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Characterization of the blood pressure response during cycle ergometer cardiopulmonary exercise testing in black and white men

Data from the Fitness Registry and Importance of Exercise: A National Database (FRIEND)

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Abstract

It has been established that blacks have higher overall incidence and prevalence of hypertension compared to their white counterparts. However, the maximum blood pressure (BP) response of blacks to exercise has not been characterized. A total of 5996 apparently healthy men from the Fitness Registry and Importance of Exercise: A National Database (FRIEND) who underwent maximum cardiopulmonary exercise tests on a cycle ergometer were included in this analysis. Of these participants, 1245 (21%) self-identified as black while the remaining 4751 (79%) identified as white. All subjects had a respiratory exchange ratio (RER) of ≥1.0 and had no reports of cardiovascular or pulmonary disease. Systolic BP (BP) response to exercise was indexed according to increase in workload (SBP/MET-slope). Both racial groups were subdivided into age groups by decade. Black men had higher peak SBP and higher SBP/MET-slopes compared to white men across all age groups (p < 0.001). Resting SBP was not different between blacks and whites except within the 18–29-year age group. The differences in peak SBP and SBP/MET-slope between age and race groups indicate that black men have an exaggerated BP response to exercise irrespective of resting BP values. Further investigation is warranted to determine the underlying mechanisms responsible and clinical implications for this exaggerated BP response to exercise.

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Fig. 1: Study flowchart.
Fig. 2: Blood pressure responses at rest and maximum exercise using a cycle ergometer in black and white men.

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Acknowledgements

FRIEND Consortium Contributors are as follows: Ball State University (Leonard Kaminsky, Matthew Harber), METTEST (Sundeep Chaudhry), Massachusetts General Hospital (Gregory Lewis). This study was supported in part by an NIH training grant to Ahmad Sabbahi (T32-HL-139439).

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Authors and Affiliations

  1. Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA

    Ahmad Sabbahi, Ross Arena & Shane A. Phillips

  2. Integrated Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA

    Ahmad Sabbahi, Ross Arena, Bo Fernhall & Shane A. Phillips

  3. South College, School of Physical Therapy, Knoxville, TN, USA

    Ahmad Sabbahi

  4. Fisher Institute of Health and Well-Being, College of Health, Ball State University, Muncie, IN, USA

    Leonard A. Kaminsky

  5. Cardiology Division, VA Palo Alto Health Care System, Palo Alto, CA, USA

    Jonathan Myers

  6. Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA

    Bo Fernhall

  7. Division of Research and Development, MET-TEST, Atlanta, GA, USA

    Chaudhry Sundeep

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  1. Ahmad Sabbahi
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Correspondence to Ahmad Sabbahi.

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Sabbahi, A., Arena, R., Kaminsky, L.A. et al. Characterization of the blood pressure response during cycle ergometer cardiopulmonary exercise testing in black and white men. J Hum Hypertens 35, 685–695 (2021). https://doi.org/10.1038/s41371-020-00411-5

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