Abnormal Systolic Blood Pressure during Treadmill Test and Brachial Artery Flow – Mediated Vasodilatation Impairment

Abstract

The aim of the study was to assess the relationship between systolic blood pressure during maximal treadmill test (SBPmtt) and flow-mediated vasodilation (FMD). Abnormal rise of SBPmtt is the phenomenon more frequent in hypertensive persons but it could be found in normotensive subjects too. 199 subjects referred to treadmill test were enrolled in the study. Four groups were formed: hypertensives with abnormal SBPmtt (group A), hypertensives with normal SBPmtt (group B), normotensives with abnormal SBPmtt (group C) and normotensives with normal SBPmtt (group D). Rise of SBPmtt above 200 mmHg was considered abnormal reaction. Simple linear regression analysis showed significant inverse relationship between SBPmtt and FMD (F=20.2036, p<0.001, R2=0.0956). Mean FMD index was worst in hypertensive subjects with abnormal SBPmtt (group A), followed by normotensives with abnormal SBPmtt (group C), hypertensives with normal SBPmtt (group B) and the best was in normotensives with normal SBPmtt (3.56±5.17, 4.19±5.14, 6.81±8.43 and 10.92±7.48%, respectively). In multivariate regression analysis FMD showed significant association with abnormal SBPmtt (p<0.001) along with brachial artery diameter (p<0.001), male gender (p<0.001), but not with hypertension (p=0.073), BMI (p=0.137) and total cholesterol (p=0.23) (coefficients: –0.26, –0.40, –0.27, –0.13, –0.11 and –0.07, respectively). There was a significant inverse relationship between SBPmtt and FMD. An impairment of FMD exists in normotensive subjects with abnormal SBPmtt. In hypertensives with abnormal SBPmtt an additional impairment of FMD exists when compared to hypertensives with normal SBPmtt. Abnormal SBPmtt should be taken into account in global cardiovascular risk assessment

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