Endothelial dysfunction in patients with exaggerated blood pressure response during treadmill test.
BACKGROUND
The diagnostic and prognostic importance of exaggerated blood pressure response to exercise is controversial. Endothelial dysfunction has been demonstrated in patients with atherosclerosis and risk factors for coronary artery disease, but there is a paucity of information on patients with exercise-induced hypertension.


OBJECTIVE
We designed the study to evaluate endothelial function in patients with exaggerated blood pressure response during exercise.


METHODS
Exercise-induced hypertension was defined as systolic blood pressure > or = 210 mmHg in men and > or = 190 mmHg in women during the treadmill test. Using a high-resolution ultrasound technique, endothelial function of the brachial artery in patients with exercise-induced hypertension (n = 25) and control subjects (n = 25) was investigated.


RESULTS
Endothelium-dependent vasodilation was impaired in patients with exercise-induced hypertension compared with controls (7.77 +/- 5.14 vs. 2.81 +/- 2.29%, p < 0.05). On univariate analysis, the extent of vasodilation correlated negatively with age (r = -0.43, p < 0.05) and delta systolic blood pressure (r = -0.39, p < 0.05). Even after adjustment for factors known to affect endothelial function, endothelium-dependent vasodilation was decreased in patients with exercise-induced hypertension (beta = 5.375, p = 0.02).


CONCLUSIONS
Patients with exercise-induced hypertension have impaired endothelium-dependent vasodilation. This study also supports the concept that endothelial dysfunction may play an important role in exercise-induced hypertension.
Department of Cardiology, Ajou University School of Medicine, Suwon, Korea. hjchang70@hotmail.com
Hyuk-Jae
HJ
Chang
Jaehoon
J
Chung
So-Yeon
SY
Choi
Myeong-Ho
MH
Yoon
Gyo-Seung
GS
Hwang
Joon-Han
JH
Shin
Seung-Jea
SJ
Tahk
Byung-Il William
BI
Choi
D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D003971:Diastole / Q000502:physiology; D004452:Echocardiography; D004562:Electrocardiography; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005080:Exercise Test; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology; D007723:Korea; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D013599:Systole / Q000502:physiology; D014664:Vasodilation / Q000502:physiology