Relationship of ambulatory arterial stiffness index with blood pressure response to exercise in the early stages of hypertension

Abstract

EBPR constitutes a sign of premature cardiovascular stiffening in the setting of uncomplicated hypertension. The close relationship between EBPR and PWV but not AASI enhances the concept of PWV as a superior measure of arterial stiffness and constitutes an important factor in the interpretation of EBPR-linked cardiovascular risk.

Insulin Resistance, Low Cardiorespiratory Fitness, and Increased Exercise Blood Pressure

“…Previous studies have shown that arterial stiffness is associated with an exaggerated BP response to exercise, obesity, IR, 30 and poor CRF. 12,31 One factor typically observed in individuals with IR and/or abdominal fat accumulation is a decrease in NO bioavailability, which could be the result of increased blood glucose and free fatty acid concentrations and an increased superoxide production by adipocytes. 32 This impairment could also be related to inflammation with visceral fat producing several proinflammatory cytokines 14 or the result of an inappropriately elevated cyclic GMP stimulated by NO, therefore impairing vasodilation.…”

“…11 However, the specific contribution of abdominal adiposity to exercise BP (after control for relevant covariates, including CRF) remains unclear, but some authors have suggested that this relationship could be related to arterial stiffness, a phenomenon caused by inflammation. [12][13][14] Although some studies have suggested an association between insulin resistance (IR) and an increase in BP during exercise, 15 discordant findings have been reported in the literature. For instance, some have observed a strong relationship between IR and exercise BP, 12,16 and others have reported modest increases in exercise DBP with increases in IR.…”

“…[12][13][14] Although some studies have suggested an association between insulin resistance (IR) and an increase in BP during exercise, 15 discordant findings have been reported in the literature. For instance, some have observed a strong relationship between IR and exercise BP, 12,16 and others have reported modest increases in exercise DBP with increases in IR. 13 One study has, however, observed a relationship among IR, CRF, and obesity (evaluated with BMI and waist:hip ratio) in men with type 2 diabetes mellitus and found an independent association between IR and SBP response to exercise.…”

The relationship between arterial stiffness and increase in blood pressure during exercise in normotensive persons

“…Although Tsiachris et al [12] reported that exaggerated BP response during exercise is associated with increased arterial stiffening in untreated hypertensive patients, there has been no such study in the normotensive (BP < 120/80 mmHg) population. Because the normotensive population with exaggerated BP response during exercise represents those with higher risk of future development of hypertension, finding of increased arterial stiffness in this group would suggest that arterial stiffness may precede the development of hypertension or at least be present at the very early stage of hypertension.…”

Impact of multi-electrode renal sympathetic denervation on short-term blood pressure variability in patients with drug-resistant hypertension. Insights from the EnligHTN I study

“…Ambulatory arterial stiffness index (AASI) was calculated as 1 minus this regression slope, as previously described [18]. AASI quantifies the combined short term variations of DBP and SBP, which may partly reflect the degree of arterial stiffness, but which is also affected by the circadian changes in BP.…”