graded exercise stress test (GEST) among a large sample of 419 healthy men (48%) and women (52%). Subjects (419, 44.1±0.8 yr) were double-blinded and randomized to 80 mg·d−1 of atorvastatin (n=202) or placebo (n=217) for 6 mo. Among the total sample, there were no differences in resting BP (SBP, P=0.30; diastolic BP [DBP], P=0.69; mean arterial pressure (P=0.76); or peak SBP on a GEST (P=0.99)) over 6 mo, regardless of drug treatment group. However, among women on atorvastatin, resting SBP/DBP (3.7±1.5 mmHg, P=0.01/3.2±0.9 mmHg, P=0.02) and peak SBP on a GEST (6.5±1.5 mmHg, P=0.04) were lower versus men. Atorvastatin lowered resting BP 3-4 mmHg and peak SBP on a GEST ~7 mmHg more among women than men over 6 mo of treatment. The inconsistent findings regarding the antihypertensive effects of statins may be partially explained by not accounting for sex effects.

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