Abstract
PurposeLow vitamin D levels have been associated with elevated blood pressure (BP) in the general population. However, whether there is an association of vitamin D insufficiency with BP changes during maximum exercise in athletes is currently unclear.MethodsA total of 120 male professional indoor athletes (age 26 ± 5 years) were examined. BP was measured at rest and during a graded cycling test. We assessed the BP response (BPR) during maximum exercise and the respective load. BP and BPR (peak-baseline BP) were analysed with respect to 25-OH vitamin D levels, with levels < 30 ng/mL defining vitamin D insufficiency.Results35 athletes were classified as being vitamin D insufficient. BP was not different between sufficient and insufficient vitamin D groups (122 ± 10/75 ± 7 vs. 120 ± 12/77 ± 9 mmHg). At maximum exercise, however, systolic BP (198 ± 17 vs. 189 ± 19, p = 0.026) and the pulse pressure (118 ± 18 vs. 109 ± 21 mmHg, p = 0.021) were higher in the sufficient group; the BPR was not different between groups (76 ± 20/5 ± 6 vs. 69 ± 22/3 ± 6 mmHg, p = 0.103). Athletes with sufficient levels had a higher maximum power output (3.99 ± 0.82 vs. 3.58 ± 0.78 W/kg, p = 0.015) and achieved higher workloads (367 ± 78 vs. 333 ± 80 W, p = 0.003). The workload-adjusted BPR (maximum systolic BP/MPO) was not different between athletes with sufficient and insufficient vitamin D levels (51 ± 10 vs. 56 ± 14 mmHg × kg/W, p = 0.079).ConclusionAthletes with sufficient vitamin D achieved a higher maximum systolic BP and a higher maximum power output. The workload-adjusted BPR was not different between groups, which suggests that this finding reflects a better performance of athletes with sufficient vitamin D.
Highlights
Insufficiency and deficiency of 25-OH vitamin D have been shown to be associated with arterial hypertension (Kunutsor et al 2013; Wang 2016), increased cardiovascular events, impaired vascular function (Al Mheid et al 2011), and even cardiovascular mortality (Wang 2016; Anderson et al 2010; Vimaleswaran et al 2014)
Our main findings are that athletes with sufficient vitamin D levels displayed a higher maximum systolic blood pressure (BP) and maximum pulse pressure during exercise compared with athletes with insufficient vitamin D levels
The BP increases during exercise (BPR) and the workload-adjusted BP response (BPR) were not different between the sufficient and insufficient groups, indicating that the higher maximum systolic BP in sufficient athletes was caused by the better maximum power output (MPO)
Summary
Insufficiency and deficiency of 25-OH vitamin D have been shown to be associated with arterial hypertension (Kunutsor et al 2013; Wang 2016), increased cardiovascular events, impaired vascular function (Al Mheid et al 2011), and even cardiovascular mortality (Wang 2016; Anderson et al 2010; Vimaleswaran et al 2014). Healthy individuals with normal blood pressure (BP) at rest but an exaggerated BP response (BPR) during exercise are at higher risk of developing arterial hypertension (Lewis et al 2008; Holmqvist et al 2012). Recommendations for athletes are absent in both guidelines, yet recently published studies proposed different thresholds for defining an exaggerated BPR to exercise (Caselli et al 2019; Pressler et al 2018). A higher exercise-induced BP response in athletes was explained as representing a superior exercise performance compared with that of the general population (Caselli et al 2016). The clinical relevance of “exaggerated” exercise-induced BP in athletes is currently unclear, a higher risk for development of arterial hypertension in these athletes was suggested (Caselli et al 2019). An exaggerated BPR to exercise testing was associated with a higher prevalence of myocardial fibrosis (Tahir et al 2018), raising concerns about potential arrhythmic consequences, including sudden cardiac death (Zorzi et al 2016)
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