| Jin Won Kim, Chang Gyu Park, Soon Yong Suh, Uk Yeol Chwe, Seung Woon Rha, Hong Seog Seo, Dong Joo Oh, Young Moo Ro |
Background: It has been suggested that a post-exercise blunted decline of systolic blood pressure (SBP) are associated with an increased risk of coronary artery disease and stroke. We investigated the relation between acute changes of aortic stiffness and SBP recovery after exercise in the newly diagnosed hypertensive patients. Methods: By using an oscillometric method (VP 1000, Colin co. Japan), we measured blood pressure, heart rate, and pulse pressure at baseline, 2 min, and 30 min and baPWV at baseline and 30 min after maximal symptom-limited treadmill exercise, performed according to the Bruce protocol (average duration of exercise 14.7±3.7 min), in the hypertensive patients without receiving medications. The decline in SBP during recovery was assessed by calculating the ratio of SBPs at 2 min of recovery to peak exercise and a value above 0.95 was considered blunted. Results: 50 subjects were eligible for analyses (age 49.6±12.8 years, male 28). There were no significant differences of blood pressure, pulse pressure and baPWV between blunted and non-blunted SBP pts (n=22, 28 respectively) at baseline. There was a blunted decrease of baPWV after exercise in patients with blunted decline of SBP after exercise than in those with normal SBP decline (mean ∆ baPWV -2.6±79.6 vs. 116.8±88.8 cm/sec, p=0.001). In multivariate logistic regression analyses, a blunted drop of baPWV was predictive of blunted decline in SBP at 2 minutes during recovery following exercise (adjusted OR 1.24, 95 % CI 0.347 to 4.434, p=0.002). The systolic blood pressure, heart rate, and baPWV were reduced significantly at 30 min following exercise as compared with baseline levels (148.9±12.9 vs. 138.7±13.8 mmHg, 94.2±17.4 vs. 74.3±18.9 bpm, 1874±450 vs. 1670±420 cm/sec, p=0.007, 0.003, 0.004, respectively). Pulse pressure and diastolic pressure did not showed significant differences. Conclusions: Blunted drop of baPWV was related to delayed SBP recovery after maximal aerobic exercise in the hypertensive patients. These results suggest that aortic stiffness may increase the risk of future atherosclerotic vascular disease in pts with blunted decline of SBP after exercise
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