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The influence of fitness on exercise blood pressure and its association with cardiac structure in adolescence

Huang, Z; Fonseca, R; Sharman, JE; Park, C; Chaturvedi, N; Howe, LD; Hughes, AD; (2020) The influence of fitness on exercise blood pressure and its association with cardiac structure in adolescence. Scandinavian Journal of Medicine and Science in Sports , 30 (6) pp. 1033-1039. 10.1111/sms.13645. Green open access

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Abstract

PURPOSE: Exaggerated exercise blood pressure (BP) is associated with altered cardiac structure and increased cardiovascular risk. Fitness modifies these associations, but the effect in healthy adolescents is unknown. We performed an observational study to determine the influence of fitness on post-exercise BP, and on its relationship with cardiac structure in adolescents. METHODS: 4835 adolescents from the Avon Longitudinal Study of Parents and Children, (15.4(0.3) years, 49% male) completed a submaximal cycle test. Fitness was estimated as physical work capacity 170 adjusted for lean body-mass and post-exercise BP measured immediately post-test. Cardiovascular structure and function, including left-ventricular (LV) mass (n=1589), left atrium (LA) size (n=1466), cardiac output (CO, n=1610) and total peripheral resistance (TPR, n=1610) were measured at rest by echocardiography 2.4(0.4) years later. RESULTS: Post-exercise systolic BP increased step-wise by fitness tertile (131.2mmHg [130.4,132.1]; 137.3mmHg [136.5,138.0]; 142.3mmHg [141.5,143.1]). Each 5mmHg of post-exercise systolic BP was associated with 2.46g [1.91,3.01] greater LV mass, 0.02cm [0.02,0.03] greater LA size and 0.25g/m2.7 [0.14,0.36] greater LV mass index. Adjustment for fitness abolished associations (0.29g [-0.16,0.74]; 0.01cm [-0.001,0.014] and 0.08g/m2.7 [-0.001,0.002]). Similar associations between post-exercise systolic BP and each outcome were found between the lowest and highest fitness thirds. CO increased with fitness third (difference 0.06L/min [-0.05,0.17]; 0.23L/min [0.12,0.34]) while TPR decreased (difference -0.13mmHg·min/L [-0.84,0.59]; -1.08mmHg·min/L [-0.1.80,0.35]). CONCLUSIONS: Post-exercise systolic BP increased with fitness, which modified its association with cardiac structure. Higher CO, but lower TPR suggests a physiologically adapted cardiovascular system with greater fitness, highlighting the importance of fitness in adolescence.

Type: Article
Title: The influence of fitness on exercise blood pressure and its association with cardiac structure in adolescence
Location: Denmark
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/sms.13645
Publisher version: https://doi.org/10.1111/sms.13645
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, Blood Pressure, Exercise, Fitness, Left Ventricle
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/10092599
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