Exaggerated Exercise Blood Pressure Response and Future Cardiovascular Disease

Area of Science:

• Cardiovascular Physiology
• Hypertension Research
• Vascular Biology

Background:

• An exaggerated blood pressure (BP) response to exercise is a predictor of future hypertension.
• The underlying mechanisms linking exercise BP response to cardiovascular disease (CVD) risk are not fully understood.

Purpose of the Study:

• To investigate the mechanisms behind an exaggerated exercise BP response in healthy males.
• To determine the relationship between exercise BP response and vascular/neurohormonal factors.

Main Methods:

• 82 healthy males were divided into hyper-responders (peak SBP ≥ 180 mm Hg) and hypo-responders (peak SBP <180 mm Hg) based on exercise BP.
• Vascular reactivity was assessed using forearm venous occlusion plethysmography with infusions of acetylcholine (ACh), L-NMMA, sodium nitroprusside (SNP), and norepinephrine (NE).
• Proximal aortic compliance was measured via ultrasound, and neurohormonal levels (angiotensin II) were analyzed at rest and peak exercise.

Main Results:

• Hyper-responders showed a significantly lower forearm blood flow (FBF) increase with ACh (endothelial dysfunction) compared to hypo-responders (215% vs 332.3%, P<.001).
• Hyper-responders exhibited impaired vasoconstriction to L-NMMA and decreased proximal aortic compliance.
• Peak exercise angiotensin II levels were significantly higher in hyper-responders (31 vs 23 pg/mL, P=.01).

Conclusions:

• An exaggerated exercise BP response is associated with endothelial dysfunction and reduced aortic compliance.
• Increased exercise-induced neurohormonal activation, specifically angiotensin II, is observed in hyper-responders.
• These factors collectively may contribute to the development of future cardiovascular disease.