UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Masked hypertension and submaximal exercise blood pressure among adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC)

Huang, Z; Sharman, JE; Fonseca, R; Park, C; Chaturvedi, N; Davey Smith, G; Howe, LD; ... Schultz, MG; + view all (2020) Masked hypertension and submaximal exercise blood pressure among adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC). Scandinavian Journal of Medicine & Science in Sports , 30 (1) pp. 25-30. 10.1111/sms.13525. Green open access

[thumbnail of Hughes_Masked hypertension and submaximal exercise blood pressure among adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC)_AAM.pdf]
Preview
Text
Hughes_Masked hypertension and submaximal exercise blood pressure among adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC)_AAM.pdf - Accepted Version

Download (785kB) | Preview

Abstract

PURPOSE: Masked hypertension is associated with increased cardiovascular risk but is undetectable by clinic blood pressure (BP). Elevated systolic BP responses to submaximal exercise reveal the presence of masked hypertension in adults, but it is unknown whether this is the case during adolescence. We aimed to determine if exercise BP was raised in adolescents with masked hypertension, and its association with cardiovascular risk markers. METHODS: 657 adolescents (aged 17.7±0.3 years; 41.9% male) from the Avon longitudinal study of parents and children (ALSPAC) completed a step-exercise test with pre-, post- and recovery-exercise BP, clinic BP and 24-hour ambulatory BP. Masked hypertension was defined as clinic BP <140/90 mmHg and 24-hour ambulatory BP ≥130/80 mmHg. Assessment of left-ventricular (LV) mass index and carotid-femoral pulse wave velocity (aortic PWV) was also undertaken. Thresholds of clinic, pre-, post- and recovery-exercise systolic BP were explored from ROC analysis to identify masked hypertension. RESULTS: Fifty participants (7.8%) were classified with masked hypertension. Clinic, pre-, post- and recovery-exercise systolic BP were associated with masked hypertension (AUC ≥0.69 for all respectively), with the clinic systolic BP threshold of 115 mmHg having high sensitivity and specificity and exercise BP thresholds of 126, 150 and 130 mmHg respectively having high specificity and negative predictive value (individually or when combined) for ruling out the presence of masked hypertension. Additionally, these exercise systolic BP above the thresholds was associated with greater left-ventricular mass index and aortic PWV. CONCLUSIONS: Submaximal exercise systolic BP is associated with masked hypertension and adverse cardiovascular structure in adolescents. Exercise BP may be useful in addition to clinic BP for screening of high BP and cardiovascular risk in adolescents.

Type: Article
Title: Masked hypertension and submaximal exercise blood pressure among adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC)
Location: Denmark
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/sms.13525
Publisher version: https://doi.org/10.1111/sms.13525
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: ALSPAC, adolescent, body composition, exercise test, masked hypertension, vascular stiffness
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing
URI: https://discovery.ucl.ac.uk/id/eprint/10079318
Downloads since deposit
152Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item