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

Würzburger, Laura; Wiech, Patrick; Rossi, Valentina A.; Neunhäuser, Daniel; Caselli, Stefano; Schmied, Christian; Niederseer, David

doi:10.1155/2022/8476751

Cited by 6 publications

(1 citation statement)

References 47 publications

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“…Such an approach could leverage novel avenues such as virtual reality exergames ( 826 , 827 ). Insights into exercise physiology are leveraged in disease diagnostic, prevention, treatment, and rehabilitation, e.g., the use of blood pressure measurements during exercise (exercise hypertension) to reveal undiagnosed or masked hypertension and predict cardiovascular disease risks ( 828 , 829 ). Many more areas exist in which concepts derived from elite sports will benefit non-athletes and patients ( 822 ).…”

Section: Summary Conclusion and Perspectivesmentioning

confidence: 99%

The molecular athlete: exercise physiology from mechanisms to medals

Furrer

Hawley

Handschin

2023

Physiological Reviews

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Human skeletal muscle demonstrates remarkable plasticity, adapting to numerous external stimuli including the habitual level of contractile loading. Accordingly, muscle function and exercise capacity encompass a broad spectrum, from inactive individuals with low levels of endurance and strength, to elite athletes who produce prodigious performances underpinned by pleiotropic training-induced muscular adaptations. Our current understanding of the signal integration, interpretation and output coordination of the cellular and molecular mechanisms that govern muscle plasticity across this continuum is incomplete. As such, training methods and their application to elite athletes largely rely on a "trial and error" approach with the experience and practices of successful coaches and athletes often providing the bases for "post hoc" scientific enquiry and research. This review provides a synopsis of the morphological and functional changes along with the molecular mechanisms underlying exercise adaptation to endurance- and resistance-based training. These traits are placed in the context of innate genetic and inter-individual differences in exercise capacity and performance, with special considerations given to the ageing athletes. Collectively, we provide a comprehensive overview of skeletal muscle plasticity in response to different modes of exercise, and how such adaptations translate from "molecules to medals".

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Section: Summary Conclusion and Perspectivesmentioning

confidence: 99%

The molecular athlete: exercise physiology from mechanisms to medals

Furrer

Hawley

Handschin

2023

Physiological Reviews

View full text Add to dashboard Cite

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Effect of a Hypertensive Response During Exercise on Growth Rates of Aortic Diameters

van der Stouwe,

Rossi,

Ghidoni

et al. 2024

American Journal of Hypertension

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Background Aortic diameters are related to age, sex, and body size. There are a scarcity of data on the long-term sequelae of a hypertensive response to exercise (HRE) on aortic diameters. In this retrospective cohort study, we aimed to evaluate the relationship between the growth rates of the aorta in individuals with a HRE. Methods Our analysis included follow-up data of 649 patients recruited between January 2009 and December 2014 with a HRE. Participants with known connective tissue disease or a history of acute aortic syndrome were excluded. Sinus of Valsalva (SoV) and ascending aorta (AscAo) diameters were measured by transthoracic echocardiography using leading edge to leading edge convention at end-diastole. Results At baseline, median age, maximum systolic blood pressure (BP), body mass index (BMI), diameter of the SoV, and AscAo were 62 years, 208 mmHg, 26.9 kg/m2, 35 mm, and 35 mm respectively. 32% of patients were female and 67% had hypertension. After a median follow-up of 7.1 years, mean yearly growth rates (±SD) of the SoV and AscAo were 0.09 (0.41) mm and 0.13 (0.56) mm respectively. No significant associations were observed between growth rates of aortic diameters and maximum systolic and diastolic BP or when considering only individuals with a baseline diameter > 40mm. Conclusion In this large cohort study, maximum systolic and diastolic BP during exercise showed no association with growth rates of aortic diameters. Furthermore, the mean growth rates of aortic diameters in this population were in line with growth rates in a normal population.

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Blood pressure response during exercise testing in individuals with and without hypertension: The value of the recovery phase

Ghidoni,

van der Stouwe,

Würzburger

et al. 2024

Eur J Clin Investigation

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BackgroundHypertension and exercise testing are essential for cardiovascular risk assessment. However, an exact description of blood pressure (BP) in patients with a hypertensive response during exercise (HRE), especially in the recovery phase is lacking. Herein, we aimed to analyse BP and heart rate during exercise testing and recovery in patients with an HRE.Methods800 patients aged 17–90 with an HRE during a standardized bicycle ergometry test were recruited. The BP behaviour during exercise testing was correlated with clinical data. Furthermore, data were analysed according to the presence of pre‐existent hypertension.ResultsOf the 800 patients included in this study 497 (62%) were previously diagnosed with hypertension. Analysis of covariance showed a significantly faster systolic (β [95% CI] 8.0 [4.9–11.1]) and diastolic (2.4 [0.4–4.4]) BP recovery 3 min after maximal exercise in patients without hypertension in univariable models. These results remained robust in fully adjusted models taking into account age, sex, body mass index, cardiovascular disease, and antihypertensive treatment for systolic (5.3 [1.2–9.4]) and diastolic BP (4.5 [1.9–7.0]). Furthermore, patients with hypertension displayed higher systolic BP during maximal exercise in univariable (3.8 [0.1–7.5]) and fully adjusted (5.5 [1.1–10.0]) models. There was no difference in maximum diastolic BP between groups.ConclusionIn this large cohort study, patients without hypertension showed a faster systolic and diastolic BP recovery and lower maximal systolic BP compared to patients with hypertension. Overall, this study provides new insights into cardiovascular health during recovery phase.

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

Cited by 6 publications

References 47 publications

The molecular athlete: exercise physiology from mechanisms to medals

The molecular athlete: exercise physiology from mechanisms to medals

Effect of a Hypertensive Response During Exercise on Growth Rates of Aortic Diameters

Blood pressure response during exercise testing in individuals with and without hypertension: The value of the recovery phase

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