Increased mean arterial pressure response to dynamic exercise in normotensive subjects with multiple metabolic risk factors

Abstract

Metabolic syndrome (MS) may influence vascular reactivity and might cause an excessive increase in blood pressure (BP) during dynamic exercise. We examined this hypothesis in 698 normotensive men (mean age: 43 years) free of cardiovascular disease, diabetes mellitus and renal disease. The response of BP to exercise was assessed by the mean arterial pressure (MAP) during bicycle ergometry. The MAP values were expressed as z-scores normalized to the relative increases in heart rate. High-normal BP, dyslipidemia and hyperglycemia were diagnosed according to the Japan-specific MS criteria. The z-score of MAP was significantly higher in subjects with high-normal BP (+0.57, P<0.001), dyslipidemia (+0.18, P<0.001) and hyperglycemia (+0.24, P<0.001) than in those without MS component (-0.38). In the high-normal BP subjects, the addition of dyslipidemia and/or hyperglycemia was associated with a progressive increase in the z-score of exercise MAP, whereas no such association was observed in the normal-BP subjects (P=0.033, two-way ANOVA). Multivariate regression analysis revealed that a greater number of MS components (β=0.102, P=0.010) was an independent determinant of increased MAP z-score after adjustment for potential confounders, including age (β=0.123, P<0.001), body mass index (β=0.145, P<0.001) and high-normal BP (β=0.410, P<0.001). These results suggest that accumulation of MS components may alter vascular structure and function and lead to the significant elevation of MAP during dynamic exercise even before clinical manifestation of arterial hypertension.

Mechanical and metabolic reflex activation of the sympathetic nervous system in younger adults with metabolic syndrome

“…These discrepancies may be due, at least in part, to the presence and/or absence of overt MetSyn. Consistent with this concept, the individual components of the MetSyn fail to predict exaggerated blood pressure responses to whole-body exercise independent of the presence of MetSyn (Miyai et al, 2013; Tsioufis et al, 2012). To investigate potential mechanisms underlying exaggerated blood pressure responses to whole-body exercise in MetSyn, we tested the hypothesis that young adults with MetSyn would exhibit augmented sympathetic and pressor responses to mechanoreflex and metaboreflex activation when compared with healthy, age-matched control subjects.…”

“…Based on reports of exaggerated blood pressure responses to exercise in patients with metabolic syndrome (MetSyn) (Miyai et al, 2013; Tsioufis et al, 2012), it is reasonable to speculate sympathetic nervous system activation during metabo- and mechanoreflex stimulation might be exaggerated as well. This augmented pressor response, if present, could negate the beneficial effects of exercise in this population, for whom exercise is recommended as a non-pharmacological strategy for improving fitness and reducing cardiovascular risk.…”

Exercise may be detrimental in hypertension: too much of a good thing!

“…The data from this study suggest that strenuous exercise should be limited in frequency (2-3 times per week), whereas moderate exercise (no sweating) had a maximal impact if performed 4-6 times per week. 11 Sex differences may exist, 12 but more importantly, patients with metabolic risk factors are prone to larger pressure increases during exercise 13 and may be more susceptible to harmful effects. Defining the fine line between the beneficial and detrimental effects of exercise seems to be crucial, but precisely defining the location of this line is extremely difficult to achieve.…”

Exaggerated haemodynamic and neural responses to involuntary contractions induced by whole‐body vibration in normotensive obese versus lean women

“…More specifically, normotensive individuals with obesity often exhibit exaggerated blood pressure (BP) responses during incremental exercise testing and altered heart rate (HR) responses to voluntary dynamic and isometric exercise (Byrne & Hills, 2002;Gondoni et al 2009;Vella et al 2009). Although these alterations have been associated with the development of future hypertension (Miyai et al 2013), the underlying mechanisms are not fully elucidated.…”

“…Individuals with obesity demonstrate alterations in cardiovascular responses during exercise compared with individuals of normal weight (Miyai et al 2013). More specifically, normotensive individuals with obesity often exhibit exaggerated blood pressure (BP) responses during incremental exercise testing and altered heart rate (HR) responses to voluntary dynamic and isometric exercise (Byrne & Hills, 2002;Gondoni et al 2009;Vella et al 2009).…”