Key result
After cardiopulmonary exercise testing, untreated hypertensive subjects exhibited a higher Aging Index and b/a ratio compared to healthy controls.
Why the study?
Does cardiopulmonary exercise testing combined with photoplethysmography reveal differences in cardiorespiratory function and arterial stiffness between untreated hypertensive subjects and healthy subjects?
Cross-Sectional (n=30)
Yes
Does cardiopulmonary exercise testing combined with photoplethysmography reveal differences in cardiorespiratory function and arterial stiffness between untreated hypertensive subjects and healthy subjects?
Cardiopulmonary exercise testing combined with photoplethysmography reveals significant differences in vascular aging indices and cardiorespiratory responses between untreated hypertensive and healthy subjects, highlighting potential early arterial stiffness.
Answers are grounded in this paper and cite their sources.
May support early arterial stiffness detection in hypertension; leaves open whether combined testing improves risk stratification.
Objective: This study aimed to compare differences in cardiorespiratory function between untreated hypertensive subjects (UHS) and healthy subjects (HS) during cardiopulmonary exercise testing (CPET). Additionally, it also aimed to explore the potential mechanisms of different exercise responses in cardiorespiratory function before, during and after CPET. Methods: Thirty subjects (15 UHS and 15 HS) were enrolled. Photoplethysmography (PPG), respiratory signal and ECG were simultaneously collected while subjects were performing CPET. Fiducial points (a, b, c, d, e) were extracted from the second derivative of the PPG (SDPPG), and the ratios b/a, c/a, d/a, e/a and (b-c-d-e)/a (named Aging Index, AGI) were calculated as markers of systolic and diastolic function. Additionally, respiratory rate was calculated and analyzed. Results: Before CPET, there were no signi- ficant differences in b/a, d/a and AGI between two groups. However, after CPET, b/a (-0.9±0.19 vs.-1.06±0.19, p-value =0.03) and AGI (-0.49±0.75 vs. -1.15±0.59, p-value=0.011) of the UHS group were significantly higher than those of the HS. The d/a (-0.32±0.24 vs. -0.14±0.17, p- value=0.024) and c/a (-0.33±0.26 vs. -0.07±0.19, p-value=0.004) were significantly lower in UHS than those in HS. In contrast, before CPET, e/a (0.22±0.11 vs. 0.32±0.09, p-value=0.007) in UHS was significantly lower than that in HS, while after CPET there was no significant difference between the two groups in this variable. In addition, during CPET, AGI (p-value=0.003) and respiratory rate (p-value=0.000) in UHS were significantly higher in comparison with before CPET. Conclusions: Different exercise responses showed the differences of cardiorespiratory function between UHS and HS. These differences not only can highlight the CV risk of UHS, but also can predict the appearance of arterial stiffness in UHS. Additionally, during CPET, significant differences in AGI, autonomic nervous function and respiratory activity assessed by respiratory rate were found between the two groups in comparison with before CPET.
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Zhang et al. (2018) conducted a cross-sectional in Primary hypertension (n=30). Untreated hypertension vs. Healthy subjects was evaluated on Aging Index (AGI) after cardiopulmonary exercise testing (p=0.011). After cardiopulmonary exercise testing, untreated hypertensive subjects exhibited a higher Aging Index and b/a ratio compared to healthy controls.
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