Blood Pressure Response and Vascular Function of Professional Athletes and Controls

Abstract

Workload-indexed blood pressure response (wiBPR) to exercise has been shown to be superior to peak systolic blood pressure (SBP) in predicting mortality in healthy men. Thus far, however, markers of wiBPR have not been evaluated for athletes and the association with vascular function is unclear. We examined 95 male professional athletes (26±5 y) and 30 male controls (26±4 y). We assessed vascular functional parameters at rest and wiBPR with a graded bicycle ergometer test and compared values for athletes with those of controls. Athletes had a lower pulse wave velocity (6.4±0.9 vs. 7.2±1.5 m/s, p=0.001) compared to controls. SBP/Watt slope (0.34±0.13 vs. 0.44±0.12 mmHg/W), SBP/MET slope (6.2±1.8 vs. 7.85±1.8 mmHg/MET) and peak SBP/Watt ratio (0.61±0.12 vs. 0.95±0.17 mmHg/W) were lower in athletes than in controls (p<0.001). The SBP/Watt and SBP/MET slope in athletes were comparable to the reference values, whereas the peak SBP/Watt-ratio was lower. All vascular functional parameters measured were not significantly correlated to the wiBPR in either athletes or controls. In conclusion, our findings indicate the potential use of the SBP/Watt and SBP/MET slope in pre-participation screening of athletes. Further, vascular functional parameters, measured at rest, were unrelated to the wiBPR in athletes and controls.

Systolic Blood Pressure Response to Exercise in Endurance Athletes in Relation to Oxygen Uptake, Work Rate and Normative Values

“…During pre-participation evaluation of athletes, resting SBP has been found to exceed the threshold for hypertension (140 mm Hg) in about 3–8% of examined athletes [ 22 , 23 ], recognizing a need to account for hypertension in the athletic population as well. Although athletes often undergo exercise testing during their career, the SBP response to exercise in athletes has not gained attention until recently [ 6 ], and data on the work rate-indexed SBP blood pressure response in athletes are scarce [ 11 , 12 , 21 ]. Ultimately, better understanding of the blood pressure physiology in athletes could guide physicians in discriminating a pathological blood pressure response, possibly implying an increased risk of hypertension [ 24 ] or other cardiovascular disease, from a physiologically high exercise SBP.…”

“…Second, using the same rationale, the SBP/VO 2 slope was calculated by dividing the increment in SBP by the difference in VO 2 , i.e., with data from the timepoints for the first and the last SBP measurement during exercise. Third, the SBP/MET slope was calculated using two different methods: (a) by using the same datapoints as for the SBP/VO 2 slope (above) and (b) by replacing the first SBP measure during exercise with SBP at rest, in the sitting position, and using one MET as oxygen uptake at rest to allow for comparison with previous studies [ 10 , 11 , 21 ]. Predicted values for the SBP max and the SBP/W slope were calculated using the formulas provided by Hedman et al [ 9 ].…”

“…Furthermore, for the increase in SBP in relation to the increase in metabolic equivalents of task (MET), the SBP/MET slope, upper limits have been suggested [ 7 ]. In addition, a few recent studies have investigated the SBP/W and the SBP/MET slopes in young athletes engaged in team sports [ 10 , 11 ]. There is, however, a lack of studies specifically dedicated to endurance athletes, who through their enhanced aerobic capacity can reach the highest VO 2 values and, thus, may be expected to reach even higher SBP max values.…”

Vascular alterations among male elite athletes recovering from SARS-CoV-2 infection

“…We showed in our prior investigations using non-invasive oscillometric devices 16 that elite athletes display lower PWV and an enhanced vascular function compared to the normal population 17 . We further investigated the association between vascular function, performance levels and maximum oxygen uptake 18 .…”

“…A higher cardiorespiratory fitness was associated with a lower risk for a severe COVID-19 course 19 and long- COVID-19 syndrome and partly attributed to an enhanced vascular function 20 . Hence, both the exercise-induced adaptations of the cardiovascular system, leading to an enhanced vascular function compared to non-athletes 17 , and the high fitness level of elite athletes might mitigate the course of COVID-19 with reduction of the vascular impairment that is associated with the infection. Consequently, these individuals' vascular functional status may represent the strongest natural defense against the direct viral insults and the inflammatory sequelae of SARS-CoV-2 infection.…”