Exaggerated blood pressure response to exercise is associated with arterial stiffening in pre-hypertensive patients

Abstract

Kyungdon Ryu, Young-Sub Byun, Byoung Kwon Lee, Choong-Won Goh, Kun-Joo Rhee. Inje University Sanggye Paik Hospital, Yonsei University Gangnam Severance Hospital Background: Individuals with a systolic BP of 120 to 139 mmHg or a diastolic BP of 80 to 89 mmHg should be considered as pre-hypertensive. however limited evidence exists on whether the early drug intervention is needed according to identification of other cardiovascular risk factors except diabetes. Aortic pulse wave velocity (PWV) as an index of aortic stiffening is known recently as a new predictor for future cardiovascular events. We examined the relation between PWV and blood pressure response during exercise in the patients with pre-hypertension, because exaggerated blood pressure response during exercise even in asymptomatic normotensive individuals is associated with other established cardiovascular risk factors. Methods: 96 consecutive patients with pre-hypertension were monitored during symptom-limited incremental exercise testing with treadmill. Cuff blood pressure was measured every minute during exercise testing with automatic indirect manometer. Results: Although there were no significant differences in diastolic blood pressure at rest and at the peak exercise between the patients with high PWV ( 15% higher than age-matched average value, nZ39) and those with low PWV(<15% than average value, nZ57), the former reached a higher systolic blood pressure at peak exercise (194.7 28.7 versus 170.0 25.3 mmHg, PZ0.021). However, there were no differences in the age, sex, total cholesterol, and glucose between two groups. Conclusion: We found that those with high PWV had significantly higher systolic blood pressure response during exercise than those without high PWV among the patients with pre-hypertension. This suggests strongly that a high PWV in pre-hypertension is associated with greater likelihood of developing hypertensive complications and may be an important factor in early evaluation of pre-hypertension related to target organ damage.