Blunted heart rate recovery is associated with exaggerated blood pressure response during exercise testing

Doğan, Umuttan; Düzenli, Mehmet Akif; Özdemi̇r, Kurtuluş; Gök, Hasan

doi:10.1007/s00380-012-0298-6

Cited by 8 publications

(9 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, when measured within 3 min after exercise, PR was not significantly different among the 3 groups, despite differences in their age-related maximum heart rate. This phenomenon may be explained by the age-related decline of cardiac vagal tone [33,34], and the recovery in PR after the exercise stress test, which has gained general acceptance [35]. Thus, PR in the younger age group after exercise would recover to baseline faster than that in the older age group.…”

Section: Discussionmentioning

confidence: 96%

Older age is associated with greater central aortic blood pressure following the exercise stress test in subjects with similar brachial systolic blood pressure

et al. 2015

View full text Add to dashboard Cite

Brachial systolic pressure (BSP) is often monitored during exercise by the stress test; however, central systolic pressure (CSP) is thought to be a more direct measure of cardiovascular events. Although some studies reported that exercise and aging may play roles in changes of both BSP and CSP, the relationship between BSP and CSP with age following the exercise stress test remains unclear. The aim of this study was to evaluate the effect of age on the relationship between BSP and CSP measured after exercise. Ninety-six subjects underwent the diagnostic treadmill exercise stress test, and we retrospectively divided them into the following 3 groups by age: the younger age group (43 ± 4 years), middle age group (58 ± 4 years), and older age group (70 ± 4 years). Subjects exercised according to the Bruce protocol, to achieve 85 % of their age-predicted maximum heart rate or until the appearance of exercise-associated symptoms. BSP, CSP, and pulse rate (PR) were measured using a HEM-9000AI (Omron Healthcare, Japan) at rest and after exercise. BSP, CSP, and PR at rest were not significantly different among the 3 groups (p = 0.92, 0.21, and 0.99, respectively). BSP and PR immediately after exercise were not significantly different among the groups (p = 0.70 and 0.38, respectively). However, CSP immediately after exercise was 144 ± 18 mmHg (younger age), 149 ± 17 mmHg (middle age), and 158 ± 19 mmHg (older age). CSP in the older age group was significantly higher than that in the younger age group (p < 0.01). Despite similar BSPs in all age groups after exercise, CSP was higher in the older age group. Therefore, older subjects have a higher CSP after exercise, which is not readily assessed by conventional measurements of BSP.

show abstract

Section: Discussionmentioning

confidence: 96%

Older age is associated with greater central aortic blood pressure following the exercise stress test in subjects with similar brachial systolic blood pressure

et al. 2015

View full text Add to dashboard Cite

show abstract

“…The mechanisms contributing to EBP are not fully understood, but contributing factors may include enhanced sympathetic nervous system activity (12,14,31), greater LV mass (2,20,34) and myocardial dysfunction (47), endothelial dysfunction (4,44), increased central arterial stiffness (2,42), and a heightened metaboreflex (31). We previously demonstrated no differences in LV mass, sympathetic reactivity to static exercise and the metaboreflex response between athletes with and without EBP (11).…”

Section: Discussionmentioning

confidence: 99%

“…In the general population, the EBP response has been associated with enhanced sympathetic activity (12,14,31), an enhanced metaboreflex (31), and resting cardiovascular dysfunctions including central arterial stiffness (2,42) and elevated left ventricular mass (2,20,34), all of which are postulated to contribute to cardiovascular morbidity later in life. We recently demonstrated that middle-aged endurance trained athletes with EBP do not exhibit these resting cardiovascular and sympathetic dysfunctions (11).…”

Section: Introductionmentioning

confidence: 99%

Vascular-ventricular coupling during exercise is not affected by exaggerated blood pressures in endurance-trained athletes

Currie

Sasson

Goodman

2019

Journal of Applied Physiology

View full text Add to dashboard Cite

This study sought to examine whether cardiovascular performance during exercise, assessed using the vascular-ventricular coupling index (VVC), was affected by exaggerated blood pressure (EBP) responses in endurance-trained athletes. Subjects were middle-aged endurance-trained men and women. Blood pressure measurements and left ventricular echocardiography were performed in a semiupright position at rest and during steady-state cycling at workloads that elicited 100–110 beats/min ( stage 1) and 130–140 beats/min ( stage 2). These data were used to calculate effective arterial elastance index ( EaI), left ventricular end-systolic elastance index ( ELVI), and their ratio (VVC). Additional measurements of left ventricular volumes and function (i.e., stroke volume, cardiac output, and longitudinal strain) and indirect assessments of peripheral vascular function (i.e., total arterial compliance and peripheral vascular resistance) were examined. Fourteen subjects with EBP (EBP+, 50% men) and 14 sex-matched subjects without EBP (EBP−) participated, with results presented as EBP+ versus EBP−. EaI and ELVI increased from rest to exercise while VVC decreased, but only ELVI was different between groups at stage 1 [7.6 (1.8) vs. 6.4 (1.0) mmHg·ml−1·m−2, P = 0.045] and stage 2 [10.3 (1.6) vs. 8.0 (1.7) mmHg·ml−1·m−2, P < 0.001]. Additional comparisons revealed no group difference in the contribution of the Frank-Starling mechanism or left ventricular and peripheral vascular function during exercise. The cardiovascular adjustment to exercise in athletes with EBP is achieved through a matched increase in both EaI and ELVI, and the absence of between-group differences in left ventricular or peripheral vascular function suggests that other factors may contribute to the EBP response. NEW & NOTEWORTHY Cardiovascular performance during submaximal exercise, assessed using vascular-ventricular coupling, is unaffected by exaggerated blood pressure (EBP) responses in endurance-trained athletes. The underlying mechanisms of EBP in athletes remain unknown as changes in left ventricular and peripheral vascular function during exercise were similar in athletes with and without EBP.

show abstract

“…Exercise induced hypertension is defined as an increase in SBP >210 mmHg for men and >190 mmHg for women [192][193][194][195][201][202][203][204][205]]. An increase of DBP more than 10 mmHg above the resting value or an absolute value of 90 mmHg also is considered abnormal and could predict increased likelihood of CAD.…”

Section: Blood Pressure (Bp) Abnormalitiesmentioning

confidence: 99%

“…A resting SBP >200 mmHg and DBP >110 mmHg are considered relative contraindications to EST. Exercise induced hypertension may indicate an increased risk for future hypertension, left ventricular hypertrophy, and cardiovascular events [192][193][194][195][201][202][203][204][205]209]. In the Coronary Risk Development in Young Adults cohort, participants with exercise-induced hypertension were 1.7 times more likely to have developed hypertension at 5-year follow- up than those with a normal response.…”

Section: Blood Pressure (Bp) Abnormalitiesmentioning

confidence: 99%

The diagnostic value of exercise stress testing for cardiovascular disease is more than just st segment changes: A review

Sharif¹,

Alway²

2016

J Integr Cardiol

View full text Add to dashboard Cite

Purpose: The objectives of this review were to: (1) identify the acute cardiovascular responses to aerobic exercise used in an exercise stress test (EST), (2) identify when and how to best conduct an EST including the stopping point, (3) identify conditions that would preclude an EST, (4) define the limiting signs and symptoms associated with an EST (5), discuss what data are needed as part of an EST and how to interpret EST data. Methods:We identify the cardiovascular responses to an EST and when an EST should or should not be used. Finally we analyze the components of an EST and potential sensitivities, significances and predictability of the changes in the outcome data that will provide diagnosis overt cardiovascular disease, and for purposes of exercise prescription and evaluation of rehabilitation effects in cardiac patients.Results: Although most of the focus for performing an EST traditionally has been on the diagnostic value to identify ST-segment abnormalities, an EST provides other valuable diagnostic and prognostic data including maximal oxygen consumption (predicted or measured), exercise capacity and fatigability, blood pressure and heart rate responses to exercise and recovery. Conclusions:This review identifies the most recent standards, and guidelines of EST, which include the acute physiological response of the cardiovascular system to aerobic exercise, the use of EST in evaluation of coronary artery disease, an updated diagnostic and prognostic variables of EST, and reporting of EST.

show abstract

Blunted heart rate recovery is associated with exaggerated blood pressure response during exercise testing

Cited by 8 publications

References 42 publications

Older age is associated with greater central aortic blood pressure following the exercise stress test in subjects with similar brachial systolic blood pressure

Older age is associated with greater central aortic blood pressure following the exercise stress test in subjects with similar brachial systolic blood pressure

Vascular-ventricular coupling during exercise is not affected by exaggerated blood pressures in endurance-trained athletes

The diagnostic value of exercise stress testing for cardiovascular disease is more than just st segment changes: A review

Contact Info

Product

Resources

About