INFLUENCE OF ANTIHYPERTENSIVE MEDICATION STATUS ON THE BLOOD PRESSURE RESPONSES TO DYNAMIC EXERCISE IN HYPERTENSIVE INDIVIDUALS

Abstract

Objective: To investigate if the blood pressure (BP) response to a maximal graded exercise test (GXT) is influenced by antihypertensive medication (AHM) in monotherapy or in combination. Design and method: Thirty-one hypertensive individuals with obesity under AHM treatment targeting the renin-angiotensin-aldosterone system (RAAS) were divided into 3 groups depending on the number of AHM taken: monotherapy (MONO, n = 15), two drugs (DUAL, n = 8) or 3 drugs (TRIPLE, n = 8). By using a randomized, double-blind, placebo-controlled, crossover design, participants completed two trials (i.e. AHM vs PLAC). In each trial, 24-h ambulatory blood pressure (ABP), plasma renin activity (PRA), aldosterone concentration and the BP responses to a GXT were measured and compared among groups. Results: In AHM trials, 24-h ABP was significantly lower (127 ± 12 vs 134 ± 10 mmHg, P < 0.001) and PRA higher (4.0 ± 2.7 vs 1.9 ± 1.8 ng/mL/h, P < 0.001) in comparison to PLAC, without differences between groups in any variable (P > 0.05). There was not any group nor trial effect on plasma aldosterone concentration (P > 0.05). During incremental exercise, there were no differences between trials nor among groups in the BP response to incremental exercise, reaching similar peak systolic BP (211 ± 25 vs 206 ± 25 mmHg in AHM and PLAC, respectively, P = 0.118). Regarding the heart rate (HR) response to exercise, the TRIPLE group showed a higher HR at submaximal intensities in AHM vs PLAC (+7 ± 4 bpm, P < 0.005). Conclusions: Antihypertensive medication reduces ABP but does not have any effect on systolic BP during exercise, independently of the number of drugs taken. Our data suggest that in chronically treated hypertensives AHM does not reduce the BP response to exercise.