Blood pressure determinants of left ventricular wall thickness and mass index in hypertension: comparing office, ambulatory and exercise blood pressures

Lim, Pin; Donnan, PT; MacDonald, TM

doi:10.1038/sj.jhh.1001229

Cited by 24 publications

(14 citation statements)

References 45 publications

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“…Excessive blood pressure elevation during physical exertion has been shown to contribute to impaired exercise tolerance in hypertensive patients even in the absence of coronary artery disease or left ventricular dysfunction (9,29,33,50). Furthermore, numerous epidemiological studies have demonstrated that exercise blood pressure predicts the pathogenesis of left ventricular hypertrophy, stroke, myocardial infarction, and death (12,23,27,28,65) independent of resting ABP. Accordingly, current safety guidelines prohibit exercise in hypertensive patients if exertional ABP reaches or exceeds 220/105 (15,51).…”

Section: Perspectives and Clinical Significancementioning

confidence: 99%

Dynamic exercise training prevents exercise pressor reflex overactivity in spontaneously hypertensive rats

Mizuno

Iwamoto

Vongpatanasin

et al. 2015

American Journal of Physiology-Heart and Circulatory Physiology

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Mizuno M, Iwamoto GA, Vongpatanasin W, Mitchell JH, Smith SA. Dynamic exercise training prevents exercise pressor reflex overactivity in spontaneously hypertensive rats. Am J Physiol Heart Circ Physiol 309: H762-H770, 2015. First published July 10, 2015; doi:10.1152/ajpheart.00358.2015.-Cardiovascular responses to exercise are exaggerated in hypertension. We previously demonstrated that this heightened cardiovascular response to exercise is mediated by an abnormal skeletal muscle exercise pressor reflex (EPR) with important contributions from its mechanically and chemically sensitive components. Exercise training attenuates exercise pressor reflex function in healthy subjects as well as in heart failure rats. However, whether exercise training has similar physiological benefits in hypertension remains to be elucidated. Thus we tested the hypothesis that the EPR overactivity manifest in hypertension is mitigated by exercise training. Changes in mean arterial pressure (MAP) and renal sympathetic nerve activity (RSNA) in response to muscle contraction, passive muscle stretch, and hindlimb intra-arterial capsaicin administration were examined in untrained normotensive Wistar-Kyoto rats (WKY UT; n ϭ 6), exercise-trained WKY (WKYET; n ϭ 7), untrained spontaneously hypertensive rats (SHR UT; n ϭ 8), and exercise-trained SHR (SHRET; n ϭ 7). Baseline MAP after decerebration was significantly decreased by 3 mo of wheel running in SHR ET (104 Ϯ 9 mmHg) compared with SHR UT (125 Ϯ 10 mmHg). As previously reported, the pressor and renal sympathetic responses to muscle contraction, stretch, and capsaicin administration were significantly higher in SHR UT than WKYUT. Exercise training significantly attenuated the enhanced contraction-induced elevations in MAP (SHR UT: 53 Ϯ 11 mmHg; SHR ET: 19 Ϯ 3 mmHg) and RSNA (SHRUT: 145 Ϯ 32%; SHRET: 57 Ϯ 11%). Training produced similar attenuating effects in SHR during passive stretch and capsaicin administration. These data demonstrate that the abnormally exaggerated EPR function that develops in hypertensive rats is significantly diminished by exercise training. exercise pressor reflex; blood pressure; sympathetic nerve activity; hypertension; exercise training NEW & NOTEWORTHYThe study demonstrates that the exercise pressor reflex overactivity manifest in hypertension is attenuated by dynamic exercise training. Moreover, training normalizes the dysfunction of the mechanically and chemically sensitive components of the reflex. These findings identify a novel mechanism by which exercise training is beneficial in the treatment of hypertension.

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Section: Perspectives and Clinical Significancementioning

confidence: 99%

Dynamic exercise training prevents exercise pressor reflex overactivity in spontaneously hypertensive rats

Mizuno

Iwamoto

Vongpatanasin

et al. 2015

American Journal of Physiology-Heart and Circulatory Physiology

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“…In contrast to peak exercise BP, which is highly effort-dependent and affected by fitness level, exercise BP measured during sub-maximal exercise represents a physiological response to low-to-moderate physical activity that is closely correlated with ambulatory BP, 11 mean daily BP and end-organ damage. 12 Understanding the clinical and vascular correlates of exercise BP response to moderate exercise may provide mechanistic insights into the development of hypertension, left ventricular hypertrophy (LVH) and CVD.…”

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confidence: 99%

Relations of Exercise Blood Pressure Response to Cardiovascular Risk Factors and Vascular Function in the Framingham Heart Study

et al. 2012

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Background Exercise blood pressure (BP) is an important marker of left ventricular hypertrophy, incident hypertension and future cardiovascular events. Although impaired vascular function is hypothesized to influence the BP response during exercise, limited data exist on the association of vascular function with exercise BP in the community. Methods and Results Framingham Offspring cohort participants (n=2115, 53% women, mean age 59 years) underwent a submaximal exercise test (first 2 stages of the Bruce protocol), applanation tonometry and brachial artery flow-mediated dilation (FMD) testing. We related exercise systolic and diastolic BP at second stage of the Bruce protocol to standard cardiovascular risk factors and to vascular function measures. In multivariable linear regression models, exercise systolic BP was positively related to age, standing BP, standing heart rate, smoking, body mass index, and the total cholesterol-to-high-density cholesterol (HDL) ratio (p≤0.01 for all). Similar associations were observed for exercise diastolic BP. Carotid-femoral pulse wave velocity (p=0.02), central pulse pressure (p<0.0001), mean arterial pressure (p=0.04) and baseline brachial flow (p=0.002) were positively associated with exercise systolic BP, whereas FMD was negatively associated (P<0.001). For exercise diastolic BP, forward pressure wave amplitude was negatively related (p<0.0001) whereas mean arterial pressure was positively related (p<0.0001). Conclusions Increased arterial stiffness and impaired endothelial function are significant correlates of a higher exercise systolic BP response. Our findings suggest that impaired vascular function may contribute to exaggerated BP responses during daily living, resulting in repetitive increments in load on the heart and vessels and increased cardiovascular disease risk.

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“…Adding to this list, our study demonstrated that dietary Pi excess detrimentally affects the sympathetic regulation of BP during exercise by potentiating the function of both the muscle mechanoreflex and metaboreflex, the two major components of the EPR and, in doing so, may contribute to the pathogenesis of Pi-induced hypertension. Just as important, numerous epidemiological studies have demonstrated that exercise BP predicts subsequent development of stroke, myocardial infarction, and death (20,23,24,47), independent of resting BP.…”

Section: Discussionmentioning

confidence: 99%

High dietary phosphate intake induces hypertension and augments exercise pressor reflex function in rats

Mizuno

Mitchell

Crawford

et al. 2016

American Journal of Physiology-Regulatory, Integrative and Comp

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An increasing number of studies have linked high dietary phosphate (Pi) intake to hypertension. It is well established that the rise in sympathetic nerve activity (SNA) and blood pressure (BP) during physical exertion is exaggerated in many forms of hypertension, which are primarily mediated by an overactive skeletal muscle exercise pressor reflex (EPR). However, it remains unknown whether high dietary Pi intake potentiates the EPR-mediated SNA and BP response to exercise. Accordingly, we measured renal SNA (RSNA) and mean BP (MBP) in normotensive Sprague-Dawley rats fed a normal Pi diet (0.6%, n = 13) or high Pi diet (1.2%, n = 13) for 3 mo. As previously reported, we found that resting BP was significantly increased by 1.2% Pi diet in both conscious and anesthetized animals. Activation of the EPR by electrically induced hindlimb contraction triggered greater increases in ΔRSNA and ΔMBP in the 1.2% compared with 0.6% Pi group (126 ± 25 vs. 42 ± 9%; 44 ± 5 vs. 14 ± 2 mmHg, respectively, P < 0.01). Activation of the muscle mechanoreflex, a component of the EPR, by passively stretching hindlimb muscle also evoked greater increases in ΔRSNA and ΔMBP in the 1.2% compared with 0.6% Pi group (109 ± 27 vs. 24 ± 7%, 38 ± 7 vs. 8 ± 2 mmHg, respectively, P < 0.01). A similar response was produced by hindlimb intra-arterial capsaicin administration to stimulate the metaboreflex arm of the EPR. Thus, our data demonstrate a novel action of dietary Pi loading in augmenting EPR function through overactivation of both the muscle mechanoreflex and metaboreflex.

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Blood pressure determinants of left ventricular wall thickness and mass index in hypertension: comparing office, ambulatory and exercise blood pressures

Cited by 24 publications

References 45 publications

Dynamic exercise training prevents exercise pressor reflex overactivity in spontaneously hypertensive rats

Dynamic exercise training prevents exercise pressor reflex overactivity in spontaneously hypertensive rats

Relations of Exercise Blood Pressure Response to Cardiovascular Risk Factors and Vascular Function in the Framingham Heart Study

High dietary phosphate intake induces hypertension and augments exercise pressor reflex function in rats

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