Key result
Exaggerated blood pressure response to exercise was associated with nonalcoholic fatty liver (47.5% vs 13.6%, P=0.002) and increased epicardial fat thickness, but not homocysteine levels (P=0.883).
Why the study?
Are homocysteine, epicardial fat thickness, and nonalcoholic hepatic steatosis associated with an exaggerated blood pressure response to exercise in patients with normal resting blood pressure?
Observational (n=84)
Are homocysteine, epicardial fat thickness, and nonalcoholic hepatic steatosis associated with an exaggerated blood pressure response to exercise in patients with normal resting blood pressure?
Visceral adiposity-related markers like epicardial fat thickness and nonalcoholic fatty liver, but not homocysteine, are associated with an exaggerated blood pressure response to exercise in normotensive individuals.
Answers are grounded in this paper and cite their sources.
May prompt metabolic evaluation in exaggerated exercise BP; hypothesis-generating for NAFLD and epicardial fat links, needs prospective validation.
OBJECTIVE: Exaggerated blood pressure response to exercise is a risk factor for the development of future hypertension. In this study, we aimed to investigate the association between homocysteine, epicardial fat thickness, nonalcoholic hepatic steatosis, and exaggerated blood pressure response to exercise. PARTICIPANTS AND METHODS: We included 44 normotensive and 40 patients with exaggerated blood pressure response to exercise who have normal resting blood pressure and without a previous diagnosis of hypertension. All patients underwent treadmill exercise test and clinical, ultrasonographic, and echocardiographic evaluation. Exaggerated blood pressure response to exercise is defined as peak exercise systolic blood pressure of at least 210 mmHg in men and at least 190 mmHg in women. Homocysteine and other biochemical parameters were determined with standardized automated laboratory tests. RESULTS: Mean age of all participants is 47.9±8.5 years, and 36 of 84 participants were female. The frequency of diabetes mellitus in both groups was similar (P=0.250). Homeostasis model assessment index-insulin resistance had a statistically insignificant trend to be higher in a patient with exercise hypertension (P=0.058). The nonalcoholic fatty liver was more frequent in patients with exercise hypertension (13.6 vs. 47.5%, P=0.002). Epicardial fat thickness was increased in patients with exercise hypertension (5.5±1.5 vs. 7.3±1.1 mm; P=0.001). However, homocysteine levels did not significantly differ between normotensive and exercise hypertensive patients [12.3 μmol/l (5.7-16.9 μmol/l) vs. 13 μmol/l (5.9-28.3 μmol/l); P=0.883]. CONCLUSION: In our study, homocysteine levels were not associated with exaggerated blood pressure response to exercise; however, fatty liver and epicardial fat thickness as visceral adiposity-related cardiometabolic risk factors were significantly related with exaggerated blood pressure response to exercise in patients without a previous diagnosis of hypertension.
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Duyuler et al. (2017) conducted an observational in Exaggerated blood pressure response to exercise (n=84). Exaggerated blood pressure response to exercise vs. Normotensive response to exercise was evaluated on Homocysteine levels (p=0.883). Exaggerated blood pressure response to exercise was associated with nonalcoholic fatty liver (47.5% vs 13.6%, P=0.002) and increased epicardial fat thickness, but not homocysteine levels (P=0.883).
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