EXERCISE HEART RATE DURING TREADMILL TEST IS RELATED TO RENAL FUNCTIONAL RESERVE IN ESSENTIAL HYPERTENSIVE PATIENTS

Background: Renal functional reserve (RFR), defined as the difference between stress and resting glomerular filtration rate (GFR), may constitute a diagnostic tool to identify patients at higher risk of developing acute kidney injury or chronic kidney disease. Blunted RFR has been demonstrated in early stages of hypertension and has been attributed to impaired vascular reactivity due to an overactive sympathetic nervous system (SNS). Objective: The purpose of this study was to investigate whether RFR correlates with other phenotypes expressing overactivity of the SNS in patients with essential hypertension and preserved renal function. Methods: Thirty-six patients with untreated essential hypertension and a GFR >60 mL/min/1.73 m2 were enrolled. The following parameters were measured: RFR, 24-h ambulatory blood pressure (BP) profile, a treadmill stress test, and an echocardiographic examination. Urine and venous samples were obtained at specific time points for the determination of clinical parameters, and both resting and stress GFR were calculated by using endogenous creatinine clearance for the measurement of RFR after an acute oral protein load (1 g/kg). Results: Twenty-one patients had a RFR <30 mL/min/1.73 m2 and 15 had a RFR above this cutoff. A nondipping pattern of 24-h BP was significantly more frequent in patients with low RFR (57.1 vs. 25.0%, p < 0.05 for systolic BP and 52.3 vs. 10.0%, p < 0.02 for diastolic BP). Moreover, patients with lower RFR values showed a blunted heart rate (HR) response to exercise during treadmill test (r = 0.439, p < 0.05). None of the echocardiographic parameters differed between the two groups of patients. Conclusions: In hypertensive patients with preserved GFR, reduced RFR is related to nondipping BP phenotype as well as to attenuated exercise HR response. Overactivity of the SNS may be a common pathway. Since loss of RFR may represent a risk factor for acute or chronic kidney injury, hypertensive patients with blunted RFR might need a more careful renal follow-up.

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RENAL FUNCTIONAL RESERVE IS RELATED TO THE NON-DIPPING PHENOTYPE AND TO THE EXERCISE HEART RATE RESPONSE IN PATIENTS WITH ESSENTIAL HYPERTESION AND A PRESERVED RENAL FUNCTION

Journal of Hypertension ◽

10.1097/01.hjh.0000744724.05067.da ◽

2021 ◽

Vol 39 (Supplement 1) ◽

pp. e34-e35

Author(s):

Katerina Damianaki ◽

Michel Burnier ◽

Constantinos Tsioufis ◽

Kyriakos Dimitriadis ◽

Demetrios Vlahakos ◽

...

Keyword(s):

Heart Rate ◽

Renal Function ◽

Heart Rate Response ◽

Exercise Heart Rate ◽

Functional Reserve ◽

Renal Functional Reserve

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Effects of Labetalol on Systemic and Pulmonary Haemodynamics at Rest and during Exercise in Hypertensive Patients

Clinical Science ◽

10.1042/cs055279s ◽

1978 ◽

Vol 55 (s4) ◽

pp. 279s-281s

Author(s):

R. Fagard ◽

A. Amery ◽

T. Reybrouck ◽

P. Lijnen ◽

L. Billiet

Keyword(s):

Heart Rate ◽

Brachial Artery ◽

Maximal Exercise ◽

Peripheral Resistance ◽

Plasma Renin ◽

Exercise Heart Rate ◽

Plasma Aldosterone Concentration ◽

Hypertensive Patients ◽

Artery Pressure ◽

Pulmonary Haemodynamics

1. Labetalol was administered to 18 hypertensive patients for an average duration of 2·44 weeks, with an average final daily dose of 1·65 g. 2. Labetalol decreased resting heart rate by 16% and maximal exercise heart rate by 21%; the phenylephrine-induced rise of systolic brachial artery pressure was reduced by 36%. 3. During labetalol brachial artery pressure was lowered by 29/15 mmHg in the recumbent position, by 41/23 mmHg at rest sitting, and by 53/23 mmHg at maximal exercise; total peripheral resistance was not significantly affected at rest recumbent, but was reduced at sitting and at exercise; cardiac output decreased in all conditions. 4. Labetalol reduced mean pulmonary artery and capillary wedge pressures only in the sitting position. Pulmonary vascular resistance remained unchanged. 5. The drug produced significant decreases of plasma renin activity and of plasma aldosterone concentration.

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Effects of Felodipine on Rest and Exercise Heart Rate and Blood Pressure in Hypertensive Patients

Drugs ◽

10.2165/00003495-198500292-00026 ◽

1985 ◽

Vol 29 (Supplement 2) ◽

pp. 154-164 ◽

Cited By ~ 8

Author(s):

A. Ross Lorimer ◽

Howard M. McAlpine ◽

Alan P. Rae ◽

Ian A. Simpson ◽

Maureen P. Barbour ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Exercise Heart Rate ◽

Hypertensive Patients ◽

Rest And Exercise

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COMPARATIVE TEST OF HEART RATE EVOLUTION BETWEEN TWO GROUPS OF UNTRAINED MEN AND WOMEN

Discobolul – Physical Education, Sport and Kinetotherapy Journal ◽

10.35189/dpeskj.2020.59.4.12 ◽

2020 ◽

pp. 472-483

Keyword(s):

Heart Rate ◽

Training Programme ◽

Individual Performance ◽

Exercise Heart Rate ◽

Female Group ◽

Resting Heart Rate ◽

Treadmill Test ◽

Men And Women ◽

Fitness Assessment ◽

Training Protocol

We developed a fitness assessment test battery to help evaluate individual performance in untrained individuals. In the current paper, we will discuss how the heart rate has evolved in two groups of men and women over a period of 120 days, during which the subjects followed a standardised training protocol. For our research, we monitored the heart rate of each subject during a standardised treadmill test. We used a test that we developed especially for untrained individuals, which required them to walk on a treadmill with a 15% incline for 10 minutes, at a constant speed of 5 km/h. We tested the subjects on days 1, 60 and 120. After conducting our experiment, we found a decrease in resting heart rate of 6.4 beats per minute in men and 3.4 beats per minute in women. Exercise heart rate recorded a drop of 9.4 beats per minute in the male group and 8.8 beats per minute in the female group throughout the 120 days of the training programme. We noted that the group of men recorded a greater improvement in resting heart rate than the group of women, with a difference of 4.84%, while exercise heart rate had almost similar values, with a difference of only 0.03% between the two groups at the end of the 120 days of the test period.

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Effects of initial treatment on the dynamics of renal functional reserve in stage-I hypertensive patients

Journal of Clinical Medicine of Kazakhstan ◽

10.23950/1812-2892-jcmk-00560 ◽

2018 ◽

Vol 2 (48) ◽

pp. 33-40

Author(s):

Lyudmila Khimion ◽

Lilia Tymoshchuk ◽

Mariia Rybytska

Keyword(s):

Initial Treatment ◽

Stage I ◽

Functional Reserve ◽

Hypertensive Patients ◽

Renal Functional Reserve

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Renal functional reserve in patients with essential hypertension: Effect of inhibition of the renin-angiotensin system

Clinical Science ◽

10.1042/cs0780585 ◽

1990 ◽

Vol 78 (6) ◽

pp. 585-590 ◽

Cited By ~ 9

Author(s):

Enrico Valvo ◽

Patrizia Casagrande ◽

Valeria Bedogna ◽

Francesca Dal Santo ◽

Daniele Alberti ◽

...

Keyword(s):

Blood Pressure ◽

Filtration Rate ◽

Urinary Albumin Excretion ◽

Urinary Albumin ◽

Converting Enzyme ◽

Functional Reserve ◽

Hypertensive Patients ◽

Renal Functional Reserve ◽

Albumin Excretion ◽

Protein Load

1. Urinary albumin excretion and the effect of an acute oral protein load (a meat meal) on glomerular filtration rate ('renal functional reserve') were evaluated in 15 essential hypertensive patients with preserved renal function and compared with 12 normal subjects. 2. Seven patients had microalbuminuria (>30 mg/day) that was not correlated with blood pressure values. 3. After an oral protein load, an average increase of 20% in glomerular filtration rate (from 91 ± 19 to 110 ± 27 ml min−1 1.73 m−2) was found in the hypertensive patients. This change was not statistically different from that observed in normal controls (from 102 ± 7 to 124 ± 9 ml min−1 1.73 m−2). The glomerular response in hypertensive patients was independent of age, duration of hypertension, blood pressure, plasma renin activity, urinary albumin excretion and retinal vascular alterations. 4. All patients were re-evaluated after 6 weeks treatment with a new orally active angiotensin-converting enzyme inhibitor, benazepril. Systolic, diastolic and mean blood pressures were lowered in all the patients, but the drug did not affect the glomerular response to acute protein ingestion or the magnitude of urinary albumin excretion. 5. The findings of a normal ‘renal functional reserve’ and a lack of change in both urinary albumin excretion and the glomerular response after angiotensin-converting enzyme inhibition cast doubt on the existence of increased intraglomerular pressure in hypertensive patients.

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