title: Neurovascular Control and Cardiac Structure in Amateur Runners with Hypertension.
abstract: OBJECTIVE
  The neurovascular mechanisms underlying hypertension are minimized by exercise training. However, it is not known whether previously trained individuals with hypertension would have deleterious repercussion of this disease. Our aim was to investigate the neurovascular control and the cardiac structure of athletes with hypertension.
  
  
  METHODS
  Muscle sympathetic nerve activity (MSNA) (microneurography), baroreflex sensitivity (intravenous infusion of phenylephrine and nitroprusside), arterial stiffness (pulse wave velocity and echotracking), and cardiac structure (echocardiography) were evaluated in 17 runners with hypertension (42 ± 1 yr) and 20 normotensive (43 ± 1 yr) amateur runners.
  
  
  RESULTS
  Runners with hypertension had higher MSNA (+24% burst frequency, P = 0.02; +24%, burst incidence, P < 0.01), left ventricular mass (+22%, P < 0.01), septum wall thickness (+9%, P = 0.04), posterior wall thickness (+11%, P = 0.04), and left atrium (+11%, P < 0.001) compared with normotensive runners. Baroreflex control of heart rate was lower in runners with hypertension during increase (P = 0.05) but not during decrease (P = 0.11) of systolic blood pressure when compared with normotensive runners. There was no difference between groups in baroreflex control of MSNA during increase (P = 0.38) and decrease (P = 0.36) of diastolic blood pressure. Pulse wave velocity (P = 0.71) and carotid variables: intima media thickness (P = 0.18), diameter (P = 0.09), and distension (P = 0.79) were similar between groups.
  
  
  CONCLUSIONS
  Sympathetic overactivity seems to be involved in the underlying mechanisms of hypertension in amateur runners. Alterations in cardiac structure and decreased baroreflex control of heart rate suggest limited protection from exercise training. However, baroreflex control of MSNA and elastic properties of artery are preserved in this population.
authors.affiliation: 1Cardiovascular Rehabilitation and Exercise Physiology Unit, Heart Institute (Incor), Medical School of University of São Paulo, São Paulo, BRAZIL; 2Hypertension Unit, Heart Institute (Incor), Medical School of University of São Paulo, São Paulo, BRAZIL; 3School of Physical Education and Sport, University of São Paulo, São Paulo, BRAZIL; and 4Hospital Israelita Albert Einstein, São Paulo, BRAZIL.
authors.forename: Patricia
authors.initials: P
authors.lastname: De Sá Perlingeiro
authors.forename: Luciene Ferreira
authors.initials: LF
authors.lastname: Azevedo
authors.forename: Igor Lucas
authors.initials: IL
authors.lastname: Gomes-Santos
authors.forename: Luiz Aparecido
authors.initials: LA
authors.lastname: Bortolotto
authors.forename: Maria Urbana Pinto Brandão
authors.initials: MU
authors.lastname: Rondon
authors.forename: Carlos Eduardo
authors.initials: CE
authors.lastname: Negrão
authors.forename: Luciana Diniz Nagem Janot
authors.initials: LD
authors.lastname: De Matos
mesh_terms: D000328:Adult; D017704:Baroreflex; D006339:Heart Rate; D006352:Heart Ventricles / Q000033:anatomy & histology*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D018482:Muscle, Skeletal / Q000294:innervation*; D012420:Running / Q000502:physiology*; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D059289:Vascular Stiffness