Correlates of endothelial function and the peak systolic blood pressure response to a graded maximal exercise test

Olson, Kayla M.; Augeri, Amanda L.; Seip, Richard L.; Tsongalis, Gregory J.; Thompson, Paul D.; Pescatello, Linda S.

doi:10.1016/j.atherosclerosis.2012.01.027

Cited by 17 publications

(4 citation statements)

References 27 publications

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“…These findings have practical relevance for practitioners, especially if they are considering the implementation of BFR training in hypertensive patients. Nevertheless, the observed increases in blood pressures were well below those previously associated with hemorrhagic events ( Haykowsky et al, 1996 ), and consistent with commonly observed changes in blood pressure during graded exercise tests ( Olson et al, 2012 ).…”

Section: Discussionsupporting

confidence: 91%

Hemodynamic Responses to Low-Load Blood Flow Restriction and Unrestricted High-Load Resistance Exercise in Older Women

et al. 2018

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Introduction: Blood flow restriction (BFR) during low-load resistance exercise increases muscle size similarly to high-load training, and may be an alternative to lifting heavy weights for older people at risk of sarcopenia. However, few studies have addressed the safety of such exercise in older people, or whether this is impacted by the actual exercises performed during training. This study aimed to compare the acute hemodynamic and perceptual responses during low-load BFR exercise to unrestricted low-load and high-load exercise in older women, and to determine whether these responses depend on the type of exercise performed.Methods: Fifteen older women (63–75 year) were assessed for maximal strength (1RM) in the leg press and leg extension. Participants then completed three protocols using these exercises in a randomized order: (1) low-load exercise (LL); (2) low-load exercise with BFR (LLBFR), and; (3) high-load exercise (HL). Blood pressure was assessed at baseline and after each set, and impedance cardiography measured cardiovascular function during trials. Rating of perceived exertion (RPE) and muscle soreness scores were obtained throughout trials.Results: Baseline hemodynamic values were consistent between trials. Systolic, diastolic, and mean arterial pressures were higher in LLBFR compared with HL and LL (p ≤ 0.021). The LL condition resulted in lower heart rate (p ≤ 0.002) and rate-pressure product (p ≤ 0.011) responses compared with LLBFR and HL. The leg press generally conferred greater hemodynamic and perceptual demands than the leg extension for all conditions (p ≤ 0.002). RPE was lower during LL compared with LLBFR and HL (p ≤ 0.008), and there were no between-condition differences in perceived muscle soreness.Conclusion: The blood pressure data indicate that LLBFR causes greater stress on the vasculature than LL and HL exercise, and that the leg press was generally more demanding than the leg extension. While additional cardiovascular measures were similar between LLBFR and HL conditions, caution should be advised when prescribing BFR exercise for individuals with compromised cardiac or vascular function. Nevertheless, LLBFR and HL exercise were perceived similarly, indicating that BFR training may be viable for healthy older people.

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Section: Discussionsupporting

confidence: 91%

Hemodynamic Responses to Low-Load Blood Flow Restriction and Unrestricted High-Load Resistance Exercise in Older Women

et al. 2018

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“…We previously found among adults with elevated BP who were overweight to obese, a study population like the firefighters in this study, fasting blood glucose explained 6% of the peak SBP to a GEST. In that study, we speculated the presence of hyperglycemia attenuated nitric oxide production possibly contributing to an exaggerated peak SBP response to the GEST [ 50 ]. It appears that caffeine and the cardiometabolic biomarkers that emerged from our linear mixed models could have shifted the vasoactive balance of the endothelium towards vasoconstriction, contributing to the adverse ABP response to vigorous exercise we observed in the firefighters.…”

Section: Discussionmentioning

confidence: 99%

Cardiometabolic Biomarkers and Habitual Caffeine Consumption Associate with the Adverse Ambulatory Blood Pressure Response to Strenuous Physical Exertion among Firefighters

et al. 2022

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Caffeine has beneficial effects on firefighter job performance reducing fatigue and improving psychomotor vigilance. However, excessive caffeine intake may raise blood pressure (BP) following a bout of acute exercise among adults with elevated BP. The influence of caffeine intake on the ambulatory BP (ABP) response to vigorous physical exertion among firefighters has not been studied. In this sub-study we conducted secondary statistical analyses from a larger clinical trial (NCT04514354) that included examining the influence of habitual caffeine intake, and cardiometabolic biomarkers shown to influence BP, on the ABP response following a bout of sudden vigorous exertion over 19 h among firefighters. Previously, we found high amounts of calcium and sodium intake raised BP following a bout of acute exercise among adults with elevated BP. Thus, other secondary aims were to examine the influence of habitual calcium and sodium intake, and cardiometabolic biomarkers have shown to influence BP, on the ABP response following sudden vigorous exertion over 19 h among firefighters. Firefighters (n = 15) completed a Food-Frequency Questionnaire assessing habitual dietary intake over the past year. They randomly completed a maximal graded exercise stress test (GEST) and non-exercise CONTROL on separate non-workdays leaving the laboratory wearing an ABP monitor for 19 h. Prior to and immediately after the GEST, fasting venous blood was collected to measure lipid-lipoproteins, c-reactive protein, and blood glucose. Height and weight were taken to calculate body mass index. Repeated measures ANCOVA tested if the ABP response differed after GEST vs. CONTROL. Linear mixed models examined the relationships among caffeine, calcium, sodium, cardiometabolic biomarkers, and the ABP response following GEST vs. CONTROL. Firefighters were middle-aged (40.2 ± 9.5 year), overweight (29.0 ± 3.9 kg/m2) men with elevated BP (124.1 ± 10.3/79.6 ± 11.5 mmHg) who consumed 542.0 ± 348.9 mg of caffeine/day, about ~50% more than the dietary reference intake. Unexpectedly, systolic ABP was higher by 18.0 ± 6.7 mmHg and diastolic ABP by 9.1 ± 5.4 mmHg (ps < 0.01) over 19 h following GEST vs. CONTROL. We found 24% of the variance in the adverse ABP response to maximal physical exertion was explained by caffeine intake, and when combined with c-reactive protein, non-high-density lipoprotein-cholesterol, body mass index, blood glucose, and resting heart rate, up to 74% of the variability in the ABP response was explained. Additionally, we found calcium (ps < 0.001) and sodium (p < 0.0001) intake each explained up to 24% of the ABP response. Further investigation is needed in a larger, more diverse sample of firefighters to better establish how caffeine contributes to the adverse BP response to strenuous physical exertion.

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“…By contrast EBPR has been repeatedly reported in studies on the general population [3][4][5] as well as in hypertensive patients. [20][21][22][23][24][25] EBPR depends on age, the resting BP level and exercise intensity, and may also depend on increased sympathetic activity, 20,21 endothelial dysfunction and/or large artery stiffness. [22][23][24][25] There is no consensus on its definition.…”

Section: Discussionmentioning

confidence: 99%

“…[20][21][22][23][24][25] EBPR depends on age, the resting BP level and exercise intensity, and may also depend on increased sympathetic activity, 20,21 endothelial dysfunction and/or large artery stiffness. [22][23][24][25] There is no consensus on its definition. In a cohort of 1999 apparently healthy middleaged (40-59 years) Norwegian individuals, 26 EBPR was defined as a systolic BP >200 mm Hg during a bicycle ergometer exercise test and predicted cardiovascular death and myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

Exercise Treadmill Testing in Moderate or Severe Aortic Stenosis: The Left Ventricular Correlates of an Exaggerated Blood Pressure Rise

Saeed

Mancia

Rajani

et al. 2018

JAHA

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Background Exaggerated blood pressure response during exercise predicts future hypertension and cardiovascular events in general population and different patients groups. However, its clinical and prognostic implications in patients with aortic stenosis have not been previously evaluated. Methods and Results We retrospectively studied 301 patients with moderate to severe asymptomatic aortic stenosis (aged 65±12 years) who underwent echocardiography and a modified Bruce exercise treadmill test. An exaggerated blood pressure response was defined as peak systolic blood pressure ≥190 mm Hg. An abnormal blood pressure response (either blunted or exaggerated) was found in 58% of patients and abnormal left ventricular geometry in 82%. There was no difference in the rates of abnormal blood pressure responses between patients with moderate and severe aortic stenosis ([exaggerated blood pressure response: 21% versus 22%, P =0.876] and [blunted blood pressure response: 35% versus 40%, P =0.647]). Patients with exaggerated blood pressure response (21%) were more likely to be older, have hypertension, higher pretest systolic blood pressure, left ventricular ejection fraction and mass, and increased arterial stiffness (all P <0.05). In a multivariate logistic regression analysis, an exaggerated blood pressure response was associated with higher pulse pressure/stroke volume index (odds ratio 2.45, 95% confidence interval 1.02–6.00, P =0.037) and left ventricular mass (odds ratio 2.04, 95% confidence interval 1.23–3.38, P =0.012) independent of age, hypertension, aortic annulus and left atrium diameter, and left ventricular ejection fraction. Conclusions In those with aortic stenosis, exaggerated blood pressure was strongly related to higher resting blood pressure values, left ventricular mass, and increased arterial stiffness independent of hypertension.

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Correlates of endothelial function and the peak systolic blood pressure response to a graded maximal exercise test

Cited by 17 publications

References 27 publications

Hemodynamic Responses to Low-Load Blood Flow Restriction and Unrestricted High-Load Resistance Exercise in Older Women

Hemodynamic Responses to Low-Load Blood Flow Restriction and Unrestricted High-Load Resistance Exercise in Older Women

Cardiometabolic Biomarkers and Habitual Caffeine Consumption Associate with the Adverse Ambulatory Blood Pressure Response to Strenuous Physical Exertion among Firefighters

Exercise Treadmill Testing in Moderate or Severe Aortic Stenosis: The Left Ventricular Correlates of an Exaggerated Blood Pressure Rise

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