April 2, 2020Open Access
Elevated exercise blood pressure in middle-aged women is associated with altered left ventricular and vascular stiffness
Structured PICO
Is elevated peak exercise blood pressure associated with altered left ventricular and vascular stiffness in healthy middle-aged women?
P
Population
47 healthy, nonobese middle-aged women (mean age 53 ± 5 years) recruited from the Dallas Heart Study. Excluded if elevated 24-h ambulatory BP ≥140/90 mmHg, history of cardiovascular disease, diabetes, COPD, current/former smokers, or BMI ≥30 kg/m2.
I
Intervention
Highest tertile of peak exercise systolic blood pressure (mean 201 ± 11 mmHg)
C
Comparator
Lower tertiles of peak exercise systolic blood pressure (Tertile 1: 142 ± 19 mmHg; Tertile 2: 178 ± 5 mmHg)
O
Outcome
Left ventricular stiffness (measured by invasive right heart catheterization and 3D echocardiography) and vascular stiffness (aortic pulse-wave velocity)surrogate
In healthy middle-aged women, an exaggerated blood pressure response to exercise is independently associated with increased left ventricular and vascular stiffness, suggesting it may serve as an early marker for HFpEF risk.
Abstract
Women are at increased risk for heart failure with preserved ejection fraction (HFpEF) largely due to higher prevalence of arterial and cardiac stiffening. We were able to identify several subclinical markers of early (stages A and B) HFpEF pathophysiology largely on the basis of exercise blood pressure (BP) response in otherwise healthy middle-aged women. Exercise BP response may be an inexpensive screening tool to identify women at highest risk for developing future HFpEF.