The physiological response of ankle systolic blood pressure and ankle to brachial index after maximal exercise in athletes is dependent on age

Abstract

The development of sports activities in the over forties has increased the number of middle-aged patients performing heavy-load exercise. The normal response of ankle systolic blood pressure (ASBP) and ankle to brachial index (ABI) to intense exercise is known in young athletes, but little is known for other age groups. Three groups of 21 athletes: <20 (G1), 20-40 (G2), and >40 (G3) years old, respectively, were studied. ASBP and brachial systolic blood pressure (BSBP) were measured simultaneously before and after an incremental maximal cycle ergometer test. Rest ABI was higher in G3 compared to G1 (P<0.001: ANOVA, Bonferroni). Compared to respective resting values, BSBP, at 1 min of recovery, was increased for the three groups of age (P<0.001) whereas ASBP was unchanged for G1 and G2, and significantly increased for G3 (P<0.001). ASBP was significantly higher in G3 than in G1 and G2, ABI was lower in G1 and G2 compared to G3: 0.70+/-0.11, 0.76+/-0.09 and 0.91+/-0.14, respectively. This age-related ABI increase is consistent with the impaired vasodilator capacity observed in aging normal subjects but not with the decrease observed in ABI resting values in epidemiological studies. ABI is higher in older than in younger athletes at rest and after exercise. In aging athletes, aiming to detect mild to moderate arterial lesions, it is likely that normal limits defined in young athletes are not valid.

Post‐exercise ankle blood pressure and ankle to brachial index after heavy load bicycle exercise

“…This was not the case for our population. Our results are consistent with previous studies that have demonstrated an increase in the resting ABI value with age in apparently healthy subjects and with the preliminary monocentric post‐exercise results observed in a small group of athletes . There are various explanations for this observation.…”

“…While results after both types of exercise correlate fairly well, the slope of the relationship is not one suggesting that the response for the two type of tests is not identical . Third, the changes in ASBP or ABI are highly dependent on the intensity level of exercise as well as the delay from end exercise . Forth, age effect on vasodilator capacity in the area of vasodilation of the active muscles might be resulting in lower acceptable ankle to arm difference (ABI) in young than in healthy subjects …”

Discordant Diagnosis of Lower Extremity Peripheral Artery Disease Using American Heart Association Postexercise Guidelines

“… 19 Furthermore, ageing induces changes in the arterial wall 20 and this can modify the pressure and the ABI. 21 Ideally, healthy control subjects should be age matched. Moreover, the 1-minute duration of exercise used by Laing et al is markedly different than current protocols in most laboratories, and extrapolation to a 5-minute walk is difficult.…”

Heart rate significantly influences the relationship between atrial fibrillation and ankle-brachial index

“…Many studies showing post-exercise ABI decreased not only in normal subjects but also in patients with PAOD [24][25][26][27]. Generally, HR increased in response to the extent of exercise.…”