Ann Rehabil Med.  2018 Aug;42(4):575-583. 10.5535/arm.2018.42.4.575.

Effects of Long-Distance Running on Cardiac Markers and Biomarkers in Exercise-Induced Hypertension Runners: An Observational Study

• Park MH
• Shin KA
• Kim CH
• Lee YH
• Park Y
• Ahn J
• Kim YJ

• KMID: 2420050
• DOI: http://doi.org/10.5535/arm.2018.42.4.575

Abstract

OBJECTIVE
To investigate changes of cardiac and muscle damage markers in exercise-induced hypertension (EIH) runners before running (pre-race), immediately after completing a 100-km ultramarathon race, and during the recovery period (24, 72, and 120 hours post-race).
METHODS
In this observational study, volunteers were divided into EIH group (n=11) whose maximum systolic blood pressure was ≥210 mmHg in graded exercise testing and normal exercise blood pressure response (NEBPR) group (n=11). Their blood samples were collected at pre-race, immediately after race, and at 24, 72, and 120 hours post-race.
RESULTS
Creatine kinase (CK) and cardiac troponin I (cTnI) levels were significantly higher in EIH group than those in the NEBPR group immediately after race and at 24 hours post-race (all p < 0.05). However, lactate dehydrogenase (LDH), creatine kinase-myocardial band (CKMB), or CKMB/CK levels did not show any significant differences between the two groups in each period. N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were significantly higher in EIH group than those in NEBPR group immediately after race and at 24 and 72 hours post-race (all p < 0.05). A high sensitivity C-reactive protein (hs-CRP) level was significantly higher in EIH group than that in NEBPR group at 24 hours post-race (p < 0.05).
CONCLUSION
The phenomenon of higher inflammatory and cardiac marker levels in EIH group may exaggerate cardiac volume pressure and blood flow restrictions which in turn can result in cardiac muscle damage. Further prospective studies are needed to investigate the chronic effect of such phenomenon on the cardiovascular system in EIH runners.

Keyword

Exercise; Hypertension; Blood pressure; Biomarkers; Running

MeSH Terms

Biomarkers*
Blood Pressure
C-Reactive Protein
Cardiac Volume
Cardiovascular System
Continental Population Groups
Creatine
Creatine Kinase
Exercise Test
Humans
Hypertension*
L-Lactate Dehydrogenase
Myocardium
Observational Study*
Prospective Studies
Running*
Troponin I
Volunteers
Biomarkers
C-Reactive Protein
Creatine
Creatine Kinase
L-Lactate Dehydrogenase
Troponin I

Figure

• 

  Fig. 1. Responses of CKMB to 100-km ultra-marathon race and its recovery in EIH and NEBPR groups. CK, creatine kinase; EIH, exercise-induced hypertension; NEBPR, normal exercise blood pressure response. a)Significantly different from the pre-race at p<0.05, b)significantly different from immediately post-race at p<0.05, c)significantly different from the 24 hours post-race at p<0.05, d)significantly different from the 72 hours post-race at p<0.05.

• 

  Fig. 2. Responses of CKMB/CK (ratio) to 100-km ultramarathon race and its recovery in EIH and NEBPR groups. CK, creatine kinase; EIH, exercise-induced hypertension; NEBPR, normal exercise blood pressure response. a)Significantly different from the 24 hours post-race at p<0.05.

• 

  Fig. 3. Responses of cTnI to 100-km ultra-marathon race and its recovery in EIH and NEBPR groups. cTnI, cardiac troponin I; EIH, exercise-induced hypertension; NEBPR, normal exercise blood pressure response. a)Significantly different from the pre-race at p<0.05, b)significantly different from immediately post-race at p<0.05, c)significantly different from the 24 hours post-race at p<0.05, d)significantly different from the 72 hours post-race at p<0.05, e)significantly different between the groups at p<0.05.

• 

  Fig. 4. Responses of NT-proBNP to 100-km ultra-marathon race and its recovery in EIH and NEBPR groups. NTproBNP, N-terminal pro B-type natriuretic peptide; EIH, exercise-induced hypertension; NEBPR, normal exercise blood pressure response. a)Significantly different from the pre-race at p<0.05, b)significantly different from immediately post-race at p<0.05, c)significantly different from the 72 hours post-race at p<0.05, d)significantly different between the groups at p<0.05.

• 

  Fig. 5. Responses of CK to 100-km ultra-marathon race and its recovery in EIH and NEBPR groups. CK, creatine kinase; EIH, exercise-induced hypertension; NEBPR, normal exercise blood pressure response. a)Significantly different from the pre-race at p<0.05, b)significantly different from immediately post-race at p<0.05, c)significantly different from the 24 hours post-race at p<0.05, d)significantly different from the 72 hours post-race at p<0.05, e)significantly different between the groups at p<0.05.

• 

  Fig. 6. Responses of hs-CRP to 100-km ultra-marathon race and its recovery in EIH and NEBPR groups. hsCRP, high sensitive C-reactive protein; EIHG, exerciseinduced hypertension; NEBPRG, normal exercise blood pressure response. a)Significantly different from the prerace at p<0.05, b)significantly different from immediately post-race at p<0.05, c)significantly different from the 24 hours post-race at p<0.05, d)significantly different from the 72 hours post-race at p<0.05, e)significantly different between the groups at p<0.05.

• 

  Fig. 7. Responses of LDH to 100-km ultramarathon race and its recovery in EIH and NEBPR groups. LDH, lactate dehydrogenase; EIH, exercise-induced hypertension; NEBPR, normal exercise blood pressure response. a)Significantly different from the pre-race at p<0.05, b)significantly different from immediately post-race at p<0.05, c)significantly different from the 24 hours post-race at p<0.05, d)significantly different from the 72 hours postrace at p<0.05.

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