Exaggerated blood pressure (BP) response to exercise is a strong predictor of cardiovascular disease, although the mechanisms remain unknown. The purpose was to examine the association between systemic markers of vascular inflammation and exercise blood pressure (BP) responses. Participants were 191 healthy men and women (aged 45–59 years). Blood pressure was measured at baseline and during 8 min of steady state cycling ergometry exercise (at 50 W). Markers of vascular inflammation (fibrinogen, von Willebrand factor antigen, tumour necrosis factor-α, interleukin-6 [IL-6], C-reactive protein [CRP]) were measured at baseline together with other traditional risk factors including central adiposity, smoking, alcohol, and habitual physical activity. CRP (β = 0.30, p < 0.001), IL-6 (β = 0.25, p = 0.001), and fibrinogen (β = 0.14, p = 0.04) were associated with exercise systolic BP. The association with CRP remained significant after adjustment for age, sex, resting BP, and other risk factors. Other independent predictors of exercise BP included resting BP, female gender, waist–hip ratio, lower employment grade, and low physical activity level. In summary, central adiposity and vascular inflammatory processes may underlie exaggerated BP responses to acute exercise.
Blood pressure Central obesity C-reactive protein Exercise Inflammation Interleukin-6
This is a preview of subscription content, log in to check access.
This research was supported by the Medical Research Council, UK, and the British Heart Foundation. We acknowledge the contributions of Dr Sabine Kunz-Ebrecht, Dr Pamela Feldman, Dr Gonneke Willemsen, Dr Natalie Owen and Bev Murray to data collection, and Dr Vidya Mohamed-Ali to the cytokine analyses.
Conflict of interest
The authors declare that they have no conflict of interest.
Danesh J, Wheeler JG, Hirschfield GM, Eda S, Eiriksdottir G, Rumley A, Lowe GD, Pepys MB, Gudnason V (2004) C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. N Engl J Med 350:1387–1397PubMedCrossRefGoogle Scholar
de Simone G, Devereux RB, Kizer JR, Chinali M, Bella JN, Oberman A, Kitzman DW, Hopkins PN, Rao DC, Arnett DK (2005) Body composition and fat distribution influence systemic hemodynamics in the absence of obesity: the HyperGEN Study. Am J Clin Nutr 81:757–761PubMedGoogle Scholar
Gaffney PJ, Wong MY (1992) Collaborative study of a proposed international standard for plasma fibrinogen measurement. Thromb Haemost 68:428–432PubMedGoogle Scholar
Greenberg AS, Obin MS (2006) Obesity and the role of adipose tissue in inflammation and metabolism. Am J Clin Nutr 83:461S–465SPubMedGoogle Scholar
Jae SY, Fernhall B, Heffernan KS, Kang M, Lee MK, Choi YH, Hong KP, Ahn ES, Park WH (2006a) Exaggerated blood pressure response to exercise is associated with carotid atherosclerosis in apparently healthy men. J Hypertens 24:881–887PubMedCrossRefGoogle Scholar
Jae SY, Fernhall B, Lee M, Heffernan KS, Lee MK, Choi YH, Hong KP, Park WH (2006b) Exaggerated blood pressure response to exercise is associated with inflammatory markers. J Cardiopulmon Rehab 26:145–149CrossRefGoogle Scholar
Kapiotis S, Holzer G, Schaller G, Haumer M, Widhalm H, Weghuber D, Jilma B, Roggla G, Wolzt M, Widhalm K, Wagner OF (2006) A proinflammatory state is detectable in obese children and is accompanied by functional and morphological vascular changes. Arterioscler Thromb Vasc Biol 26:2541–2546PubMedCrossRefGoogle Scholar
Kokkinos PF, Narayan P, Fletcher RD et al (1997) Effects of aerobic training on exaggerated blood pressure response to exercise in African-Americans with hypertension treated with indapamide, verapamil and enalapril. Am J Cardiol 79:1424–1426PubMedCrossRefGoogle Scholar
Manolio TA, Burke GL, Savage PJ, Sidney S, Gardin JM, Oberman A (1994) Exercise blood pressure response and 5-year risk of elevated blood pressure in a cohort of young adults: the CARDIA study. Am J Hypertens 7:234–241PubMedGoogle Scholar
Mittleman MA, Maclure M, Tofler GH, Sherwood JB, Goldberg RJ, Muller JE (1993) Triggering of acute myocardial infarction by heavy physical exertion Protection against triggering by regular exertion. Determinants of Myocardial Infarction Onset Study Investigators. N Engl J Med 329:1677–1683PubMedCrossRefGoogle Scholar
Mundal R, Kjeldsen SE, Sandvik L, Erikssen G, Thaulow E, Erikssen J (1994) Exercise blood pressure predicts cardiovascular mortality in \ men. Hypertension 24:56–62PubMedGoogle Scholar
Mundal R, Kjeldsen SE, Sandvik L, Erikssen G, Thaulow E, Erikssen J (1998) Clustering of coronary risk factors with increasing blood pressure at rest and during exercise. J Hypertens 16:19–22PubMedCrossRefGoogle Scholar
Singh JP, Larson MG, Manolio TA, O’Donnell CJ, Lauer M, Evans JC, Levy D (1999) Blood pressure response during treadmill testing as a risk factor for new-onset hypertension. The Framingham heart study. Circulation 99:1831–1836PubMedGoogle Scholar
Steinberg HO, Chaker H, Leaming R, Johnson A, Brechtel G, Baron AD (1996) Obesity/insulin resistance is associated with endothelial dysfunction. Implications for the syndrome of insulin resistance. J Clin Invest 97:2601–2610PubMedCrossRefGoogle Scholar
Stewart KJ, Sung J, Silber HA, Fleg JL, Kelemen MD, Turner KL, Bacher AC, Dobrosielski DA, DeRegis JR, Shapiro EP, Ouyang P (2004) Exaggerated exercise blood pressure is related to impaired endothelial vasodilator function. Am J Hypertens 17:314–320PubMedCrossRefGoogle Scholar
Wesseling KH (1995) A century of non-invasive arterial pressure measurement: from Marey to Penaz and Finapres. Homeostasis 36:50–66Google Scholar
Wesseling KH, Jansen JR, Settels JJ, Schreuder JJ (1993) Computation of aortic flow from pressure in humans using a nonlinear, three-element model. J Appl Physiol 74:2566–2573PubMedGoogle Scholar
Willich SN, Lewis M, Löwel H, Arntz HR, Schubert F, Schröder R (1993) Physical exertion as a trigger of acute myocardial infarction. Triggers and Mechanisms of Myocardial Infarction Study Group. N Engl J Med 329:1684–1690PubMedCrossRefGoogle Scholar