Blood Pressure Response and Pulse Arrival Time During Exercise Testing in Well-Trained Individuals

Abstract

Introduction: There is a lack of data describing the blood pressure response (BPR) in well-trained individuals. In addition, continuous bio-signal measurements are increasingly investigated to overcome the limitations of intermittent cuff-based BP measurements during exercise testing. Thus, the present study aimed to assess the BPR in well-trained individuals during a cycle ergometer test with a particular focus on the systolic BP (SBP) and to investigate pulse arrival time (PAT) as a continuous surrogate for SBP during exercise testing.Materials and Methods: Eighteen well-trained male cyclists were included (32.4 ± 9.4 years; maximal oxygen uptake 63 ± 10 ml/min/kg) and performed a stepwise lactate threshold test with 5-minute stages, followed by a continuous test to voluntary exhaustion with 1-min increments when cycling on an ergometer. BP was measured with a standard automated exercise BP cuff. PAT was measured continuously with a non-invasive physiological measurements device (IsenseU) and metabolic consumption was measured continuously during both tests.Results: At lactate threshold (281 ± 56 W) and maximal intensity test (403 ± 61 W), SBP increased from resting values of 136 ± 9 mmHg to maximal values of 219 ± 21 mmHg and 231 ± 18 mmHg, respectively. Linear within-participant regression lines between PAT and SBP showed a mean r2 of 0.81 ± 17.Conclusion: In the present study focusing on the BPR in well-trained individuals, we observed a more exaggerated systolic BPR than in comparable recent studies. Future research should follow up on these findings to clarify the clinical implications of the high BPR in well-trained individuals. In addition, PAT showed strong intra-individual associations, indicating potential use as a surrogate SBP measurement during exercise testing.

Home Blood Pressure in Health and Disease

“…In these participants, additionally, the systolic office-home BP difference was no longer associated with the HbA1c value, P = .793. 137 (18) 139 (17) 133 (18) .002 Diastolic 83 (10) 85 (11) 85 (10) 83 (10) .002…”

“…During weight lifting, systolic BP as high as 480 mmHg has been recorded (5). During aerobic exercise, systolic BP can increase by around 40-60%, from normotensive to between 170 to 220 mmHg (9)(10)(11). In fact, although high systolic BP during and after exercise is associated with incident hypertension and increased cardiovascular risk (12)(13)(14), during maximum aerobic exercise, a low rather than a high peak systolic BP is associated with increased mortality (14).…”

Accuracy of non-invasive cuffless blood pressure in the intensive care unit: Promises and challenges

“…A prototype cuffless BP sensor (cuffless BP device) was used in this study (7)(8)(9). It consists of a one-channel electrocardiogram (ECG) sensor, a photo-plethysmography (PPG) sensor and an inertial measurement unit (3D accelerometer and 3D gyroscope) integrated in a wearable chest belt.…”

“…In addition, non-invasive cuffless BP methods use different approaches such as pulse wave propagation-based measurements (such as pulse arrival time (PAT)) and photo-plethysmography (PPG) waveform features. Studies, including research performed by our multidisciplinary team, have shown strong correlations between PAT and BP, particularly during various exercise methods (5)(6)(7)(8)(9) but its accuracy across differing populations and hemodynamic conditions are uncertain (6). New advances in non-invasive cuffless BP indicate that complex modeling by machine learning methods of sensor-based measurements are key toward improved results (6).…”

Clinical and Prognostic Value of Exaggerated Blood Pressure Response to Exercise

“…In both normotensive and hypertensive individuals, physical exercise, either dynamic or isometric, carried out in the clinical setting for cardiovascular (CV) diagnostics, is associated to significant blood pressure (BP) variations, in particular sharp increments in systolic BP (SBP) and variable changes in diastolic BP (DBP), that may either decrease, increase or remain unchanged [ 1 , 2 ]. In physiological conditions, BP changes during exercise are the result of the rise in cardiac output in response to the increased oxygen demand from working muscles via activation of the adrenergic tone [ 3 , 4 ].…”