Exaggerated blood pressure response to exercise is associated with carotid atherosclerosis in apparently healthy men.
OBJECTIVE
Although an exaggerated systolic blood pressure (SBP) response to exercise is a predictor of future hypertension and cardiovascular mortality, the underlying mechanisms are not fully understood. We tested the hypothesis that an exaggerated SBP response is associated with carotid atherosclerosis in a cross-sectional study of 9073 healthy men (aged 47.8 +/- 8.8 years).


METHODS
Exaggerated SBP response was defined as an SBP of 210 mmHg or greater during a maximal treadmill test. Carotid atherosclerosis was defined as stenosis greater than 25% or intima-media thickness greater than 1.2 mm using B-mode ultrasonography.


RESULTS
An exaggerated SBP response was present in 375 men (4.1%). The proportion of individuals with carotid atherosclerosis in the group with an exaggerated SBP response to exercise was higher than in the group with a normal SBP response (14.4 versus 5.3%, P < 0.001). In a multivariable logistic regression model, individuals with an exaggerated SBP (>or= 210 mmHg) response to exercise had a 2.02 times [95% confidence interval (CI) 1.33-3.05] increased risk of carotid atherosclerosis compared with individuals with an SBP response of less than 210 mmHg. The highest quartile (> 61 mmHg) group of relative exercise-induced increases in SBP showed a 1.57 (95% CI 1.18-2.08) greater risk of carotid atherosclerosis compared with individuals in the lowest quartile (< 38 mmHg) in the adjusted model.


CONCLUSIONS
These results suggest that an exaggerated SBP response to exercise is strongly associated with carotid atherosclerosis, independent of established risk factors in healthy men. It may be an important factor in evaluating hypertension related to target-organ damage.
Jae
Sae Young
SY
Exercise and Cardiovascular Research Laboratory, Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, Illinois, USA.
Fernhall
Bo
B
Heffernan
Kevin S
KS
Kang
Mira
M
Lee
Moon-Kyu
MK
Choi
Yoon Ho
YH
Hong
Kyung Pyo
KP
Ahn
Eui Soo
ES
Park
Won Hah
WH
D000328:Adult; D050197:Atherosclerosis / Q000150:complications* / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology*; D002340:Carotid Artery Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D003430:Cross-Sectional Studies; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014463:Ultrasonography