Document Detail


Relations of exercise blood pressure response to cardiovascular risk factors and vascular function in the Framingham Heart Study.
MedLine Citation:
PMID:  22572915     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Exercise blood pressure (BP) is an important marker of left ventricular hypertrophy, incident hypertension, and future cardiovascular events. Although impaired vascular function is hypothesized to influence the BP response during exercise, limited data exist on the association of vascular function with exercise BP in the community.
METHODS AND RESULTS: Framingham Offspring cohort participants (n=2115, 53% women, mean age 59 years) underwent a submaximal exercise test (first 2 stages of the Bruce protocol), applanation tonometry, and brachial artery flow-mediated dilation testing. We related exercise systolic and diastolic BP at second stage of the Bruce protocol to standard cardiovascular risk factors and to vascular function measures. In multivariable linear regression models, exercise systolic BP was positively related to age, standing BP, standing heart rate, smoking, body mass index, and the total cholesterol-to-high-density cholesterol ratio (P≤0.01 for all). Similar associations were observed for exercise diastolic BP. Carotid-femoral pulse wave velocity (P=0.02), central pulse pressure (P<0.0001), mean arterial pressure (P=0.04), and baseline brachial flow (P=0.002) were positively associated with exercise systolic BP, whereas flow-mediated dilation was negatively associated (P<0.001). For exercise diastolic BP, forward pressure wave amplitude was negatively related (P<0.0001), whereas mean arterial pressure was positively related (P<0.0001).
CONCLUSIONS: Increased arterial stiffness and impaired endothelial function are significant correlates of a higher exercise systolic BP response. Our findings suggest that impaired vascular function may contribute to exaggerated BP responses during daily living, resulting in repetitive increments in load on the heart and vessels and increased cardiovascular disease risk.
Authors:
George Thanassoulis; Asya Lyass; Emelia J Benjamin; Martin G Larson; Joseph A Vita; Daniel Levy; Naomi M Hamburg; Michael E Widlansky; Christopher J O'Donnell; Gary F Mitchell; Ramachandran S Vasan
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-05-09
Journal Detail:
Title:  Circulation     Volume:  125     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-12     Completed Date:  2012-08-23     Revised Date:  2013-06-25    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2836-43     Citation Subset:  AIM; IM    
Affiliation:
National Institutes of Health/National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, MA 01702, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Blood Flow Velocity / physiology
Blood Pressure / physiology*
Brachial Artery / physiology,  ultrasonography
Cohort Studies
Exercise / physiology*
Exercise Test
Female
Humans
Hypertension / epidemiology*,  physiopathology*
Hypertrophy, Left Ventricular / epidemiology*,  physiopathology*
Male
Manometry
Massachusetts / epidemiology
Middle Aged
Multivariate Analysis
Risk Factors
Vascular Stiffness / physiology
Grant Support
ID/Acronym/Agency:
6R01-NS 17950/NS/NINDS NIH HHS; N01 HC025195/HC/NHLBI NIH HHS; N01-HC-25195/HC/NHLBI NIH HHS; R01 HL080124/HL/NHLBI NIH HHS; R01 NS017950/NS/NINDS NIH HHS; R01HL080124/HL/NHLBI NIH HHS; //Canadian Institutes of Health Research
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