Key result
Post-exercise systolic blood pressure link to left ventricular mass index disappears after adjusting for fitness.
Why the study?
Fitness modifies associations between exaggerated exercise blood pressure, altered cardiac structure, and cardiovascular risk, but this effect was unknown in healthy adolescents.
Does cardiorespiratory fitness modify the association between post-exercise systolic blood pressure and cardiac structure in healthy adolescents?
Cohort (n=4,835)
Does cardiorespiratory fitness modify the association between post-exercise systolic blood pressure and cardiac structure in healthy adolescents?
Cardiorespiratory fitness modifies the relationship between post-exercise blood pressure and cardiac structure, suggesting that higher exercise BP in fit adolescents reflects physiological adaptation rather than pathology.
Answers are grounded in this paper and cite their sources.
Fitness adjustment may nullify post-exercise BP links to LV mass in adolescents; leaves open whether fitness modifies remodeling risk.
Purpose Exaggerated exercise blood pressure (BP) is associated with altered cardiac structure and increased cardiovascular risk. Fitness modifies these associations, but the effect in healthy adolescents is unknown. We performed an observational study to determine the influence of fitness on post‐exercise BP, and on its relationship with cardiac structure in adolescents. Methods 4835 adolescents from the Avon Longitudinal Study of Parents and Children, (15.4 (0.3) years, 49% male) completed a submaximal cycle test. Fitness was estimated as physical work capacity 170 adjusted for lean body mass and post‐exercise BP measured immediately posttest. Cardiovascular structure and function, including left ventricular (LV) mass (n = 1589), left atrium (LA) size (n = 1466), cardiac output (CO, n = 1610), and total peripheral resistance (TPR, n = 1610) were measured at rest by echocardiography 2.4 (0.4) years later. Results Post‐exercise systolic BP increased stepwise by fitness tertile (131.2 mm Hg [130.4, 132.1]; 137.3 mm Hg [136.5, 138.0]; 142.3 mm Hg [141.5, 143.1]). Each 5 mm Hg of post‐exercise systolic BP was associated with 2.46 g [1.91, 3.01] greater LV mass, 0.02 cm [0.02, 0.03] greater LA size, and 0.25 g/m 2.7 [0.14, 0.36] greater LV mass index. Adjustment for fitness abolished associations (0.29 g [−0.16, 0.74]; 0.01 cm [−0.001, 0.014] and 0.08 g/m 2.7 [−0.001, 0.002]). Similar associations between post‐exercise systolic BP and each outcome were found between the lowest and highest fitness thirds. CO increased with fitness third (difference 0.06 L/min [−0.05, 0.17]; 0.23 L/min [0.12, 0.34]) while TPR decreased (difference −0.13 mm Hg·min/L [−0.84,0.59]; −1.08 mm Hg·min/L [−0.1.80, 0.35]). Conclusions Post‐exercise systolic BP increased with fitness, which modified its association with cardiac structure. Higher CO, but lower TPR suggests a physiologically adapted cardiovascular system with greater fitness, highlighting the importance of fitness in adolescence.
No takes yet. Share an insight, caveat, or question.
Huang et al. (2020) conducted a cohort in Healthy adolescents (n=4,835). Cardiorespiratory fitness and post-exercise systolic blood pressure vs. Lower fitness tertiles was evaluated on Left ventricular mass index per 5 mmHg increase in post-exercise systolic BP (MD 0.25 g/m2.7, 95% CI 0.14-0.36). Higher post-exercise systolic blood pressure was associated with greater left ventricular mass index, but this association was abolished after adjusting for cardiorespiratory fitness.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: