Heart rate behavior during an exercise stress test in obese patients

Gondoni, Luca Alessandro; Titon, Anna Maria; Nibbio, Ferruccio; Augello, Giovanni; Caetani, Giulia; Liuzzi, Antonio

doi:10.1016/j.numecd.2008.07.001

Cited by 41 publications

(34 citation statements)

References 31 publications

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“…In a systematic review of these studies, it was concluded that all-cause and CVD mortality risk were greater among those with normal BMI but low fitness compared to those with high BMI and high fitness [29]. Studies assessing the interrelationship between fitness and BMI on exercise HR are scant; the only similar study we found examined the impact of a short-term physical training on obese subjects [8]. They demonstrated that the peak HR, CI and HRR were higher among nonobese subjects than obese individuals who were fit or unfit, but that the METS of all obese subjects were similar.…”

Section: Discussionmentioning

confidence: 99%

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Obesity Modifies the Effect of Fitness on Heart Rate Indices during Exercise Stress Testing in Asymptomatic Individuals

Aneni¹,

Oni

Osondu

et al. 2015

Cardiology

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Objective: To assess the impact of aerobic fitness on exercise heart rate (HR) indices in an asymptomatic cohort across different body mass index (BMI) categories. Methods: We performed a cross-sectional analysis of 506 working-class Brazilian subjects, free of known clinical cardiovascular disease (e.g. ischemic heart disease and stroke) who underwent an exercise stress test. Results: There was a significant trend towards decreased HR at peak exercise, HR recovery and chronotropic index (CI) measures as BMI increased, but resting HR increased significantly across BMI categories. In multivariate analysis, the change in CI per unit change in metabolic equivalents of task was greater among the obese subjects than the normal-weight (2.7 vs. -0.07; p interaction = 0.029) and overweight (2.7 vs. 0.7; p interaction = 0.044) subjects. A similar pattern was seen with peak HR and HR recovery, although the formal tests of interaction did not achieve statistical significance. Conclusion: Our findings strongly suggest that fitness is associated with a favorable HR profile and is modified by BMI. Intervention programs should place emphasis on fitness and not only on weight loss.

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Section: Discussionmentioning

confidence: 99%

“…Obesity has also been implicated in all-cause and CVD-related mortality, accounting for as many as 112,000 excess deaths yearly [7]. Obesity is associated with poor exercise HR profiles, including lower peak HR, slower HRR and lower CI [8,9,10,11]. …”

Section: Introductionmentioning

confidence: 99%

Obesity Modifies the Effect of Fitness on Heart Rate Indices during Exercise Stress Testing in Asymptomatic Individuals

Aneni¹,

Oni

Osondu

et al. 2015

Cardiology

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“…Studying these alterations is important, because they are implicated in the development of future hypertension and contribute to exercise intolerance in obese individuals (Deniz et al 2007;Gondoni et al 2009;Gaudreault et al 2013). The main findings of this study were as follows: (i) passive contractions elicited by WBV resulted in an augmented BP and lower BRS in normotensive obese women compared with lean women; (ii) the BP response was significantly correlated with body fat percentage and The beat-by-beat Finapres-derived variables were averaged over each of the three testing periods.…”

Section: Discussionmentioning

confidence: 99%

“…During voluntary exercise, obese individuals exhibit a blunted increase in HR compared with lean individuals (Gondoni et al 2009;Dipla et al 2010). Based on the traditional view that the initial increase in HR is entirely attributable to the withdrawal of parasympathetic activity and subsequent increases in HR are attributable to increases in sympathetic activity (Rowell & O'Leary, 1990), previous studies associated this chronotropic dysfunction with a lower parasympathetic withdrawal during exercise in obese versus lean individuals (Emdin et al 2001).…”

Section: Neural Control Of Blood Pressure and Heart Rate During Vibramentioning

confidence: 99%

“…More specifically, normotensive individuals with obesity often exhibit exaggerated blood pressure (BP) responses during incremental exercise testing and altered heart rate (HR) responses to voluntary dynamic and isometric exercise (Byrne & Hills, 2002;Gondoni et al 2009;Vella et al 2009). Although these alterations have been associated with the development of future hypertension (Miyai et al 2013), the underlying mechanisms are not fully elucidated.…”

Section: Introductionmentioning

confidence: 99%

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Exaggerated haemodynamic and neural responses to involuntary contractions induced by whole‐body vibration in normotensive obese versus lean women

Δίπλα

Kousoula

Zafeiridis

et al. 2016

Experimental Physiology

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New Findings r What is the central question of this study?In obesity, the exaggerated blood pressure response to voluntary exercise is linked to hypertension, yet the mechanisms are not fully elucidated. We examined whether involuntary contractions elicit greater haemodynamic responses and altered neural control of blood pressure in normotensive obese versus lean women. r What is the main finding and its importance? During involuntary contractions induced by whole-body vibration, there were augmented blood pressure and spontaneous baroreflex responses in obese compared with lean women. This finding is suggestive of an overactive mechanoreflex in the exercise-induced hypertensive response in obesity. Passive contractions did not elicit differential heart rate responses in obese compared with lean women, implying other mechanisms for the blunted heart rate response reported during voluntary exercise in obesity.In obesity, the exaggerated blood pressure (BP) response to exercise is linked to hypertension, yet the mechanisms are not fully elucidated. In this study, we examined whether involuntary mechanical oscillations, induced by whole-body vibration (WBV), elicit greater haemodynamic responses and altered neural control of BP in obese versus lean women. Twenty-two normotensive, premenopausal women (12 lean and 10 obese) randomly underwent a passive WBV (25 Hz) and a control protocol (similar posture without WVB). Beat-by-beat BP, heart rate, stroke volume, systemic vascular resistance, cardiac output, parasympathetic output (evaluated by heart rate variability) and spontaneous baroreceptor sensitivity (sBRS) were assessed. We found that during WBV, obese women exhibited an augmented systolic BP response compared with lean women that was correlated with body fat percentage (r = 0.77; P < 0.05). The exaggerated BP rise was driven mainly by the greater increase in cardiac output index in obese versus lean women, associated with a greater stroke volume index in obese women. Involuntary contractions did not elicit a differential magnitude of responses in heart rate, heart rate variability indices and systemic vascular resistance in obese versus lean women; however, they did result in greater sBRS responses (P < 0.05) in obese women. In conclusion, involuntary contractions elicited an augmented BP and sBRS response in normotensive obese versus lean women. The

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