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Post-exercise effects on aortic wave reflection derived from wave separation analysis in young- to middle-aged pre-hypertensives and hypertensives

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Abstract

Purpose

Decreases in brachial blood pressure (BP) may occur for several hours following a bout of exercise. Although aortic backward waves predict cardiovascular damage independent of brachial BP, whether decreases in aortic backward waves also occur post-exercise in young-to-middle-aged hypertensives, the extent to which these changes exceed brachial BP changes, and the best method of identifying these changes is uncertain.

Methods

We examined aortic function at baseline and 15-min post-exercise in 20 pre-hypertensive or hypertensive men and women (age 45 ± 7 years). Central aortic pressure, forward (Pf) and backward (Pb) wave pressures, the reflection index (RI) and augmentation pressure (AP) and index (AIx) were determined using applanation tonometry, and SphygmoCor software.

Results

Decreases in central aortic (p < 0.001) but not brachial systolic BP and pulse pressure (PP) occurred post-exercise. In addition, decreases in post-exercise (baseline versus post-exercise) Pb (19 ± 4 vs 13 ± 3 mm Hg p < 0.0001), RI (72.9 ± 22.1 vs 47.6 ± 12.8 %, p < 0.0001), AIx (26.3 ± 10.8 vs 7.8 ± 11.6 %, p < 0.0001) and AP (9.9 ± 3.9 vs 2.8 ± 3.9 mm Hg, p < 0.0001), but not Pf, were noted. However, decreases in AIx were not correlated with decreases in Pb, and whilst decreases in aortic PP correlated with decreases in Pb (p < 0.0001), no correlations were noted with decreases in AP or AIx.

Conclusion

In young-to-middle-aged pre-hypertensive and hypertensive individuals, aortic backward waves decrease post-exercise; this change is not reflected in brachial BP measurements and is poorly indexed by measures of pressure augmentation.

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Abbreviations

Δ:

Change in

AIx:

Aortic augmentation index

AP:

Aortic augmentation pressure

BMI:

Body mass index

BP:

Blood pressure

ECG:

Electrocardiograph

Pb:

Aortic backward wave pressure

Pf:

Aortic forward wave pressure

PP:

Pulse pressure

PPc:

Central aortic pulse pressure

PWV:

Pulse wave velocity

RI:

Aortic reflection index

SBP:

Systolic blood pressure

SBPc:

Central aortic systolic blood pressure

VO2peak :

Peak oxygen consumption

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Acknowledgments

This study would not have been possible without the voluntary collaboration of the participants.

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Authors and Affiliations

  1. Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa

    Aletta M. E. Millen, Angela J. Woodiwiss & Gavin R. Norton

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  1. Aletta M. E. Millen
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  2. Angela J. Woodiwiss
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  3. Gavin R. Norton
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Correspondence to Aletta M. E. Millen.

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Sources of funding

This study was supported by the University Research Council of the University of the Witwatersrand, the South African National Research Foundation, the Carnegie Corporation and the Ernst and Ethel Eriksen Trust.

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None.

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Communicated by Massimo Pagani.

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Millen, A.M.E., Woodiwiss, A.J. & Norton, G.R. Post-exercise effects on aortic wave reflection derived from wave separation analysis in young- to middle-aged pre-hypertensives and hypertensives. Eur J Appl Physiol 116, 1321–1329 (2016). https://doi.org/10.1007/s00421-016-3391-1

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