Abstract .ca



AbstractApparently healthy individuals who have an exaggerated blood pressure response (EBPR) to graded exercise have a greater risk of developing latent hypertension. There are few data describing blood pressure responses in a middle-aged endurance-trained cohort and where present, what mechanisms contribute to this response. We tested the hypothesis that decreased vasodilatory capacity, increased arterial stiffness, increased sympathetic reactivity and increased left ventricular mass index (LVMI) contribute towards the EBPR. Subjects included 40 middle-age endurance-trained athletes, who underwent maximal graded exercise testing with blood pressure measurements every two minutes until peak effort. There were 22 subjects with a peak SBP equal to or above the median and 18 subjects with peak SBP below the median. Assessment of vascular and autonomic function included non-invasive measurement of pulse-wave velocity (PWV), peak calf blood flow, and a cold-pressor and metaboreflex test. Echocardiography was performed to assess LVMI. Individuals with an EBPR had significantly greater peak calf blood flow and had a hyperreactive SBP response to the cold pressor test. In addition, pooled analysis showed significant correlations between peak SBP and peak vasodilatory blood flow, LVMI, and PWV. These differences suggest that adaptations of the LV to maintain larger peripheral blood flow secondary to an elevated cardiac output, coupled with elevations in arterial stiffness may contribute towards the EBPR. ................
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