Lacy, PS;
Brunel, P;
Baschiera, F;
Botha, J;
Williams, B;
(2015)
Effects of exercise on central aortic pressure before and after treatment with renin–angiotensin system blockade in patients with hypertension.
Journal of the Renin-Angiotensin-Aldosterone System
, 16
(4)
1052 -1060.
10.1177/1470320314538879.
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Abstract
Introduction: Brachial blood pressure increases with exercise and an excessive rise predicts increased cardiovascular risk. Measurement of brachial blood pressure alone may exaggerate the true blood pressure elevation due to exercise-induced change to pressure amplification. Whether blood pressure-lowering treatment modulates pressure amplification during exercise is unknown. Methods: Thirty-two participants with stage 1–2 hypertension (mean age 59.2 years) received eight weeks’ blood pressure lowering with either aliskiren (300mg, n=16) or valsartan (320mg, n=16). Brachial and central aortic pressure (CASP) were measured non-invasively during treadmill exercise (Bruce protocol) at baseline, after eight weeks’ treatment and 48 hours following treatment withdrawal. Results: The rise in brachial blood pressure with exercise exceeded the rise in CASP, indicative of enhanced pressure amplification. Eight weeks’ treatment elicited similar reductions in brachial blood pressure and CASP which did not differ between rest and peak exercise (p>0.05). The exercise-induced increase in systolic pressure amplification did not differ between baseline and following eight weeks’ treatment (p>0.05). These effects remained unchanged following treatment withdrawal. Conclusion: Blood pressure lowering does not directly influence the relationship between aortic and brachial pressure either at rest or during exercise in patients with hypertension, other than through proportionate lowering of both pressures. These effects remained unchanged 48 hours after a simulated missed medication dose.
| Type: | Article |
|---|---|
| Title: | Effects of exercise on central aortic pressure before and after treatment with renin–angiotensin system blockade in patients with hypertension |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1177/1470320314538879 |
| Publisher version: | http://dx.doi.org/10.1177/1470320314538879 |
| Language: | English |
| Additional information: | This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (http://www.uk.sagepub.com/aboutus/openaccess.htm). |
| Keywords: | Hypertension, exercise test, central aortic blood pressure, direct renin inhibitor, angiotensin receptor blocker |
| 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 |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1437209 |
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