Cor Vasa 2015, 57(3):e163-e167 | DOI: 10.1016/j.crvasa.2015.03.010
The determinants of blood pressure response to exercise
- III. interní klinika - klinika endokrinologie a metabolismu, 1. lékařská fakulta Univerzity Karlovy a Všeobecná fakultní nemocnice, Praha, Česká republika
Introduction: There is currently no consensus on the definition of normal BP (blood pressure) increase during exercise and thus of the exaggerated BP response to exercise. The aim of the present study was a description of the relationship between BP and work rate corrected by body weight on cycle ergometer. A secondary objective was to explore the possible components of this relationship.
Materials and methods: An observational study with retrospective analysis of the BP data acquired during standard stress tests on cycle ergometer was performed. For the analysis each work rate was expressed corrected to the patient's body weight.
Results: We analysed BP data from a total of 313 stress tests. From the linear regression analysis we found that at the first exercise step systolic BP depends primarily on resting BP (p = 0.001), on W/kg (p = 0.001), on BMI (p = 0.005) and age (p = 0.002) (BP = 25.059 + 0.927*BPrest + 31.625*W/kg1 + 0.840*BMI + 0.235*age) and diastolic BP depends primarily on resting BP (p = 0.001), and on resting diastolic BP (p = 0.033): BP = 29.790 + 0.583*BPrest + 0.071*BPrest. On subsequent steps age did no more influence systolic BP and resting diastolic BP remained the main determinant of diastolic BP.
Conclusion: The main finding of this study is the confirmation that the exercise blood pressure depends principally on resting blood pressure and work rate and to a lesser amount on BMI and age. In future studies work rate should be corrected by body weight at submaximal levels.
Keywords: Exercise blood pressure; Exercise stress test; Test protocol
Received: January 7, 2015; Revised: March 13, 2015; Accepted: March 14, 2015; Published: June 1, 2015 Show citation
References
- J. Perk, G. De Backer, H. Gohlke, et al., European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts), European Heart Journal 33 (2012) 1635-1701.
Go to original source...
Go to PubMed...
- K. Wasserman, J.E. Hansen, D.Y. Sue, et al., Principles of Exercise Testing and Interpretation. Lippincott Williams and Wilkins, Philadelphia, 2012.
- D.L. Smith and B. Fernhall, Advances Cardiovascular Exercise Physiology. Advanced Exercise Physiology Series. Human Kinetics, United States of America, 2011.
- G. Mancia, R. Fagard, K. Narkiewicz, et al., 2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology/ESC), Journal of Hypertension 31 (2013) 1281-1357.
Go to original source...
Go to PubMed...
- J.P. Singh, M.G. Larson, T.A. Manolio, et al., Blood pressure response during treadmill testing as a risk factor for new-onset hypertension. The Framingham heart study, Circulation 99 (1999) 1831-1836.
Go to original source...
- N. Miyai, M. Arita, I. Morioka, et al., Exercise BP response in subjects with high-normal BP: exaggerated blood pressure response to exercise and risk of future hypertension in subjects with high-normal blood pressure, Journal of the American College of Cardiology 36 (2000) 1626-1631.
Go to original source...
Go to PubMed...
- M.C. Sieira, A.O. Ricart, R.S. Estrany, Blood pressure response to exercise testing, Apunts Medicine de l'Esport 45 (2010) 191-200.
Go to original source...
- J. Filipovsky, P. Ducimetiere, M.E. Safar, Prognostic significance of exercise blood pressure and heart rate in middle-aged men, Hypertension 20 (1992) 333-339.
Go to original source...
- J.A. Laukkanen, S. Kurl, R. Rauramaa, et al., Systolic blood pressure response to exercise testing is related to the risk of acute myocardial infarction in middle-aged men, European Journal of Cardiovascular Prevention and Rehabilitation 13 (2006) 421-428.
Go to original source...
- R.G. Smith, S.A. Rubin, M.H. Ellestad, Exercise hypertension: an adverse prognosis?, Journal of the American Society of Hypertension 3 (2009) 366-373.
Go to original source...
Go to PubMed...
- M.P. Gupta, S. Polena, N. Coplan, et al., Prognostic significance of systolic blood pressure increases in men during exercise stress testing, American Journal of Cardiology 100 (2007) 1609-1613.
Go to original source...
Go to PubMed...
- C.E. Matthews, R.R. Pate, K.L. Jackson, et al., Exaggerated blood pressure response to dynamic exercise and risk of future hypertension, Journal of Clinical Epidemiology 51 (1998) 29-35.
Go to original source...
- J.O. Zanettini, J. Pisani Zanettini, M.T. Zanettini, et al., Correction of the hypertensive response in the treadmill testing by the work performance improves the prediction of hypertension by ambulatory blood pressure monitoring and incidence of cardiac abnormalities by echocardiography: results of an eight year follow-up study, International Journal of Cardiology 141 (2010) 243-249.
Go to original source...
Go to PubMed...
- M. Máček, J. Radvanský, et al., Fyziologie a klinické aspekty pohybové aktivity. Galén, Praha, 2011.
- V. Chaloupka, Zátěžové testy v kardiologii - Zátěžová elektrokardiografie, Cor et Vasa 42 (2000) K54-K56.
- M. Albaghdadi, Baroreflex control of long-term arterial pressure, Revista Brasileira de Hipertensão 14 (2007) 212-225.
- M.W. Brands, Chronic blood pressure control, Comprehensive Physiology 2 (2012) 2481-2494.
Go to original source...
Go to PubMed...
- N.M. Kaplan, Kaplan's Clinical Hypertension. Lippincott Williams and Wilkins, Philadelphia, 2006.
- V.F. Froelicher, J. Myers, Exercise and the Heart. Saunders Elsevier, Philadelphia, 2006.
- N. Tzemos, P.O. Lim, T.M. MacDonald, Exercise blood pressure and endothelial dysfunction in hypertension, International Journal of Clinical Practice 63 (2009) 202-206.
Go to original source...
Go to PubMed...
- Y. Higashi, M. Yoshizumi, Exercise and endothelial function: role of endothelium-derived nitric oxide and oxidative stress in healthy subjects and hypertensive patients, Pharmacology & Therapeutics 102 (2004) 87-96.
Go to original source...
Go to PubMed...
- R. Mundal, S.E. Kjeldsen, L. Sandvik, et al., Exercise blood pressure predicts cardiovascular mortality in middle-aged men, Hypertension 24 (1994) 56-62.
Go to original source...