Early blood pressure response to isometric exercise is attenuated in obese individuals who have undergone bariatric surgery

Abstract

Blood pressure (BP) reactivity is predictive of the development of cardiovascular disease. We hypothesized that the BP response at the onset of isometric handgrip exercise would occur earlier and to a lesser degree in individuals who underwent bariatric surgery compared with obese adults and that the reliance on total peripheral resistance (TPR) would be attenuated. Twenty-six individuals (7 nonobese, 11 obese, 8 postbariatric surgery) completed isometric handgrip exercise (40% maximum voluntary contraction) to exhaustion. Heart rate (HR, ECG) and arterial BP (brachial catheter) were measured continuously. Stroke volume was estimated from the pressure waveform, and cardiac output (CO) and TPR were calculated. Peak change, time to peak, and rate of rise in BP were assessed during the first 30 s of exercise. Obese adults exhibited a slower rise in BP and higher peak BP at exercise onset compared with nonobese controls ( P < 0.05). Peak BP and the rate of rise were not different between individuals who underwent bariatric surgery and nonobese controls ( P > 0.05). Nonobese controls exhibited an exercise-mediated increase in CO, whereas obese adults increased TPR ( P < 0.05). The increases in CO and TPR were less apparent in individuals who underwent bariatric surgery ( P > 0.05). In contrast to obese adults, individuals who underwent bariatric surgery exhibit a rapid rise in BP at exercise onset. This rapid increase in BP is associated with a fall in TPR and results in lower peak BP at the onset of isometric exercise. These data suggest that bariatric surgery improves BP reactivity via changes in the time course of hemodynamic responses. NEW & NOTEWORTHY Bariatric surgery has been shown to reduce the blood pressure (BP) response to isometric handgrip exercise. By examining the time course of the BP response to exercise, we found, in contrast to obese adults, individuals who underwent bariatric surgery exhibit a rapid rise in BP at exercise onset, which is associated with a fall in total peripheral resistance and results in lower peak BP at the onset of isometric exercise. These data suggest that bariatric surgery improves BP reactivity via reflex autonomic adjustments.

Orthostatic intolerance after bariatric surgery: A systematic review and meta‐analysis

“…All potential sources of bias, including selection bias, performance bias, detection bias and information bias, were assessed (Table 2). Eleven studies 19,21,22,24,25,27,29,32–35 had a low risk of bias, 7 studies 10,12,18,20,26,30,31 had a moderate risk of bias and 2 studies had a high risk of bias 23,28 …”

Effect of bariatric surgery on blood pressure response to exercise in a severely obese population

“…To our knowledge, this is the first study examining the impact of bariatric surgery on the blood pressure response to maximal exercise and its main determinants prior and after the surgery. It was demonstrated that after Roux-en-Y bypass, patients tended to have lower ΔSBP during a static exercise (handgrip) in comparison with the control group [16]. Moreover, de Sousa et al .…”

Aging exaggerates blood pressure response to ischemic rhythmic handgrip exercise in humans

“…2, the primary experiment, was performed to observe the BP and HR responses to 1 min of PWM, and subsequently, 1 min of RHG exercise after a 1‐min rest period during the 3 min period of PEMI (Figure 1 ). Finally, we also examined whether age remained a significant, independent determinant of pressor responses to ischemic exercise using a multivariate analysis, because some clinical parameters are known to affect cardiovascular response to exercise, for example, sex (Smith et al, 2019 ; Trinity et al, 2018 ), body mass index (BMI) (Limberg et al, 2018 ), and arterial stiffness (Thanassoulis et al, 2012 ).…”