Abstract
Objective: To investigate if an exaggerated peak exercise systolic blood pressure (peak ESBP) is associated with alteration of cardiometabolic risk factors and predict future resting hypertension in middle aged women. Methods: Data analysis was performed in 95 healthy normotensive premeno-pausal women at baseline and 84 after 5-year follow-up (age, 49.9 ± 1.9 years; BMI, 23.3 ± 2.2 kg/m2; resting BP, 117/73 ± 11.8/7.6 mmHg). Blood pressure was measured at rest and during a progressive exercise test on treadmill. Women were divided into two groups according to their peak ESBP <190 mmHg vs. ≥190 mmHg. Other outcome measures were: cardiorespiratory fitness (VO2 peak), body composition, body fat distribution and fasting plasma lipids, glucose and insulin levels. Results: 15% and 27% of women presented an exaggerated peak ESBP response (≥190 mmHg) at baseline and year 5 respectively. Linear mixed model repeated measures analysis revealed higher values of fasting glucose, resting systolic and diastolic BP in women with an exaggerated peak ESBP (≥190 mmHg) compared to women with a peak ESBP (<190 mmHg). No significant difference was observed between the two groups for VO2 peak, body composition and body fat distribution indices and other cardiometabolic risk factors. Finally, baseline peak ESBP was not a significant risk factor for future resting hypertension (OR: 2.96, 95%CI [0.48 - 18.12]; P = 0.24). Conclusion: Our results, despite being non significant, are of great interest because in healthy and active premenopausal women, exaggerated peak ESBP is not predictive of future hypertension after 5-year follow-up throughout menopause transition.
Highlights
Hypertension (HT) is one of the major risk factors for cardiovascular diseases (CVD) [1]
Because none of the participants presented an exaggerated peak EDBP, we focused only on exaggerated peak ESBP
There were no significant differences in the women characteristics and cardiometabolic risk factors between the original cohort and the sub-sample
Summary
Hypertension (HT) is one of the major risk factors for cardiovascular diseases (CVD) [1]. An exaggerated peak exercise blood pressure (peak EBP) is defined as an abnormally elevated systolic (S) and/or diastolic (D) BP response during exercise testing in individuals with a normal resting BP [6]. Exaggerate EBP response is diagnosed when peak ESBP is ≥190 and/or peak EDBP ≥ 105 mmHg in women and peak ESBP ≥ 210 and/or peak EDBP ≥ 105 mmHg in men [7] [8]. This phenotype has been suggested to be a risk factor for future development of HT at rest in asymptomatic individuals [9] [10]. The most common are high values of resting systolic and diastolic BP [6] [11], body mass index (BMI) [12] [13], waist circumference [13], fasting glucose [11] [13] and insulin levels, as well as insulin resistance [11] [13] and abnormal lipid profile [14] [15]
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