Effect of polycystic ovary syndrome on the exercise pressor reflex

Background: Polycystic ovary syndrome (PCOS) is associated with a 1.7-fold increased risk of high blood pressure (i.e., hypertension). Although exercise training may be prescribed to mitigate this risk, training-induced reductions in blood pressure (BP) are blunted in women with PCOS. The study of BP responses to acute exercise, including the role of metaboreflex activation, may reveal mechanisms limiting long-term adaptations to training in PCOS. Objective: We assessed acute exercise pressor responses using isometric handgrip (HG) exercise to exhaustion followed by post-exercise circulatory occlusion (PECO; i.e. isolation of the metaboreflex) in women with (n=6; 24±4 years) and without (CTRL; n=6; 22±4 years; P=0.43) PCOS. Although these responses have yet to be assessed in women with PCOS, we hypothesized that HG- and PECO-induced BP responses would be greater in PCOS than CTRL, consistent with other pre-hypertensive populations. Methods: Systolic BP, diastolic BP, cardiac output (CO), and total peripheral resistance (TPR) were measured continuously via finger photoplethysmography (calibrated to manual sphygmomanometry-derived values) during 90-sec baseline, HG at 40% of maximal voluntary contraction to fatigue, 2-min PECO (suprasystolic cuff inflation to 220 mmHg), and 3-min recovery. Outcomes were averaged across each condition; between-group differences in absolute and delta (Δ HG-baseline and PECO-baseline) values were compared via unpaired two-tailed t-tests. Results: PCOS and CTRL did not differ in baseline systolic BP (122±12 vs 112±14mmHg, respectively, P=0.22), diastolic BP (75±10 vs 72±7mmHg, P=0.45), CO (6.9±2.8 vs 5.9±1.6L/min, P=0.47), or TPR (15±4.6 vs 16±3.8mmHg/L/min, P=0.69). Similarly, HG-induced increases in systolic BP (+13±3 vs +8±8 mmHg, P=0.19) and CO (+0.8±0.9 vs +1.5±0.5L/min, P=0.17) did not differ between PCOS and CTRL. In contrast, HG-induced changes in both diastolic BP (+13±2 vs +7±5mmHg, P=0.02), and TPR (+1.0±2.6 vs -2.2±2.3mmHg/L/min, P=0.04) were greater in PCOS than CTRL. PECO-induced changes in systolic BP (+14±7 vs +12±12 mmHg, P=0.74), diastolic BP (+10±5 vs +7±6mmHg, P=0.40), CO (+0.2±2.0 vs +0.4±1.1L/min, P=0.80), and TPR (+1.2±2.3 vs +0.7±2.6, P=0.83) did not differ between PCOS and CTRL. Conclusion: Collectively, these preliminary findings suggest that PCOS may alter the pressor response to isometric handgrip. Greater exercise-induced increases in diastolic BP and TPR, but not systolic BP or CO, point to a potential sympathetic neuro-vascular mechanism whereby the sympathetic neural response to HG exercise may be greater in PCOS than CTRL. As such, the peripheral vasculature may represent a viable target for exercise intervention in women with PCOS. Further investigation is required to identify the mechanisms mediating the exaggerated contribution of TPR during exercise in this high-hypertension risk population. Funding: Canadian Institutes of Health Research; Fonds de Recherche du Quebec – Santé. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.