Korean Circ J.  2009 Feb;39(2):52-56. 10.4070/kcj.2009.39.2.52.

Effects of Physical Activity and Aerobic Exercise Capacity on Aortic Stiffness in Patients With Untreated Hypertension

• Na SH
• Kim YS
• Bae JH
• Nah DY
• Kim YK
• Lee MM
• Kim HY
• Rhee MY

• KMID: 2297949
• DOI: http://doi.org/10.4070/kcj.2009.39.2.52

Abstract

BACKGROUND AND OBJECTIVES
High aerobic exercise capacity and sport-related physical activity are reported to be inversely associated with arterial stiffness in healthy young adults. However, it is unknown whether increased physical activity and/or high aerobic exercise capacity attenuate arterial stiffness in patients with untreated hypertension.
SUBJECTS AND METHODS
We studied subjects with never-treated hypertension {n=84 (55 males); mean age+/-SD, 49+/-7 years; age range, 36-65 years}. We excluded subjects with a history of diabetes, angina, myocardial infarction, major arrhythmia, or cerebrovascular diseases and those who were taking any cardiovascular medications, including lipid-lowering agents. Carotid intima-media thickness (IMT) and heart-femoral pulse wave velocity (hfPWV) were measured before exercise testing was performed. Physical activity was estimated using a modified Baecke questionnaire. Aerobic exercise capacity was measured with maximal cardiopulmonary exercise testing (maximum oxygen uptake, Vo2max).
RESULTS
Linear regression analysis showed a significant inverse correlation between sport-index and hfPWV (r=-0.404; p<0.001), which multiple linear regression analysis showed to be independent of the individual variables of age, gender, body mass index, mean arterial pressure, total cholesterol, fasting blood glucose, and heart rate (beta=-0.277; p=0.004). However, the work- and leisure-indices and Vo2max were not associated with hfPWV (p>0.05). Carotid IMT was not associated with physical activity indices or Vo2max.
CONCLUSION
In patients with untreated hypertension, increased sport activity was associated with lower aortic stiffness, but high aerobic exercise capacity was not. These results suggest that regular daily exercise, but not exercise capacity, is an important determinant of aortic stiffness in patients with untreated hypertension.

Keyword

Exercise; Aortic stiffness; Hypertension

MeSH Terms

Arrhythmias, Cardiac
Arterial Pressure
Blood Glucose
Body Mass Index
Carotid Intima-Media Thickness
Cholesterol
Exercise
Exercise Test
Fasting
Heart Rate
Humans
Hypertension
Linear Models
Motor Activity
Myocardial Infarction
Oxygen
Pulse Wave Analysis
Sports
Vascular Stiffness
Young Adult
Surveys and Questionnaires
Blood Glucose
Cholesterol
Oxygen

Figure

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  Fig. 1 Linear regression analysis showed a significant inverse correlation between sport-index and heart-femoral pulse wave velocity (r=-0.404, p<0.0001).

Reference

1. Laurent S, Boutouyrie P, Asmar R, et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension. 2001. 37:1236–1241.

2. Cruickshank K, Riste L, Anderson SG, Wright JS, Dunn G, Gosling RG. Aortic pulse-wave velocity and its relationship to mortality in diabetes and glucose intolerance: an integrated index of vascular function? Circulation. 2002. 106:2085–2090.

3. Blacher J, Guerin AP, Pannier B, Marchais SJ, Safar ME, London GM. Impact of aortic stiffness on survival in end-stage renal disease. Circulation. 1999. 99:2434–2439.

4. Sutton-Tyrrell K, Najjar SS, Boudreau RM, et al. Elevated aortic pulse wave velocity, a marker of arterial stiffness, predicts cardiovascular events in well-functioning older adults. Circulation. 2005. 111:3384–3390.

5. Mattace-Raso FU, van der Cammen TJ, Hofman A, et al. Arterial stiffness and risk of coronary heart disease and stroke. Circulation. 2006. 113:657–663.

6. Willum-Hansen T, Staessen JA, Torp-Pedersen C, et al. Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population. Circulation. 2006. 113:664–670.

7. Bots ML, Hoes AW, Koudstaal PJ, Hofman A, Grobbee DE. Common carotid intima-media thickness and risk of stroke and myocardial infarction. Circulation. 1997. 96:1432–1437.

8. Chambless LE, Heiss G, Folsom AR, et al. Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: The Atherosclerosis Risk in Communities (ARIC) study, 1987-1993. Am J Epidemiol. 1997. 146:483–494.

9. Mancia G, De Backer G, Dominiczak A, et al. 2007 guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2007. 25:1105–1187.

10. Guerin AP, Blacher J, Pannier B, Marchais SJ, Safar ME, London GM. Impact of aortic stiffness attenuation on survival of patients in end-stage renal failure. Circulation. 2001. 103:987–992.

11. Evenson KR, Stevens J, Thomas R, Cai J. Effect of cardiorespiratory fitness on mortality among hypertensive and normotensive women and men. Epidemiology. 2004. 15:565–572.

12. Paffenbarger RS Jr, Hyde RT, Wing AL, Hsieh CC. Physical activity, all-cause mortality, and longevity of college alumni. N Engl J Med. 1986. 314:605–613.

13. Tanaka H, Dinenno FA, Monahan KD, Clevenger CM, DeSouza CA, Seals DR. Aging, habitual exercise, and dynamic arterial compliance. Circulation. 2000. 102:1270–1275.

14. Tanaka H, DeSouza CA, Seals DR. Absence of age-related increase in central arterial stiffness in physically active women. Arterioscler Thromb Vasc Biol. 1998. 18:127–132.

15. Gates PE, Tanaka H, Graves J, Seals DR. Left ventricular structure and diastolic function with human ageing: relation to habitual exercise and arterial stiffness. Eur Heart J. 2003. 24:2213–2220.

16. Boreham CA, Ferreira I, Twisk JW, Gallagher AM, Savage MJ, Murray LJ. Cardiorespiratory fitness, physical activity, and arterial stiffness. Hypertension. 2004. 44:721–726.

17. Jae SY, Carnethon MR, Heffernan KS, Choi YH, Lee MK, Fernhall B. Association between cardiorespiratory fitness and prevalence of carotid atherosclerosis among men with hypertension. Am Heart J. 2007. 153:1001–1005.

18. Kraft KA, Arena R, Arrowood JA, Fei DY. High aerobic capacity does not attenuate aortic stiffness in hypertensive subjects. Am Heart J. 2007. 154:976–982.

19. Baecke JA, Burema J, Frijters JE. A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr. 1982. 36:936–942.

20. Rhee MY, Lee HY, Park JB. Measurements of arterial stiffness: methodological aspects. Korean Circ J. 2008. 38:343–350.

21. Rhee M. Acute and chronic effects of smoking on the arterial wall properties and the hemodynamics in smokers with hypertension. Korean Circ J. 2005. 35:493–499.

22. Bae JH, Seung KB, Jung HO, et al. Analysis of Korean carotid intima-media thickness in Korean healthy subjects and patients with risk factors: Korea Multi-Center Epidemiological Study. Korean Circ J. 2005. 35:513–524.

23. Fletcher GF, Balady GJ, Amsterdam EA, et al. Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. Circulation. 2001. 104:1694–1740.

24. Kingwell BA, Cameron JD, Gillies KJ, Jennings GL, Dart AM. Arterial compliance may influence baroreflex function in athletes and hypertensives. Am J Physiol. 1995. 268:H411–H418.

25. Tabara Y, Yuasa T, Oshiumi A, et al. Effect of acute and long-term aerobic exercise on arterial stiffness in the elderly. Hypertens Res. 2007. 30:895–902.

26. Cameron JD, Dart AM. Exercise training increases total systemic arterial compliance in humans. Am J Physiol. 1994. 266:H693–H701.

27. Nelson L, Jennings GL, Esler MD, Korner PI. Effect of changing levels of physical activity on blood-pressure and haemodynamics in essential hypertension. Lancet. 1986. 2:473–476.

28. Ferrier KE, Waddell TK, Gatzka CD, Cameron JD, Dart AM, Kingwell BA. Aerobic exercise training does not modify large-artery compliance in isolated systolic hypertension. Hypertension. 2001. 38:222–226.

29. Stewart KJ, Bacher AC, Turner KL, et al. Effect of exercise on blood pressure in older persons: a randomized controlled trial. Arch Intern Med. 2005. 165:756–762.

30. Pereira MA, FitzerGerald SJ, Gregg EW, et al. A collection of physical activity questionnaires for health-related research. Med Sci Sports Exerc. 1997. 29:S5–S9.