Resting functional air trapping was significantly higher in medically controlled hypertensives with exercise hypertension compared to those without (43.6% vs. 38.1%; p=0.005).
Cross-Sectional (n=373)
Are resting E/A inversion and air trapping associated with an exaggerated blood pressure response during exercise in medically controlled hypertensives?
Resting E/A inversion and air trapping can screen for exercise-induced hypertension in medically controlled hypertensives, and RAAS blockers provide better exercise blood pressure control than CCBs or thiazides.
Absolute Event Rate: 43.6% vs 38.1%
p-value: p=0.005
Exaggerated blood pressure response during exercise is a risk factor for cardiovascular disease, but is inhomogeneously defined in the literature. We used a novel approach by taking into account both workload and blood pressure to define exercise hypertension (systolic values > 200 mmHg at 100W). We examined medically controlled hypertensives (n = 373; mean age 56.7 ± 14.8 years) and their blood pressure response during bicycle ergometry. Exercise hypertension was inversely associated with E/A wave ratio but not E/E’ during resting echocardiography (p = 0.045; p = 0.293). Functional air trapping (residual volume/total lung capacity, RV/TLC) was significantly higher in the group of exercise hypertensives (43.6% ± 11.6 vs. 38.1% ± 10.0; p = 0.005). Patients treated with renin-angiotensin aldosterone system (RAAS) blockers showed lower blood pressure response during exercise than those treated with calcium channel blockers (CCBs) and thiazides (both <0.001) and also displayed higher E/A (p = 0.023) and lower E/E’ values (p = 0.042). We provide evidence that the easily accessible parameters E/A inversion and air trapping at rest could be used in clinical routine to screen for exercise-induced hypertension in medically controlled hypertensives. We also show that RAAS blockers have a more favorable effect on blood pressure response during exercise than CCBs and thiazides.
Wernhart et al. (2019) conducted a cross-sectional in Medically controlled hypertension (n=373). Resting echocardiography (E/A ratio) and lung function (air trapping) was evaluated on Functional air trapping (RV/TLC) in exercise hypertensives vs non-hypertensives (p=0.005). Resting functional air trapping was significantly higher in medically controlled hypertensives with exercise hypertension compared to those without (43.6% vs. 38.1%; p=0.005).