Key result
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).
Why the study?
Exaggerated blood pressure response during exercise is a cardiovascular risk factor but is inhomogeneously defined in the literature.
Are resting E/A inversion and air trapping associated with an exaggerated blood pressure response during exercise in medically controlled hypertensives?
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.
Answers are grounded in this paper and cite their sources.
Resting air trapping was associated with exercise hypertension; hypothesis-generating for screening, needs prospective validation before practice change.
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.
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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).
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