Exercise Blood Pressure Research Articles

Blood pressure response to exercise in endurance athletes with and without paroxysmal atrial fibrillation.

Abstract Background Atrial fibrillation (AF) is more prevalent among endurance-trained athletes when compared to non-athletes. The underlying pathophysiology and mechanisms for this phenomenon remain unknown but repeated exposure to an exaggerated blood pressure (BP) response during exercise may contribute to the development of AF in this population. Purpose We aimed to assess whether endurance athletes with AF have a higher maximal systolic BP (SBP) or a higher BP relative to exercise intensity compared to endurance athletes without AF. Methods Endurance athletes with paroxysmal AF (n=66, 96% male) from the ProAFHeart, NEXAF Detraining and Master@Heart studies were matched for age and sex to endurance athletes without AF (n=66, 96% male). Participants with a history of hypertension were excluded. All athletes underwent a maximal graded cardiopulmonary exercise test on a cycle ergometer to assess exercise BP using an automated auscultatory BP machine, maximal oxygen uptake (VO2peak) and peak workload. All athletes were in sinus rhythm at the time of testing and BP was measured pre-exercise seated on the bike and every 2 min throughout the test. Exercise BP measurements included the maximum exercise SBP (SBPmax) and the slopes of the relationships between SBP, diastolic BP (DBP) and workload (W) as determined from linear regression analysis (SBP/W-slope and DBP/W-slope, respectively). The resting SBP and DBP were measured in the supine position after 10min of rest. Independent T-test (parametric data) or the Mann-Whitney U-test (non-parametric data) assessed for the differences between the two groups. Results The 66 athletes with AF were of similar age and sex as the 66 athletes without AF, median age (55 [IQR 45, 61] vs 54 [IQR 44, 62] years, p=0.839), 4% female. There was no difference in (mean±SD) VO2peak (46 ±9 vs 49±10 mL/kg/min, p=0.114) and peak workload (365±67 vs 385±83 W, p=0.136), nor resting SBP (131±13 vs 128±13 mmHg, p=0.169) and resting DBP (76±9 vs 75±11 mmHg, p=0.465) between athletes with and without AF respectively (Table 1). Athletes with AF showed no significant difference to athletes without AF for exercise BP responses (Figure 1) including SBPmax (222±22 vs 219±28 mmHg, p=0.479), SBP/W-slope (0.22±0.07 vs 0.24±0.08 mmHg/W, p=0.310) and median DBP/W-slope (-0.01 [IQR -0.02, 0.01] vs -0.01 [IQR -0.03, 0.02] mmHg/W, p=0.703). Conclusion When comparing endurance athletes with and without paroxysmal AF, there were no differences in the maximal BP attained during exercise or in their BP response indexed to external workload (SBP/W-slope) suggesting that exercise-induced hypertension does not explain the athletic predisposition to AF.

Correlation of exercise blood pressure levels with concomitant cardiovascular disease.

Hypertension is a fatal but preventable risk factor for cardiovascular disease and an important cause of death from cardiovascular disease. Exercise training has a definite clinical effect on blood pressure control. However, inappropriate exercise is ineffective and may also cause disease. The aim of this study was to evaluate the possible factors influencing blood pressure level in an exercise treadmill test and its relationship with accompanying clinical diseases. Five hundred sixty-four patients who underwent exercise treadmill test were selected and divided into the abnormal exercise blood pressure group (n = 156, age 60.46 ± 9.2 years) and normal exercise blood pressure group (n = 408, age 56.57 ± 8.8 years) according to whether the peak exercise systolic blood pressure was more than or equal to 180 mm Hg. General clinical data and associated clinical diseases were collected from both groups. The prevalence of hypertension and coronary atherosclerotic heart disease in the abnormal exercise blood pressure group was significantly higher than that in the normal exercise blood pressure group (all P < .05). At the same time, the smoking rate and glycohemoglobin level of the patients with abnormal exercise blood pressure were significantly increased (all P < .05), but there was no statistically significant difference in age, sex, body mass index, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and other indicators between the 2 groups (all P > .05). Patients with abnormal exercise blood pressure response have a higher prevalence of hypertension and coronary heart disease. Exercise blood pressure level may be an important factor affecting patients' cardiovascular prognosis.

Effects of low and high dietary nitrate intake on human saliva, plasma and skeletal muscle nitrate and nitrite concentrations and their functional consequences

Dietary nitrate (NO3−) supplementation has been shown to reduce blood pressure (BP), improve exercise performance, and alter the oral microbiome. Following a “control” diet (CON), we manipulated dietary NO3− intake to examine the effect of a short-term (7-day) low NO3− diet (LOW) followed by a 3-day high NO3− diet (HIGH), compared to a 7-day standard (STD) NO3− diet followed by HIGH, on saliva, plasma, and muscle [NO3−] and nitrite ([NO2−]), BP, and cycling exercise performance in healthy young adults. We also examined the effect of LOW on the oral microbiome. Saliva [NO3−] and [NO2−], and plasma [NO3−] were significantly lower than CON following LOW (all P < 0.05) but there was no change in plasma [NO2−] or muscle [NO3−] and [NO2−] (all P > 0.05). Following HIGH, saliva and plasma [NO3−] and [NO2−], and muscle [NO3−], were significantly elevated above CON, LOW and STD (all P < 0.05), but there was no difference between CON-LOW-HIGH and CON-STD-HIGH (P < 0.05). BP and exercise performance were not altered following LOW (P > 0.05). HIGH significantly reduced systolic and diastolic BP compared to CON when preceded by STD (both P < 0.05) but not when preceded by LOW (P > 0.05). Peak (+4 %) and mean (+3 %) power output during sprint cycling was significantly improved following HIGH (both P < 0.05), with no differences between CON-LOW-HIGH and CON-STD-HIGH (both P > 0.05). LOW altered the oral microbiome composition, including decreases in relative abundances of phylum Proteobacteria and genus Neisseria. The findings indicate that a short-term low NO3− diet lowers plasma but not skeletal muscle [NO3−]. The maintenance of plasma [NO2−] and muscle [NO3−] and [NO2−] following LOW may be indicative of their importance to biological functions, including BP regulation and exercise performance.

Combination of Moderate Intensity Exercise and Rose Petals Yoghurt Alters Blood Pressure and Soluble Rage Level in High Advanced Glycation End Products Diet Induced Wistar Rat

Combination of Moderate Intensity Exercise and Rose Petals Yoghurt Alters Blood Pressure and Soluble Rage Level in High Advanced Glycation End Products Diet Induced Wistar Rat

Acute partial sleep deprivation attenuates blood pressure responses to cycling exercise.

Exaggerated blood pressure (BP) responses during exercise are independently associated with future development of hypertension. Partial sleep deprivation (PSD) can increase 24-h ambulatory BP, but the effects on exercise BP are unclear. We hypothesized that acute PSD would augment the BP response to constant load cycling exercise and a 20-min time trial. Twenty-two healthy adults (22 ± 3 yr old; 13 males; V̇o2peak, 43.6 ± 8.2 mL·kg-1·min-1) completed a randomized crossover trial in which they either slept normally (normal sleep-wake schedule for each participant) or sleep was partially deprived (early awakening, 40% of normal sleep duration). Each participant completed a 12-min warm-up consisting of two 6-min steps (step 1, 62 ± 25 W; step 2, 137 ± 60 W) followed by a 20-min time trial on a cycle ergometer. PSD did not alter power output during the 20-min time trial [(control vs. PSD) 170 ± 68 vs. 168 ± 68 W, P = 0.65]. Systolic BP did not differ during step 1 of the warm-up (141 ± 15 vs. 137 ± 12 mmHg, P = 0.39) but was lower following PSD during step 2 (165 ± 21 vs. 159 ± 22 mmHg, P = 0.004) and the 20-min time trial (171 ± 20 vs. 164 ± 23 mmHg, P < 0.001). These results were maintained when peak oxygen uptake (V̇o2peak) was included as a covariate. Systolic BP responses were modulated by sex (time × visit × sex interaction P = 0.03), with attenuated systolic BP during the warm-up and the 20-min time trial in males but not in females. In contrast to our hypothesis, acute PSD attenuates systolic BP responses during constant load and 20-min time trial cycling exercise; however, these observations appear to be primarily driven by changes in males.NEW & NOTEWORTHY A single night of partial sleep deprivation (PSD) can increase ambulatory blood pressure (BP) the following day. Despite this phenomenon, the present study found that acute PSD attenuates systolic BP responses to both constant load cycling and a 20-min cycling time trial in young healthy adults. Interestingly, the attenuated systolic BP responses following PSD appeared to be modulated by sex such that attenuations were observed in males but not in females.

Test-retest reliability of exercise blood pressure and the workload-indexed systolic blood pressure slope in healthy males and females.

The reliability of blood pressure (BP) measured during submaximal and maximal exercise, and confounding effects of biological sex, remain to be fully established but have implications for using exercise BP as a cardiovascular risk factor. We hypothesize that exercise BP test-retest reliability will not differ between sexes but will be higher during submaximal compared to maximal exercise. Eighty-four participants (22±5 years; 36 females) completed two maximal treadmill tests (modified Bruce protocol) separated by ≥2 days. Exercise BP was measured every 90-seconds using automated auscultation (Tango M2 monitor). Breath-by-breath oxygen uptake was analyzed. Test-retest reliability was assessed using two-way, mixed effects, consistency, single-rater intraclass correlation coefficient (ICC) analysis on the total group and separated by sex at submaximal and maximal exercise. Systolic BP during submaximal (ICC=0.65 [0.49-0.76], p<0.01) and maximal (ICC=0.66 [0.52-0.77], p<0.01) exercise both displayed substantial reliability between visits. In contrast, the SBP/MET slope showed poor submaximal (ICC=0.12 [-0.09-0.33], p=0.13) but substantial maximal (ICC=0.63 [0.48-0.75], p<0.01) exercise reliability. Females showed substantial reliability in submaximal systolic BP (ICC=0.73 [0.53-0.85], p<0.01), and peak systolic BP (ICC=0.74 [0.54-0.87], p<0.01) and SBP/MET slope (ICC=0.78 [0.60-0.88], p<0.01); the submaximal SBP/MET slope had fair reliability (ICC=0.28 [-0.06-0.56], p=0.05). Males showed moderate reliability in submaximal systolic BP (ICC=0.53 [0.26-0.72], p<0.01), and peak systolic BP (ICC=0.41 [0.15-0.62], p<0.01) and SBP/MET slope (ICC=0.48 [0.22-0.67], p<0.01); the submaximal SBP/MET slope had poor reliability (ICC=0.06 [-0.18-0.31], p=0.32). Systolic BP showed similar reliability during submaximal and maximal exercise, with females demonstrating higher reliability in exercise systolic BP compared to males.

The Role of Exercise Blood Pressure in Hypertension: Measurement, Mechanisms and Management.

Hypertension affects one in three adults globally and is the leading modifiable risk factor for cardiovascular disease. While blood pressure measurements at rest are fundamental to the detection and management of hypertension, abnormal blood pressure responses to exercise, namely an exaggerated exercise blood pressure (EEBP), can provide additional independent information about current and future hypertension risk. This paper summarizes a symposium entitled: "The Role of Exercise BP in Hypertension: Measurement, Mechanisms and Management" included at the 2023 American College of Sports Medicine annual meeting, which presented a timely discussion about the clinical utility of EEBP. Here we will summarize the evidence presented by the speakers including considerations for blood pressure measurement during exercise, an overview of EEBP thresholds and discussion about the value of EEBP during submaximal exercise for the identification and management of hypertension, a summary of the potential physiological mechanisms underpinning an EEBP, and a review of exercise prescription guidelines based on new and emerging evidence as they relate to the American College of Sports Medicine's exercise recommendations for hypertension. We conclude by highlighting areas for future research with the overarching goal of improving the measurement and management of hypertension.

Effects of spironolactone on exercise blood pressure in patients at increased risk of developing heart failure: report from the HOMAGE trial

None of the spironolactone trials in heart failure (HF) assessed the blood pressure (BP) responses to exercise, while conflicting results were reported for exercise capacity. In the HOMAGE trial, 527 patients at increased HF risk were randomized to usual treatment with or without spironolactone (25–50 mg/day). The current substudy included 113 controls and 114 patients assigned spironolactone, who all completed the incremental shuttle walk test at baseline and months 1 and 9. Quality of life (QoL) was assessed by EQ5D questionnaire. Between-group differences (spironolactone minus control [Δs]) were analyzed by repeated measures ANOVA with adjustment for baseline and, if appropriate, additionally for sex, age and body mass index. Δs in the pre-exercise systolic/diastolic BP were −8.00 mm Hg (95% CI, −11.6 to −4.43)/−0.85 mm Hg (−2.96 to 1.26) at month 1 and −9.58 mm Hg (−14.0 to −5.19)/−3.84 mm Hg (−6.22 to −1.47) at month 9. Δs in the post-exercise systolic/diastolic BP were −8.08 mm Hg (−14.2 to −2.01)/−2.07 mm Hg (−5.79 to 1.65) and −13.3 mm Hg (−19.9 to −6.75)/−4.62 mm Hg (−8.07 to −1.17), respectively. For completed shuttles, Δs at months 1 and 9 were 2.15 (−0.10 to 4.40) and 2.49 (−0.79 to 5.67), respectively. Δs in QoL were not significant. The correlations between the exercise-induced BP increases and the number of completed shuttles were similar in both groups. In conclusion, in patients at increased risk of developing HF, spironolactone reduced the pre- and post-exercise BP, but did not improve exercise capacity or QoL.

Blood pressure response to graded bicycle exercise in males and females across the age and fitness spectrum.

Blood pressure (BP) responses to exercise are frequently measured, with the concern that greater increases are a marker of disease. We sought to characterize the normal exercise BP response in healthy adults and its relationships with age, sex, and fitness. 589 participants (median age 46 [IQR 24-56] years, 81% male) underwent cardiopulmonary exercise testing with repeated, automated BP measures. An exaggerated maximal systolic BP (SBPmax) was defined from current guidelines as ≥210 mmHg in males and ≥190 mmHg in females. Individual linear regression analyses defined the relationship between BP and workload (SBP/W-slope and DBP/W-slope). Participants with or without an exaggerated SBPmax and above or below median SBP/W-slope were compared. An exaggerated SBPmax was found in 51% of males and 64% of females and was more prevalent in endurance-trained athletes (males 58%, females 72%, p<0.001). The mean SBP/W-slope was lower in males (0.24±0.10 mmHg/W) than females (0.27±0.12 mmHg/W), p=0.031. In both sexes, peak oxygen uptake (VO2peak) was inversely correlated with SBP/W-slope (p<0.01). Those with an exaggerated SBPmax and below-median SBP/W-slope were 10 years younger and had a 20% higher VO2peak, on average (p<0.001). A non-exaggerated SBPmax and above-median SBP/W-slope was observed in older individuals with the lowest VO2peak. In a large cohort of healthy individuals, an exaggerated SBPmax was common and associated with higher fitness. In contrast, higher SBP indexed to workload was associated with older age, lower fitness, and female sex. Thus, sex, age and fitness should be considered when evaluating BP response to exercise.

Exercise blood pressure, cardiorespiratory fitness, fatness and cardiovascular risk in children and adolescents

Exercise blood pressure, cardiorespiratory fitness, fatness and cardiovascular risk in children and adolescents

Plasma Proteomics of Exercise Blood Pressure and Incident Hypertension

Blood pressure response during acute exercise (exercise blood pressure [EBP]) is associated with the future risk of hypertension and cardiovascular disease (CVD). Biochemical characterization of EBP could inform disease biology and identify novel biomarkers of future hypertension. To identify protein markers associated with EBP and test their association with incident hypertension. This study assayed 4977 plasma proteins in 681 healthy participants (from 763 assessed) of the Health, Risk Factors, Exercise Training and Genetics (HERITAGE; data collection from January 1993 to December 1997 and plasma proteomics from January 2019 to January 2020) Family Study at rest who underwent 2 cardiopulmonary exercise tests. Individuals were free of CVD at the time of recruitment. Individuals with resting SBP ≥160 mm Hg or DBP ≥100 mm Hg or taking antihypertensive drug therapy were excluded from the study. The association between resting plasma protein levels to both resting BP and EBP was evaluated. Proteins associated with EBP were analyzed for their association with incident hypertension in the Framingham Heart Study (FHS; n = 1177) and validated in the Jackson Heart Study (JHS; n = 772) and Multi-Ethnic Study of Atherosclerosis (MESA; n = 1367). Proteins associated with incident hypertension were tested for putative causal links in approximately 700 000 individuals using cis-protein quantitative loci mendelian randomization (cis-MR). Data were analyzed from January 2023 to January 2024. Plasma proteins. EBP was defined as the BP response during a fixed workload (50 W) on a cycle ergometer. Hypertension was defined as BP ≥140/90 mm Hg or taking antihypertensive medication. Among the 681 participants in the HERITAGE Family Study, the mean (SD) age was 34 (13) years; 366 participants (54%) were female; 238 (35%) were self-reported Black and 443 (65%) were self-reported White. Proteomic profiling of EBP revealed 34 proteins that would not have otherwise been identified through profiling of resting BP alone. Transforming growth factor β receptor 3 (TGFBR3) and prostaglandin D2 synthase (PTGDS) had the strongest association with exercise systolic BP (SBP) and diastolic BP (DBP), respectively (TGFBR3: exercise SBP, β estimate, -3.39; 95% CI, -4.79 to -2.00; P = 2.33 × 10-6; PTGDS: exercise DBP β estimate, -2.50; 95% CI, -3.29 to -1.70; P = 1.18 × 10-9). In fully adjusted models, TGFBR3 was inversely associated with incident hypertension in FHS, JHS, and MESA (hazard ratio [HR]: FHS, 0.86; 95% CI, 0.75-0.97; P = .01; JHS, 0.87; 95% CI, 0.77-0.97; P = .02; MESA, 0.84; 95% CI, 0.71-0.98; P = .03; pooled cohort, 0.86; 95% CI, 0.79-0.92; P = 6 × 10-5). Using cis-MR, genetically predicted levels of TGFBR3 were associated with SBP, hypertension, and CVD events (SBP: β, -0.38; 95% CI, -0.64 to -0.11; P = .006; hypertension: odds ratio [OR], 0.99; 95% CI, 0.98-0.99; P < .001; heart failure with hypertension: OR, 0.86; 95% CI, 0.77-0.97; P = .01; CVD: OR, 0.84; 95% CI, 0.77-0.92; P = 8 × 10-5; cerebrovascular events: OR, 0.77; 95% CI, 0.70-0.85; P = 5 × 10-7). Plasma proteomic profiling of EBP identified a novel protein, TGFBR3, which may protect against elevated BP and long-term CVD outcomes.

Exercise systolic blood pressures are unaffected by time of day in healthy young adults.

Blood pressure (BP) assessment during exercise testing has the capacity to identify exaggerated exercise BP (EEBP). BP has a circadian rhythm; therefore, exercise BPs may change throughout the day complicating EEBP identification. The purpose of this study was to determine the effect of time of day on exercise BP in healthy young adults. Thirty-one participants [48% female; 23(4) years] completed a modified Bruce treadmill protocol in the morning (M), afternoon (A), and evening (E). Submaximal (stage 4) and peak (highest value) systolic BP (SBP) were determined and ΔSBP was calculated (peak SBP-pre-exercise SBP). Repeated-measures tests were used to compare SBP data. EEBP was defined as a submaximal SBP ≥ 170 mmHg. Chronotype was assessed using the Morning-Eveningness Questionnaire (MEQ) and Pearson correlations were used to determine the relationship between MEQ score and ΔSBP during all tests. Significance was set at P < 0.05. Submaximal SBP (M:159(25); A:156(16); E:162(24) mmHg; P = 0.295), peak SBP (M:177(32); A:184(25); E:185(26) mmHg; P = 0.087) and ΔSBP (M:62(29); A:67(23); 65(20) mmHg; P = 0.546) were similar across time points. Eight participants had an EEBP on at least two tests. MEQ scores were correlated with ΔSBP during the A test (r = 0.357, P = 0.049) and E test (r = 0.363, P = 0.045). In conclusion, time of day had no effect on SBP responses to exercise, but our correlational analysis suggests changes in SBP may differ between chronotypes depending on the time of day of exercise. Given the clinical value of EEBP, it is notable that 26% of our healthy young sample had EEBP.

Effect of an endothelial regulatory module on plasma proteomics in exercising horses

Elite performing exercise requires an intricate modulation of the blood pressure to support the working muscles with oxygen. We have previously identified a genomic regulatory module that associates with differences in blood pressures of importance for elite performance in racehorses. This study aimed to determine the effect of the regulatory module on the protein repertoire. We sampled plasma from 12 Coldblooded trotters divided into two endothelial regulatory module haplotype groups, a sub-elite performing haplotype (SPH) and an elite performing haplotype (EPH), each at rest and exercise. The haplotype groups and their interaction were interrogated in two analyses, i) individual paired ratio analysis for identifying differentially abundant proteins of exercise (DAPE) and interaction (DAPI) between haplotype and exercise, and ii) unpaired ratio analysis for identifying differentially abundant protein of haplotype (DAPH). The proteomics analyses revealed a widespread change in plasma protein content during exercise, with a decreased tendency in protein abundance that is mainly related to lung function, tissue fluids, metabolism, calcium ion pathway and cellular energy metabolism. Furthermore, we provide the first investigation of the proteome variation due to the interaction between exercise and related blood pressure haplotypes, which this difference was related to a faster switch to the lipoprotein and lipid metabolism during exercise for EPH. The molecular signatures identified in the present study contribute to an improved understanding of exercise-related blood pressure regulation.

Association of exercise blood pressure response with subclinical abnormalities of cardiac remodeling and function in middle-aged women

Association of exercise blood pressure response with subclinical abnormalities of cardiac remodeling and function in middle-aged women

Chronic Use of Antihypertensive Medications and Peak Exercise Blood Pressure in Adult Men and Women from the BALL ST Cohort.

To determine if individuals chronically (>1 yr) prescribed antihypertensive medications have a normal BP response to peak exercise compared with unmedicated individuals. Participants included 2555 adults from the Ball State Adult Fitness Longitudinal Lifestyle STudy cohort who performed a peak treadmill exercise test. Participants were divided into groups by sex and antihypertensive medication status. Individuals prescribed antihypertensive medications for >1 yr were included. Exaggerated and blunted SBP within each group was categorized using the Fitness Registry and the Importance of Exercise: A National Database (FRIEND) and absolute criteria as noted by the American Heart Association. The unmedicated group had a greater prevalence ( P < 0.05) of blunted SBP responses, whereas the medicated group had a higher prevalence ( P < 0.05) of exaggerated SBP responses using both the FRIEND and absolute criteria. Peak SBP was higher ( P < 0.01) in medicated compared with unmedicated participants in the overall cohort when controlling for age and sex, but not after controlling for resting SBP ( P = 0.613), risk factors ( P = 0.104), or cardiorespiratory fitness ( P = 0.191). When men and women were assessed independently, peak SBP remained higher in the medicated women after controlling for age and resting SBP ( P = 0.039), but not for men ( P = 0.311). Individuals on beta-blockers had a higher peak SBP even after controlling for age, sex, risk factors, and cardiorespiratory fitness ( P = 0.022). Individuals on antihypertensive medications have a higher peak SBP response to exercise. Given the prognostic value of exaggerated peak SBP, control of exercise BP should be considered in routine BP assessment and in the treatment of hypertension.

The effects of partial sleep deprivation on blood pressure responses during cycling are intensity dependent

Introduction: Exaggerated blood pressure (BP) responses during exercise are associated with increased risk of clinical cardiovascular outcomes. Partial sleep deprivation (PSD), defined as ≤6 hours of sleep, can increase 24-hour ambulatory BP but the effects on exercise BP have not been studied. We hypothesized that acute PSD would augment the exercise BP response to constant load exercise (below and above estimated lactate threshold) and during a 20-min time trial. Methods: Fourteen, healthy adults (22 ± 3 years; 9 males; VO2peak: 43.2 ± 9.5 ml/kg/min [25.3-60.9]) completed a randomized crossover trial where they slept normally (normal sleep-wake schedule for each participant), or sleep was partially deprived (early awakening, 40% of normal sleep duration). Prior to the testing visits, participants completed two familiarization visits under normal sleep conditions. Each participant completed a 12-minute warm (6-minutes below estimated lactate threshold [moderate intensity; 65 ± 24 W] and 6-minutes above estimated lactate threshold but below respiratory compensation point [heavy intensity; 147 ± 60 W]) followed by a time-trial where they were asked to cycle as far as possible in 20 minutes. BP was assessed at rest (BpTRU, Medical Devices) and on the cycle ergometer every 2 minutes during the warmup and 20-minute time-trial (Tango M2, SunTech Medical). Sleep timing and duration was assessed daily for 1-week prior to each testing visit using self-report and an accelerometer worn on the non-dominate wrist (wGT3X-BT, ActiGraph). Results: Resting systolic ( P=0.08) and diastolic BP ( P=0.06) tended to be higher following PSD (normal sleep: 105 ± 8/62 ± 8 mmHg vs. PSD: 107 ± 6/64 ± 7 mmHg). PSD did not alter VO2 during the moderate- (normal sleep: 1291 ± 394 ml/min vs. PSD: 1258 ± 364 ml/min) and heavy-intensity (normal sleep: 1903 ± 758 ml/min vs. PSD: 1893 ± 724 ml/min) warmup or 20-minute time-trial (normal sleep: 2713 ± 1120 ml/min vs. PSD: 2669 ± 1134 ml/min) or distance covered (normal sleep: 10.16 ± 2.024 km vs. PSD: 10.08 ± 2.145 km) and power output (normal sleep: 175 ± 79 W vs. PSD: 173 ± 79 W) during the 20-min time-trial (all P&gt;0.27). Systolic (normal sleep: 140 ± 17 mmHg vs. PSD: 136 ± 11 mmHg, P=0.14) and diastolic (normal sleep: 67 ± 11 mmHg vs. PSD: 69 ± 8 mmHg, P=0.44) BP did not differ during the moderate-intensity warmup following PSD. However, systolic BP was lower during the heavy-intensity warmup (normal sleep: 165 ± 25 mmHg vs. PSD: 155 ± 22 mmHg, P=0.008) and 20-minute time-trial (normal sleep: 174 ± 20 mmHg vs. PSD: 165 ± 25 mmHg, P=0.05) following PSD. No differences were observed in diastolic BP (all P&gt;0.57). Heart rate during the moderate-intensity warmup (normal sleep: 110 ± 11 bpm vs. PSD: 110 ± 10 bpm), heavy-intensity warmup (normal sleep: 137 ± 14 bpm vs. PSD: 136 ± 14 bpm), and time-trial (normal sleep: 171 ± 16 bpm vs. PSD: 169 ± 19 bpm) did not differ between conditions (all P&gt;0.39). Conclusion: In contrast to our hypothesis, these preliminary findings suggest that a single night of PSD results in lower systolic BP responses during heavy-intensity, but not moderate-intensity, cycling exercise. This research was supported by a Natural Science and Engineering Research Council (NSERC) of Canada Discovery Grant (P.J.M). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

COMPARING THE EFFECTS OF AROMATASE INHIBITORS AND SELECTIVE OESTROGEN RECEPTOR MODULATORS ON BODY COMPOSITION, EXERCISE TOLERANCE AND MARKERS OF CARDIOVASCULAR RISK IN FEMALES WITH BREAST CANCER

INTRODUCTION Adjuvant endocrine therapy (AET) blocks the action of estrogens and is commonly prescribed in hormone receptor-positive breast cancer. Given the putative cardioprotective role of estrogens in females, AET may exacerbate the negative metabolic side-effects of anthracycline chemotherapy. This study examined the early effects of combined anthracycline chemotherapy and AET on body composition, exercise tolerance and markers of cardiovascular risk in a cohort of females with breast cancer. METHODS This was a secondary analysis of the BReast cancer EXercise InTervention (BREXIT) Trial. Females with breast cancer (n=105, aged 51 ± 8 years, BMI 27.4 ± 5.1, mean ± SD) scheduled for anthracycline chemotherapy participated in this study. Aerobic exercise capacity, body composition, physical function, and blood pressure were measured before anthracycline treatment and after 4- and 12-months follow-up. Linear mixed models assessed whether aromatase inhibitors (AI) or selective estrogen receptor modulators (SERMS) affected exercise tolerance, body composition and markers of cardiovascular risk compared to non-endocrine breast cancer treatments. RESULTS Twelve months of anthracycline treatment combined with AI or SERMs decreased total body lean mass by 1.4 kg (2%; interaction p=0.01) and 1kg (1%; interaction p=0.16) respectively, when compared to non-endocrine therapies. There were trends for AET to decrease total fat (-1.5%, interaction p=0.05) and android fat (-2.3%, interaction p=0.07) mass compared to non-endocrine therapy after 12 months. AIs significantly increased both systolic (5.8mmHg, interaction p=0.05) and diastolic (4.0mmHg, interaction p=0.05) blood pressure after 12 months of treatment compared to SERMs or non-endocrine therapies. There was no effect of either AET or SERMS on VO2peak, leg press or seated row 1RM, 30 second sit to stand or handgrip strength. DISCUSSION AND CONCLUSION Short-term treatment with adjuvant endocrine therapies may accelerate muscle loss and increase blood pressure compared to non-endocrine therapies. However, these changes were not associated with worsening of physical function.

Study of Correlation of TMT Results with Angiogram Findings in Coronary Artery Disease Predictability in Patients with Angina Equivalents in DAE Hospital

Introduction Coronary artery disease is leading cause of mortality and morbidity worldwide. The early detection and treatment of CAD is vital to prevent complications with non invasive tests like stress tests Exercise treadmill testing (ETT) is a wellvalidated, inexpensive test that can be used for the evaluation of patients with suspected coronary artery diseases (CAD). In addition to identifying patients who have exercise-induced ECG changes suggestive of ischemia, ETT also provides important data on exercise capacity, blood pressure, and heart rate response to exercise, symptoms, and the presence of exercise-induced arrhythmias. In a person at high risk for coronary heart disease (e.g., advanced age, multiple coronary risk factors), an abnormal TMT is very predictive of the presence of coronary heart disease (&gt; 90% accurate). In the present study ,we studied the patients with changing risk factor profiles along with increasing incidence of CAD in younger population (even as young as 30-35 years), in females versus males by TMT and also the correlation of TMT results with angiogram findings in the predictability of CAD

Using Principles of Digital Development for a Smartphone App to Support Data Collection in Patients With Acute Myocardial Infarction and Physical Activity Intolerance: Case Study.

Advances in health have highlighted the need to implement technologies as a fundamental part of the diagnosis, treatment, and recovery of patients at risk of or with health alterations. For this purpose, digital platforms have demonstrated their applicability in the identification of care needs. Nursing is a fundamental component in the care of patients with cardiovascular disorders and plays a crucial role in diagnosing human responses to these health conditions. Consequently, the validation of nursing diagnoses through ongoing research processes has become a necessity that can significantly impact both patients and health care professionals. We aimed to describe the process of developing a mobile app to validate the nursing diagnosis "intolerance to physical activity" in patients with acute myocardial infarction. We describe the development and pilot-testing of a mobile system to support data collection for validating the nursing diagnosis of activity intolerance. This was a descriptive study conducted with 11 adults (aged ≥18 years) who attended a health institution for highly complex needs with a suspected diagnosis of coronary syndrome between August and September 2019 in Floridablanca, Colombia. An app for the clinical validation of activity intolerance (North American Nursing Diagnosis Association [NANDA] code 00092) in patients with acute coronary syndrome was developed in two steps: (1) operationalization of the nursing diagnosis and (2) the app development process, which included an evaluation of the initial requirements, development and digitization of the forms, and a pilot test. The agreement level between the 2 evaluating nurses was evaluated with the κ index. We developed a form that included sociodemographic data, hospital admission data, medical history, current pharmacological treatment, and thrombolysis in myocardial infarction risk score (TIMI-RS) and GRACE (Global Registry of Acute Coronary Events) scores. To identify the defining characteristics, we included official guidelines, physiological measurements, and scales such as the Piper fatigue scale and Borg scale. Participants in the pilot test (n=11) had an average age of 63.2 (SD 4.0) years and were 82% (9/11) men; 18% (2/11) had incomplete primary schooling. The agreement between the evaluators was approximately 80% for most of the defining characteristics. The most prevalent characteristics were exercise discomfort (10/11, 91%), weakness (7/11, 64%), dyspnea (3/11, 27%), abnormal heart rate in response to exercise (2/10, 20%), electrocardiogram abnormalities (1/10, 9%), and abnormal blood pressure in response to activity (1/10, 10%). We developed a mobile app for validating the diagnosis of "activity intolerance." Its use will guarantee not only optimal data collection, minimizing errors to perform validation, but will also allow the identification of individual care needs.

Association of childhood socioeconomic status with adulthood maximal exercise blood pressure: the Cardiovascular Risk in Young Finns Study

Purpose Socioeconomic status has been related to resting blood pressure (BP) levels at different stages of life. However, the association of childhood socioeconomic status (SES) and adulthood exercise BP is largely unknown. Therefore, we studied the association of childhood SES with adulthood maximal exercise BP. Materials and methods This investigation consisted of 373 individuals (53% women) participating in the Cardiovascular Risk in Young Finns Study who had data concerning family SES in childhood (baseline in 1980, at age of 6–18 years) and exercise BP response data in adulthood (follow-up in adulthood in 27–29 years since baseline). A maximal cardiopulmonary exercise test with BP measurements was performed by participants, and peak exercise BP was measured. Results In stepwise multivariable analysis including childhood risk factors and lifestyle factors (body mass index, systolic BP, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, insulin, fruit consumption, vegetable consumption, and physical activity), lower family SES in childhood was associated with higher maximal exercise BP in adulthood (β value ± SE, 1.63 ± 0.77, p = 0.035). The association remained significant after further adjustment with participants SES in adulthood (β value ± SE, 1.68 ± 0.65, p = 0.011) and after further adjustment with adulthood body-mass index, systolic BP, maximal exercise capacity, and peak heart rate in exercise (β value ± SE, 1.25 ± 0.56, p = 0.027). Conclusions These findings suggest that lower childhood family SES is associated with higher maximal exercise BP in adulthood.