Arterial stiffness, sex, and age difference on hypertensive response to supine bicycle exercise

Background. In the general population, hypertensive response to exercise (HRE) predicts new-onset resting hypertension or other cardiovascular diseases. Methods. PubMed was searched for English articles published between January 1st 2000 and April 30th 2020. Additional studies were identified via reference lists of included studies. 92 papers were selected for full text analysis, finally 30 studies were included. Results. The results from 5 follow-up studies suggested an association between HRE and the risk of developing hypertension, while 10 studies reported a link with adverse cardiovascular events in the general population. Another study showed an association between HRE and future hypertension in athletes after a follow-up of 7 years. HRE in athletes was associated with left ventricular hypertrophy in three studies. Two other studies showed a link between HRE and focal myocardial fibrosis in triathletes and myocardial injury, respectively. One study found lower Apoliprotein-1 serum levels in athletes with HRE leading to a higher risk for cardiovascular disease. Only in one study no association with cardiovascular dysfunction in athletes with HRE was found. Conclusions. Based on current evidence, HRE is not a normal finding in athletes. If detected, it should be interpreted as a risk factor for future cardiovascular complications. Future research should address the adequate follow-up and management of athletes with HRE.

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“…Even after adjustment for other risk factors, the association remained significant. Differences were found according to sex and age [ 16 ].…”

Section: Resultsmentioning

confidence: 99%

Hypertensive Response to Exercise in Athletes: Unremarkable Finding or Relevant Marker for Future Cardiovascular Complications?

Würzburger

Wiech

Rossi

et al. 2022

International Journal of Hypertension

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“…Fatigue fractures of elastic elements are often considered to be responsible for age-related increases in aortic PWV ( 21 ). The results of a cross-sectional study showed that women had lower systemic vascular compliance and higher systemic vascular resistance than men ( 22 ). A longitudinal study showed that resistance increased in women and decreased in men with age ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Determinants of arterial elastic function in middle-aged and elderly people: A population-based cross-sectional study from a low-income population in China

Sun

Zhang²,

Fei³

et al. 2023

Front. Cardiovasc. Med.

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BackgroundArterial stiffness is closely associated with the occurrence of many cardiovascular and cerebrovascular diseases. However, the risk factors and mechanisms related to arterial stiffness development have only been partially elucidated. We aimed to describe arterial elastic function and its influencing factors in middle-aged and elderly people in rural China.MethodsThis was a cross-sectional study conducted among residents, aged ≥45 years, of Tianjin, China, between April and July 2015. Data regarding participant demographics, medical history, lifestyle, and physical examination results were collected and assessed the association with arterial elastic function using linear regression.ResultsOf the 3,519 participants, 1,457 were male (41.4%). Brachial artery distensibility (BAD) decreased by 0.5%/mmHg with every 10-year increment in age. The mean BAD value was 0.864%/mmHg lower in women than in men. With each unit increase in mean arterial pressure, the BAD decreased by 0.042%/mmHg. In patients with hypertension or diabetes, the BAD decreased by 0.726 and 0.183%/mmHg, respectively, compared with those without hypertension or diabetes. For each unit increase in triglyceride (TG) level, the mean BAD increased by 0.043%/mmHg. With each increase in body mass index (BMI) category, the BAD increased by 0.113%/mmHg. Brachial artery compliance (BAC) decreased by 0.007 ml/mmHg with each 10-year increase in age, and brachial artery resistance (BAR) increased by 30.237 dyn s–1 cm–5. The mean BAC in women was 0.036 ml/mmHg lower and the mean BAR was 155.231 dyn s–1 cm–5 higher in women than in men. In individuals with hypertension, the mean BAC decreased by 0.009 ml/mmHg and the mean BAR increased by 26.169 dyn s–1 cm–5. With each increase in BMI category, the mean BAC increased by 0.005 ml/mmHg and the mean BAR decreased by 31.345 dyn s–1 cm–5. For each unit increase in TG level, the mean BAC increased by 0.001 ml/mmHg.ConclusionThese findings indicate that age, sex, mean arterial pressure, BMI, diabetes, hypertension, and TG level are independently associated with the components of peripheral arterial elasticity. Understanding the factors influencing arterial stiffness is important for developing interventions to minimize arterial aging and cardiovascular and cerebrovascular diseases caused by arterial aging.

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“…Chung et al investigated data from 797 patients (38% women, mean age 64 ± 10 years, 75% with a history of hypertension) and showed that the prevalence of HRE was higher in women than in men. Furthermore, patients with HRE presented with pathologic variations in LV mass index, LAVI, E/e', end diastolic elastance and relative wall thickness, which are echocardiographic parameters of diastolic dysfunction and ventricular remodelling and known risk factors for the development of HFpEF [53].…”

Section: K Review Articlementioning

confidence: 99%

Hypertensive response to exercise, hypertension and heart failure with preserved ejection fraction (HFpEF)—a continuum of disease?

Wiech

Würzburger

Rossi

et al. 2023

Wien Klin Wochenschr

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Summary Introduction Heart failure with preserved ejection fraction (HFpEF) has been shown to be a long-term consequence of uncontrolled arterial hypertension (aHT). Other than that, hypertensive response to exercise (HRE) precedes aHT. We aim to evaluate the available evidence for a continuum of HRE, aHT and HFpEF. Methods A literature search on PubMed was conducted to assembly the most recent data on the topic. After collecting the data, a qualitative analysis was instrumented. Results 10 studies including 16,165 subjects were analyzed with respect to the association between HRE and the future risk of developing aHT. With the exception of one study, all reported on a positive association between HRE and the future development of aHT despite methodological issues related to different definitions for HRE. Furthermore, HRE was associated with an increased risk of coronary artery disease. Moreover, we analysed 6 studies including overall 1366 subjects investigating the association between HRE and HFpEF. In these studies, increased left atrial volume index (LAVI), elevated E/e’ (as surrogate parameters of increased LV end-diastolic filling pressure and of diastolic dysfunction) and higher LV mass index have been proposed as independent predictor of HRE in patients with no known HFpEF diagnosis. Discussion and conclusion The literature search revealed suggestive data on a connection of HRE, aHT and HFpEF. HRE seems to be an independent risk factor for aHT and aHT in turn is one of the main risk factors for HFpEF. However, further research is needed to improve our knowledge of a possible continuum of disease.

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Arterial stiffness, sex, and age difference on hypertensive response to supine bicycle exercise

Cited by 9 publications

References 32 publications

Hypertensive Response to Exercise in Athletes: Unremarkable Finding or Relevant Marker for Future Cardiovascular Complications?

Hypertensive Response to Exercise in Athletes: Unremarkable Finding or Relevant Marker for Future Cardiovascular Complications?

Determinants of arterial elastic function in middle-aged and elderly people: A population-based cross-sectional study from a low-income population in China

Hypertensive response to exercise, hypertension and heart failure with preserved ejection fraction (HFpEF)—a continuum of disease?

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