Blood Pressure and Vascular Function Response to Maximal Graded Exercise Tests in Young Men with Masked Hypertension

Individuals with masked hypertension have out-of-office blood pressure (BP) readings in the hypertensive range, but office BP readings below the hypertensive cutoff, making masked hypertension less likely to be diagnosed. The aim of this study was to determine whether in-laboratory measurements of BP and vascular function in response to exercise can serve as indicators of masked hypertension in young adults. Thirty-three young men with office BP <130/80 mmHg, free of smoking and clinical diseases, were included in this study. All participants underwent 24-hr ambulatory BP monitoring for BP classification, as well as in-laboratory BP and vascular assessments at rest and after a maximal graded exercise test on a cycle ergometer. These assessments included peripheral and central BP, arterial stiffness, wave reflection, and endothelial function. Compared to participants without masked hypertension (CON; n=17), those with masked hypertension (MH; n=16) had a higher level of 24-hr, daytime, and nighttime systolic BP (P≤0.005), but similar office BP (P≥0.5). No differences between groups were found in peripheral BP and vascular function measurements at baseline (P≥0.2) and in responses to exercise (P≥0.2 for group by time interaction effects). While central systolic BP at rest was similar between groups (P=0.17), MH had a higher marginal mean of central systolic BP from resting, following exercise, and during recovery (MH vs. CON: 113±2 vs. 108±2 mmHg, P=0.047 for group effect). These findings suggest that in young men, masked hypertension may be associated with an elevated central systolic BP, which could be induced by exercise.