The Exercise Pressor Reflex and Changes in Radial Arterial Pressure and Heart Rate During Walking in Patients with Arteriosclerosis Obliterans

Baccelli, G; Reggiani, P.; Mattioli, A.; Corbellini, Ezio; Garducci, Stefano; Catalano, M

doi:10.1177/000331979905000502

Cited by 93 publications

(44 citation statements)

References 13 publications

(2 reference statements)

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“…These results suggest that cardiovascular responses during constant load exercise are exaggerated in patients with PAD. Previous studies have shown that cardiovascular responses during constant load exercise are greater in PAD patients than in healthy subjects (3, 4). In addition, changes in HR and BP described in subjects with left ventricular dysfunction (2) were lower than the ones observed in this study.…”

Section: Discussionmentioning

confidence: 97%

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Cardiovascular Responses to Walking in Patients with Peripheral Artery Disease

Ritti‐Dias

Menêses

Parker

et al. 2011

Medicine &Amp; Science in Sports &Amp; Exercise

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Purposes To assess the cardiovascular responses during constant load walking and to identify predictors of this response in peripheral artery disease (PAD) patients. Methods Seventy-nine patients with PAD performed a constant load treadmill test (2 mph, 0% grade). During the test, systolic blood pressure (BP), diastolic BP, and heart rate (HR) were obtained at the fourth minute to the last minute of exercise. Patients were also characterized on demographic measures, cardiovascular risk factors, baseline exercise performance and vascular measures. Results During constant load walking, there was a significant increase (p<0.01) in systolic BP (+12 ± 10 mmHg), diastolic BP (+6 ± 9 mmHg), and HR (+5 ± 5 bpm). The HR responses was negatively correlated with ischemic window (r= −0.23; p<0.05), expressed as an area under the curve of the resting ankle systolic BP and its recovery from maximal graded treadmill test, and positively correlated with the HR during the first minute of recovery from maximal graded treadmill test (r= 0.27; p<0.05). The increase in cardiovascular variables during constant load walking was greater in subjects with higher body mass index and in men (p<0.05). Conclusion Patients with PAD had an increased cardiovascular response during constant load walking, and these responses were greater in obese patients and in men. The clinical implication is that PAD patients engaged in walking training programs, particularly men and those with obesity, require frequent assessment of cardiovascular parameters to avoid exaggerated increases in BP and HR during constant load walking.

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Section: Discussionmentioning

confidence: 97%

“…Cardiovascular responses during walking are altered in patients with PAD(3, 5). Previous studies have reported that blood pressure (BP) and heart rate (HR) both increase during constant load exercise in patients with PAD, but not in age matched controls(5).…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Responses to Walking in Patients with Peripheral Artery Disease

Ritti‐Dias

Menêses

Parker

et al. 2011

Medicine &Amp; Science in Sports &Amp; Exercise

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show abstract

“…PAD affects 8 to 12 million people in the United States, and those people are at a high risk for myocardial infarction and stroke (Criqui et al, 1992, Hirsch et al, 2001). PAD reduces blood flow to working skeletal muscle and results in an augmented blood pressure response to dynamic exercise that is thought to be caused in part by an exaggerated exercise pressor reflex (Baccelli et al, 1999, Bakke et al, 2007), part of which is thought to be evoked by mechanoreceptors (Muller et al, 2012). Oxidative stress has also been shown to play a role in the exaggerated pressor reflex in PAD.…”

Section: Exercise Pressor Reflex In Pad Patientsmentioning

confidence: 99%

The exercise pressor reflex and peripheral artery disease

Stone

Kaufman

2015

Autonomic Neuroscience

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The exercise pressor reflex contributes to increases in cardiovascular and ventilatory function during exercise. These reflexive increases are caused by both mechanical and metabolic stimulation of Group III and IV afferents with endings in contracting skeletal muscle. Patients with peripheral artery disease (PAD) have an augmented exercise pressor reflex. Recently, an animal model of PAD was established which allows further investigation of possible mechanisms involved in this augmented reflex. Earlier studies have identified ASIC3 channels, bradykinin receptors, P2X receptors, endoperoxide receptors, and thromboxane receptors as playing a role in evoking the exercise pressor reflex in healthy rats. This review focuses on recent studies using a rat model of PAD in order to determine possible mechanisms contributing to the exaggerated exercise pressor reflex seen in patients with this disease.

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“…The submaximal exercise task was not only more challenging metabolically for those with diabetes, but it also elicited a more exaggerated cardiovascular response, measured by a higher systolic blood pressure during ambulation than compared to the non-diabetic controls. It is possible that the higher exercise systolic blood pressure in participants with type 2 diabetes was related to greater endothelial dysfunction [22] or greater activation of the pressor reflex [23]. …”

Section: Discussionmentioning

confidence: 99%

Walking Economy is Impaired in Older Men and Women with Type 2 Diabetes

2016

IJDVR

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Objective We compared the walking economy in older participants with and without type 2 diabetes. Methods Walking economy was determined in 115 older participants with type 2 diabetes and 130 older control participants without diabetes by continuously measuring oxygen uptake during a treadmill test in which the work rate was at a constant speed of 2 mph and a grade of 0% for a duration of 10 minutes. Participants also completed a Balke treadmill protocol for the determination of peak oxygen uptake, defined as the highest oxygen uptake value attained during the final work stage attained. Fractional utilization was then calculated as the walking economy oxygen uptake divided by peak oxygen uptake, expressed as a percentage. Results Compared to those without diabetes, participants with type 2 diabetes were older (p=0.042), had higher prevalence of men (p=0.034), obesity (p=0.010), chronic kidney disease (p=0.020), peripheral artery disease (p=0.024), and had a higher body mass index (p=0.025), and waist/hip ratio (p=0.006). After adjusting for these variables, the participants with diabetes had higher walking economy (p<0.001), fractional utilization (p<0.001), and lower peak oxygen uptake (p<0.001) than those without diabetes (p<0.001). Conclusions Older men and women with type 2 diabetes are less economical when they ambulate at a given speed than compared to control participants without diabetes, independent of their greater co-morbid burden. The impaired walking economy in the diabetic participants is further magnified by their lower aerobic fitness, thereby leading to a higher fractional utilization of oxygen consumed during a given walking task.

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The Exercise Pressor Reflex and Changes in Radial Arterial Pressure and Heart Rate During Walking in Patients with Arteriosclerosis Obliterans

Cited by 93 publications

References 13 publications

Cardiovascular Responses to Walking in Patients with Peripheral Artery Disease

Cardiovascular Responses to Walking in Patients with Peripheral Artery Disease

The exercise pressor reflex and peripheral artery disease

Walking Economy is Impaired in Older Men and Women with Type 2 Diabetes

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