title: Exercise blood pressure response, albuminuria, and arterial stiffness in hypertension.
abstract: BACKGROUND
  A hypertensive response to exercise is associated with high cardiovascular risk, whereas the data about its relation to surrogates of subclinical atherosclerosis are scarce. We investigated the relationships of a hypertensive response to exercise with urinary albumin excretion and arterial stiffness in hypertensives.
  
  
  METHODS
  There were 171 untreated males (mean age 52 years, all Caucasian) with stage I-II essential hypertension and a negative treadmill exercise test divided into those with a hypertensive response to exercise (n=48) (peak exercise systolic blood pressure > or =210 mm Hg) and to those with normal blood pressure response (n=123). Albumin-to-creatinine ratio values were determined as the mean of 3 nonconsecutive morning spot urine samples, and arterial stiffness was evaluated on the basis of carotid-to-femoral pulse wave velocity.
  
  
  RESULTS
  Patients with a hypertensive response to exercise compared with those with normal blood pressure response exhibited greater log albumin-to-creatinine ratio (1.52+/-0.59 vs 0.97+/-0.33 mg/g) and higher pulse wave velocity (8.7+/-1.6 vs 7.7+/-1.2 m/s), independent of potentially confounding demographic and clinical factors. Resting systolic blood pressure (odds ratio [OR] 1.11, 95% confidence interval [CI], 1.06-1.16), body mass index (OR 1.12, 95% CI, 1.02-1.23), resting heart rate (OR 0.96, 95% CI, 0.93-0.99), and albumin-to-creatinine ratio (OR 7.45, 95% CI, 2.54-21.83) were independently associated with a hypertensive response to exercise.
  
  
  CONCLUSIONS
  A hypertensive response to exercise is related to augmented albumin-to-creatinine ratio and arterial stiffness, reflecting accelerated subclinical atherosclerosis. The association of albumin excretion with exercise blood pressure response suggests that albuminuria constitutes an important factor in the interpretation of the hypertensive response to exercise-associated risk.
authors.affiliation: First Cardiology Clinic, University of Athens, Greece. ktsioufis@hippocratio.gr
authors.forename: Costas
authors.initials: C
authors.lastname: Tsioufis
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Dimitriadis
authors.forename: Costas
authors.initials: C
authors.lastname: Thomopoulos
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tsiachris
authors.forename: Maria
authors.initials: M
authors.lastname: Selima
authors.forename: Elli
authors.initials: E
authors.lastname: Stefanadi
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tousoulis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kallikazaros
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000209:etiology / Q000503:physiopathology*; D001158:Arteries / Q000503:physiopathology*; D001794:Blood Pressure; D003404:Creatinine / Q000652:urine; D004548:Elasticity; D015444:Exercise / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow
chemical_list: D003404:Creatinine