J Korean Soc Hypertens.  2013 Jun;19(2):45-54. 10.5646/jksh.2013.19.2.45.

Association of Blood Pressure and Heart Rate Response to Graded Exercise Test with Left Atrial Volume Index and Pulse Wave Velocity

• Park JH
• Jin SA
• Lee YD
• Seong SW
• Lee HS
• Kim MJ
• Park KI
• Oh JK
• Ahn KT
• Park SJ
• Kim JH
• Park JH
• Lee JH
• Choi SW
• Seong IW
• Jeong JO

• KMID: 1500272
• DOI: http://doi.org/10.5646/jksh.2013.19.2.45

Abstract

BACKGROUND
Exaggerated blood pressure (BP) response to exercise can be an independent risk factor for cardiovascular mortality and morbidity. The purpose of this study was to define the factor that effect on early systolic BP response to exercise.
METHODS
We examined echocardiographic data, BP, heart rate from graded exercise test and brachial ankle pulse wave velocity (PWV) of 205 patients (137 men and 68 women; mean age 58 +/- 11 years; range, 19 to 83 years). Graded exercise test was conducted in BRUCE protocol. We define delta systolic blood pressure (SBP) as systolic BRUCE stage "n" BP minus baseline BP.
RESULTS
Resting BP (127 +/- 16 mm Hg) was elevated to 171 +/- 26 mm Hg after peak graded exercise test. Resting heart rate (80 +/- 15 bpm) was increased to 146 +/- 27 bpm after peak graded exercise test. Stepwise regression test between baseline SBP, delta SBP, maximal SBP and left atrial volume index (LAVI) was done. Supine SBP, delta SBP, maximal SBP was not associated with LAVI (p > 0.5). But increased LAVI was significantly associated with delta SBP1 in woman (R2 = 0.192, p = 0.002). PWV was significantly associated with base line (R2 = 0.311, p < 0.01) and maximal SBP (R2 = 0.051, p < 0.01). However, PWV was not associated with delta SBP.
CONCLUSIONS
LAVI and PWV were not associated with early SBP response to exercise. But in women, elevation of early SBP during exercise is associated with LAVI.

Keyword

Exercise test; Pulse wave analysis; Blood pressure; Heart rate

MeSH Terms

Blood Pressure*
Exercise Test*
Female
Heart Rate*
Heart
Humans
Male
Pulse Wave Analysis*
Risk Factors
Mustard Compounds

Figure

• 

  Fig. 1. Association of left atrial volume index (LAVI) by gender on early systolic blood pressure (SBP) response to exercise. Stepwise regression test between baseline SBP, delta SBP, maximal SBP and LAVI was done. Supine SBP, delta SBP, maximal SBP was not significantly associated with LAVI (p > 0.5). Increased LAVI was significantly associated with delta SBP1 only in woman (R2 = 0.192, p = 0.002). Delta SBP, SBP difference between Bruce protocol stage and baseline ; All, both male and female ; M, male ; F, female.

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  Fig. 2. Association of left pulse wave velocity (PWV) on early systolic blood pressure (SBP) response. PWV was significantly associated with baseline SBP (R2 = 0.311, p < 0.01) and maximal SBP (R2 = 0.051, p < 0.01). But PWV was not associated with delta SBP. All, both male and female ; M, male; F, female ; Lt, left.

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  Fig. 3. Average maximal heart rate was decreased in order of atypical chest pain, stable angina and unstable angina. Maximal heart rate was significantly different according to ischemic heart disease (atypical chest pain vs. stable angina and unstable angina, p = 0.006, < 0.001). However maximal SBP and maximal DBP were not significantly different according to ischemic heart disease. NS, non-specific; HR, heart rate; SBP, systolic blood pressure; DBP, diastolic blood pressure.

Reference

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