Exercise Capacity and 24-h Blood Pressure in Prehypertensive Men and Women

Kokkinos, Peter; Pittaras, Andreas; Manolis, Athanasios; Panagiotakos, Demosthenes B.; Narayan, Puneet; Manjoros, Demitra; Amdur, Richard; Singh, Steven

doi:10.1016/j.amjhyper.2005.07.021

Cited by 50 publications

(31 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It has been postulated that the microvasculature of the brain is particularly vulnerable to the excessive fluctuations in BP, 28 as a consequence of vascular dysfunction 15 and poor CV fitness. 10 The current investigation revealed that higher DBP response to a submaximal exercise test in midlife was associated with smaller brain volume in later life. This evidence complements previous studies supporting the association between exaggerated exercise BP and target organ damage 16,32 or CV events.…”

Section: 31mentioning

confidence: 93%

See 1 more Smart Citation

Midlife exercise blood pressure, heart rate, and fitness relate to brain volume 2 decades later

et al. 2016

View full text Add to dashboard Cite

Objective: To determine whether poor cardiovascular (CV) fitness and exaggerated exercise blood pressure (BP) and heart rate (HR) were associated with worse brain morphology in later life.Methods: Framingham Offspring participants (n 5 1,094, 53.9% female) free from dementia and CV disease (CVD) underwent an exercise treadmill test at a mean age of 40 6 9 years. A second treadmill test and MRI scans of the brain were administered 2 decades later at mean age of 58 6 8 years.Results: Poor CV fitness and greater diastolic BP and HR response to exercise at baseline were associated with a smaller total cerebral brain volume (TCBV) almost 2 decades later (all p , 0.05) in multivariable adjusted models; the effect of 1 SD lower fitness was equivalent to approximately 1 additional year of brain aging in individuals free of CVD. In participants with prehypertension or hypertension at baseline, exercise systolic BP was also associated with smaller TCBV (p , 0.05). Conclusion:Our results suggest that lower CV fitness and exaggerated exercise BP and HR responses in middle-aged adults are associated with smaller brain volume nearly 2 decades later. Promotion of midlife CV fitness may be an important step towards ensuring healthy brain aging. Cardiovascular (CV) fitness is emerging as a factor associated with cognitive health in older age.1,2 Cross-sectional and short-term (2-year) observational studies have demonstrated that lower fitness levels are associated with increased brain atrophy in patients with Alzheimer disease. 3,4 Similarly, healthy elderly individuals with low fitness have increased cerebral white matter hyperintensity volume (WMHV).5 A recent study also reported that higher physical fitness levels in middle-aged adults was associated with larger brain volumes 5 years later. 6Exercise training programs may increase cerebral blood flow and oxygen delivery, 7 improve neuroplasticity, and prevent age-related brain atrophy over the short term, 2,8 but it is not clear whether physical fitness throughout adulthood has an impact on brain aging in later life.Higher CV fitness may also reduce the impact of vascular risk factors 9,10 that are associated with brain structural abnormalities and cognitive decline.11,12 Poor CV fitness and vascular dysfunction exaggerate fluctuations in blood pressure (BP) and heart rate (HR) during lowlevel exercise.13-15 Therefore, the hemodynamic response to low-level exercise may unmask underlying vascular dysfunction and poor CV fitness. Exaggerated exercise hemodynamics has been associated with target organ damage 16 in relation to CV disease (CVD), 17 but the association of midlife exercise hemodynamics and fitness with late-life brain structure has not

show abstract

Section: 31mentioning

confidence: 93%

“…Higher CV fitness may also reduce the impact of vascular risk factors 9,10 that are associated with brain structural abnormalities and cognitive decline. 11,12 Poor CV fitness and vascular dysfunction exaggerate fluctuations in blood pressure (BP) and heart rate (HR) during lowlevel exercise.…”

mentioning

confidence: 99%

Midlife exercise blood pressure, heart rate, and fitness relate to brain volume 2 decades later

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Moderate and high-fit prehypertensive individuals exhibit significantly lower ambulatory BP, 11 exercise BP, and heart rate (HR) at submaximal and absolute workloads 12 when compared with unfit. We also reported significantly lower exercise BP at the absolute submaximal workloads of 3 to 6 METs 13 and LVM 14 in hypertensive patients after 16 weeks of low-to-moderate intensity exercise training.…”

mentioning

confidence: 99%

Exercise Capacity and Blood Pressure Associations With Left Ventricular Mass in Prehypertensive Individuals

et al. 2007

View full text Add to dashboard Cite

Abstract-Prehypertensive individuals are at increased risk for developing hypertension and cardiovascular disease compared with those with normal blood pressure. Early compromises in left ventricular structure may explain part of the increased risk. We assessed echocardiographic and exercise parameters in prehypertensive individuals (nϭ790) to determine associations between exercise blood pressure and left ventricular structure. The exercise systolic blood pressure at 5 metabolic equivalents (METs) and the change in blood pressure from rest to 5 METs were the strongest predictors of left ventricular hypertrophy. We identified the systolic blood pressure of 150 mm Hg at the exercise levels of 5 METs as the threshold for left ventricular hypertrophy. There was a 4-fold increase in the likelihood for left ventricular hypertrophy for every 10-mm Hg increment in systolic blood pressure beyond this threshold 2,3 It is estimated that substantial reductions in hospitalizations, nursing home admissions, and deaths would be realized if prehypertension is eliminated 4 or the progression from prehypertension to hypertension is prevented.The factors involved in the increased risk are not well defined. Prehypertension may mark the beginning of a progressive remodeling of the left ventricle that may go unnoticed for years. Increased left ventricular mass (LVM) is an independent predictor of cardiovascular disease and mortality. 5-7 Naturally, reversing or retarding the rate of progression from prehypertension to hypertension and preventing target-organ injury is desirable.Daytime ambulatory systolic BP is directly associated with LVM and is a stronger predictor of it than resting BP. 8,9 This suggests that the impetus for increased LVM is an elevated hemodynamic load during routine daily activities. Because the metabolic demand of most routine daily activities is within 5 metabolic equivalents (METs), 10 the BP taken during an exercise tolerance test (ETT) at the workload of 5 METs is likely to reflect the hemodynamic load during daily activities. Thus, this exercise BP may be used as a practical and relatively inexpensive predictor of increased risk for left ventricular hypertrophy (LVH) in prehypertensive individuals.Moderate and high-fit prehypertensive individuals exhibit significantly lower ambulatory BP, 11 exercise BP, and heart rate (HR) at submaximal and absolute workloads 12 when compared with unfit. We also reported significantly lower exercise BP at the absolute submaximal workloads of 3 to 6 METs 13 and LVM 14 in hypertensive patients after 16 weeks of low-to-moderate intensity exercise training. Collectively, these findings support that moderate increases in cardiorespiratory fitness may result in lower BP, HR, and hemodynamic

show abstract

“…The level of decreased coronary risk attributable to regular physical activity is similar to that of other lifestyle factors such as avoiding cigarette smoking or Mediterranean diet. The risk of CVD (including CHD and stroke) or CHD alone is significantly reduced in more physically active or fitter persons, with a relative risk reduction nearly twice as great for cardiorespiratory fitness (CFR) than for physical activity increase at all percentiles (Kokkinos et al, 2006, Kokkinos et al, 2016. A possible explanation for the stronger dose-response gradient for fitness than for physical activity is that fitness is measured objectively, whereas physical activity is assessed by self-reports and questionnaires that may lead to misclassification and bias towards finding weaker physical activity or health benefit associations (Moore et al, 2012).…”

Section: Sedentary Lifestylementioning

confidence: 99%

Physical activity, physical fitness and prevention: Role for the working population

Löllgen¹,

Zupet²,

Bachl³

2017

Zdravje Delovno Aktivne Populacije / Health of the Working-Age Population

View full text Add to dashboard Cite

Introduction: Physical inactivity and increasing daily screen time is an emerging health problem within the working population as well in the general population worldwide. This is called the exercise deficiency syndrom (EDS).On the other hand a large number of single studies as well of meta-analysis strongly support the positive health effects of regular physical activity. Discussion: Regular physical activity (PA) is now widely accepted as one of the most important factors to maintain or improve health and to prevent numerous non-communicable diseases. PA reduces risks of all-cause-and cardiovascular morbidity, mortality. Therefore, PA is a cornerstone in prevention and therapy of many diseases thus improving quality of life and longevity. PA also counteracts the effects of sitting time and sedentary lifestyle (EDS). PA acts like a drug: there are many indications, a non-linear doseresponse curve, many somatic and psychosomatic effects, few side effects and contraindications. Similar results can be observed for physical fitness assessed by maximal watt or Vo2 max in exercise testing. PA therefore is the real polypill for prevention and therapy of many diseases. Conclusion: There is now a general agreement and convincing evidence that regular PA including daily life activities are essentials for maintaining health in the working age population. For staying health and preserving health, everybody should reduce or avoid the four main risk factors: no smoking, regular PA, healthy diet and normal body weight.

show abstract

Exercise Capacity and 24-h Blood Pressure in Prehypertensive Men and Women

Cited by 50 publications

References 39 publications

Midlife exercise blood pressure, heart rate, and fitness relate to brain volume 2 decades later

Midlife exercise blood pressure, heart rate, and fitness relate to brain volume 2 decades later

Exercise Capacity and Blood Pressure Associations With Left Ventricular Mass in Prehypertensive Individuals

Physical activity, physical fitness and prevention: Role for the working population

Contact Info

Product

Resources

About