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The physiological response of ankle systolic blood pressure and ankle to brachial index after maximal exercise in athletes is dependent on age

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Abstract

The development of sports activities in the over forties has increased the number of middle-aged patients performing heavy-load exercise. The normal response of ankle systolic blood pressure (ASBP) and ankle to brachial index (ABI) to intense exercise is known in young athletes, but little is known for other age groups. Three groups of 21 athletes: <20 (G1), 20–40 (G2), and >40 (G3) years old, respectively, were studied. ASBP and brachial systolic blood pressure (BSBP) were measured simultaneously before and after an incremental maximal cycle ergometer test. Rest ABI was higher in G3 compared to G1 (P<0.001: ANOVA, Bonferroni). Compared to respective resting values, BSBP, at 1 min of recovery, was increased for the three groups of age (P<0.001) whereas ASBP was unchanged for G1 and G2, and significantly increased for G3 (P<0.001). ASBP was significantly higher in G3 than in G1 and G2, ABI was lower in G1 and G2 compared to G3: 0.70±0.11, 0.76±0.09 and 0.91±0.14, respectively. This age-related ABI increase is consistent with the impaired vasodilator capacity observed in aging normal subjects but not with the decrease observed in ABI resting values in epidemiological studies. ABI is higher in older than in younger athletes at rest and after exercise. In aging athletes, aiming to detect mild to moderate arterial lesions, it is likely that normal limits defined in young athletes are not valid.

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References

  • Abraham P, Desvaux B, Colin D, Leftheriotis G, Saumet JL (1995) Heart rate-corrected ankle-to-arm index in the diagnosis of moderate lower extremity arterial disease. Angiology 46:673–677

    PubMed  CAS  Google Scholar 

  • Abraham P, Chevalier JM, Leftheriotis G, Saumet JL (1997a) Lower extremity arterial disease in sports. Am J Sports Med 25:581–584

    Article  CAS  Google Scholar 

  • Abraham P, Saumet JL, Chevalier JM (1997b) External iliac artery endofibrosis in athletes. Sports Med 24:221–226

    Article  CAS  Google Scholar 

  • Abraham P, Bickert S, Vielle B, Chevalier JM, Saumet JL (2001) Pressure measurements at rest and after heavy exercise to detect moderate arterial lesions in athletes. J Vasc Surg 33:721–727

    Article  PubMed  CAS  Google Scholar 

  • Abraham P, Bouye P, Quere I, Chevalier JM, Saumet JL (2004) Past, present and future of arterial endofibrosis in athletes: a point of view. Sports Med 34:419–425

    Article  PubMed  Google Scholar 

  • Beere PA, Russell SD, Morey MC, Kitzman DW, Higginbotham MB (1999) Aerobic exercise training can reverse age-related peripheral circulatory changes in healthy older men. Circulation 100:1085–1094

    PubMed  CAS  Google Scholar 

  • Bergholm R, Makimattila S, Valkonen M, Liu ML, Lahdenpera S, Taskinen MR, Sovijarvi A, Malmberg P, Yki-Jarvinen H (1999) Intense physical training decreases circulating antioxidants and endothelium-dependent vasodilatation in vivo. Atherosclerosis 145:341–349

    Article  PubMed  CAS  Google Scholar 

  • Carter SA (1969) Clinical measurement of systolic pressures in limbs with arterial occlusive disease. JAMA 207:1869–1874

    Article  PubMed  CAS  Google Scholar 

  • Carter SA (1972) Response of ankle systolic pressure to leg exercise in mild or questionable arterial disease. N Engl J Med 287:578–582

    Article  PubMed  CAS  Google Scholar 

  • DeSouza CA, Shapiro LF, Clevenger CM, Dinenno FA, Monahan KD, Tanaka H, Seals DR (2000) Regular aerobic exercise prevents and restores age-related declines in endothelium-dependent vasodilation in healthy men. Circulation 102:1351–1357

    PubMed  CAS  Google Scholar 

  • Desvaux B, Abraham P, Colin D, Leftheriotis G, Saumet JL (1995) Ankle systolic blood pressure following sub-maximal and maximal exercises in healthy young men. J Sports Med Phys Fitness 35:127–130

    PubMed  CAS  Google Scholar 

  • Desvaux B, Abraham P, Colin D, Leftheriotis G, Saumet JL (1996a) Ankle to arm index following maximal exercise in normal subjects and athletes. Med Sci Sports Exerc 28:836–839

    CAS  Google Scholar 

  • Desvaux B, Abraham P, Colin D, Leftheriotis G, Saumet JL (1996b) Ankle to arm index response to exercise and heat stress in healthy subjects. Clin Physiol 16:1–7

    CAS  Google Scholar 

  • Dinenno FA, Jones PP, Seals DR, Tanaka H (1999) Limb blood flow and vascular conductance are reduced with age in healthy humans: relation to elevations in sympathetic nerve activity and declines in oxygen demand. Circulation 100:164–170

    PubMed  CAS  Google Scholar 

  • Fernandez-Garcia B, Alvarez Fernandez J, Vega Garcia F, Terrados N, Rodriguez-Alonso M, Alvarez Rodriguez E, Rodriguez Olay JJ, Llaneza Coso JM, Carreno Morrondo JA, Angeles Menendez-Herrero M, Maria Gutierrez Julian J (2002) Diagnosing external iliac endofibrosis by postexercise ankle to arm index in cyclists. Med Sci Sports Exerc 34:222–227

    Article  PubMed  Google Scholar 

  • Fitzgerald DE, O’Shaughnessy AM (1984) Cardiac and peripheral arterial responses to isoprenaline challenge. Cardiovasc Res 18:414–418

    Article  PubMed  CAS  Google Scholar 

  • Fowkes FG, Housley E, Cawood EH, Macintyre CC, Ruckley CV, Prescott RJ (1991) Edinburgh artery study: prevalence of asymptomatic and symptomatic peripheral arterial disease in the general population. Int J Epidemiol 20:384–392

    Article  PubMed  CAS  Google Scholar 

  • Hiatt WR, Hoag S, Hamman RF (1995) Effect of diagnostic criteria on the prevalence of peripheral arterial disease The San Luis Valley diabetes study. Circulation 91:1472–1479

    PubMed  CAS  Google Scholar 

  • Higashi Y, Sasaki S, Kurisu S, Yoshimizu A, Sasaki N, Matsuura H, Kajiyama G, Oshima T (1999) Regular aerobic exercise augments endothelium-dependent vascular relaxation in normotensive as well as hypertensive subjects: role of endothelium-derived nitric oxide. Circulation 100:1194–1202

    PubMed  CAS  Google Scholar 

  • Kelly R, Hayward C, Avolio A, O’Rourke M (1989) Noninvasive determination of age-related changes in the human arterial pulse. Circulation 80:1652–1659

    PubMed  CAS  Google Scholar 

  • King LT, Strandness DE Jr, Bell JW (1965) The hemodynamic response of the lower extremities to exercise. J Surg Res 148:167–171

    Article  PubMed  Google Scholar 

  • Lakatta EG, Levy D (2003) Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: Part I: aging arteries: a “set up” for vascular disease. Circulation 107:139–146

    Article  PubMed  Google Scholar 

  • Martin WH III, Ogawa T, Kohrt WM, Malley MT, Korte E, Kieffer PS, Schechtman KB (1991) Effects of aging, gender, and physical training on peripheral vascular function. Circulation 84:654–664

    PubMed  Google Scholar 

  • McDermott MM, Greenland P, Liu K, Guralnik JM, Celic L, Criqui MH, Chan C, Martin GJ, Schneider J, Pearce WH, Taylor LM, Clark E (2002) The ankle brachial index is associated with leg function and physical activity: the walking and leg circulation study. Ann Intern Med 136:873–883

    PubMed  Google Scholar 

  • Pollock ML, Mengelkoch LJ, Graves JE, Lowenthal DT, Limacher MC, Foster C, Wilmore JH (1997) Twenty-year follow-up of aerobic power and body composition of older track athletes. J Appl Physiol 82:1508–1516

    PubMed  CAS  Google Scholar 

  • Proctor DN, Shen PH, Dietz NM, Eickhoff TJ, Lawler LA, Ebersold EJ, Loeffler DL, Joyner MJ (1998) Reduced leg blood flow during dynamic exercise in older endurance-trained men. J Appl Physiol 85:68–75

    PubMed  CAS  Google Scholar 

  • Rosen MJ, Sorkin JD, Goldberg AP, Hagberg JM, Katzel LI (1998) Predictors of age-associated decline in maximal aerobic capacity: a comparison of four statistical models. J Appl Physiol 84:2163–2170

    PubMed  CAS  Google Scholar 

  • Schep G, Schmikli SL, Bender MH, Mosterd WL, Hammacher ER, Wijn PF (2002) Recognising vascular causes of leg complaints in endurance athletes Part 1: validation of a decision algorithm. Int J Sports Med 23:313–321

    Article  PubMed  CAS  Google Scholar 

  • Smith DT, Hoetzer GL, Greiner JJ, Stauffer BL, DeSouza CA (2003) Effects of ageing and regular aerobic exercise on endothelial fibrinolytic capacity in humans. J Physiol 546:289–298

    Article  PubMed  CAS  Google Scholar 

  • Smith FB, Lee AJ, Price JF, van Wijk MC, Fowkes FG (2003) Changes in ankle brachial index in symptomatic and asymptomatic subjects in the general population. J Vasc Surg 38:1323–1330

    Article  PubMed  Google Scholar 

  • Strandness DE Jr, Bell JW (1964) An evaluation of the hemodynamic response of the claudicating extremity to exercise. Surg Gynecol Obstet 119:1237–1242

    PubMed  Google Scholar 

  • Taddei S, Virdis A, Mattei P, Ghiadoni L, Gennari A, Fasolo CB, Sudano I, Salvetti A (1995) Aging and endothelial function in normotensive subjects and patients with essential hypertension. Circulation 91:1981–1987

    PubMed  CAS  Google Scholar 

  • Tanaka H, Desouza CA, Jones PP, Stevenson ET, Davy KP, Seals DR (1997) Greater rate of decline in maximal aerobic capacity with age in physically active vs sedentary healthy women. J Appl Physiol 83:1947–1953

    PubMed  CAS  Google Scholar 

  • Taylor AJ, George KP (2001) Ankle to brachial pressure index in normal subjects and trained cyclists with exercise-induced leg pain. Med Sci Sports Exerc 33:1862–1867

    Article  PubMed  CAS  Google Scholar 

  • Vaitkevicius PV, Fleg JL, Engel JH, O’Connor FC, Wright JG, Lakatta LE, Yin FC, Lakatta EG (1993) Effects of age and aerobic capacity on arterial stiffness in healthy adults. Circulation 88:1456–1462

    PubMed  CAS  Google Scholar 

  • van der Heijden-Spek JJ, Staessen JA, Fagard RH, Hoeks AP, Boudier HA, van Bortel LM (2000) Effect of age on brachial artery wall properties differs from the aorta and is gender dependent: a population study. Hypertension 35:637–642

    PubMed  Google Scholar 

  • Yao JS (1973) New techniques in objective arterial evaluation. Arch Surg 106:600–604

    PubMed  CAS  Google Scholar 

  • Yao ST, Hobbs JT, Irvine WT (1969) Ankle systolic pressure measurements in arterial disease affecting the lower extremities. Br J Surg 56:676–679

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

Alexis Le Faucheur benefits from the financial support of “Conseil Général du Maine-et-Loire”.

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Authors and Affiliations

  1. Laboratory for Vascular Investigations and Sports Medicine, University Hospital, 49033, Angers Cedex 01, France

    Alexis Le Faucheur, Philippe Bouyé, Vincent Jaquinandi, Jean Louis Saumet & Pierre Abraham

  2. Institute of Physical Education and Sports Sciences, 49, rue des Perrins, 49136, Les Ponts de Cé, France

    Bénédicte Noury Desvaux

Authors
  1. Alexis Le Faucheur
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  2. Bénédicte Noury Desvaux
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  3. Philippe Bouyé
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  4. Vincent Jaquinandi
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  5. Jean Louis Saumet
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  6. Pierre Abraham
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Correspondence to Pierre Abraham.

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Le Faucheur, A., Desvaux, B.N., Bouyé, P. et al. The physiological response of ankle systolic blood pressure and ankle to brachial index after maximal exercise in athletes is dependent on age. Eur J Appl Physiol 96, 505–510 (2006). https://doi.org/10.1007/s00421-005-0105-5

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  • DOI: https://doi.org/10.1007/s00421-005-0105-5

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