Abnormal systolic blood pressure during treadmill test and brachial artery flow: mediated vasodilatation impairment

Mirat, Jure and Bernat, Robert and Majdančić, Željko and Kolčić, Ivana and Galić, Edvard and Zeljko, Hrvojka and Bergovec, Mijo and Reiner, Željko (2007) Abnormal systolic blood pressure during treadmill test and brachial artery flow: mediated vasodilatation impairment. Collegium Antropologicum, 31 (2). pp. 517-522. ISSN 0350-6134

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Abstract

The aim of the study was to assess the relationship between systolic blood pressure during maximal treadmill test (SBP9mtt)) and flow-mediated vasodilation (FMD). Abnormal rise of SBP(mtt) 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 SBP(mtt) (group A), hypertensives with normal SBP(mtt) (group B), normotensives with abnormal SBP(mtt) (group C) and normotensives with normal SBP(mtt) (group D). Rise of SBP(mtt) above 200 mmHg was considered abnormal reaction. Simple linear regression analysis showed significant inverse relationship between SBP(mtt) and FMD (F = 20.2036, p < 0.001, R2 = 0.0956). Mean FMD index was worst in hypertensive subjects with abnormal SBP(mtt) (group A), followed by normotensives with abnormal SBP(mtt) (group C), hypertensives with normal SBP(mtt) (group B) and the best was in normotensives with normal SBP(mtt) (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 SBP(mtt) (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 SBP(mtt) and FMD. An impairment of FMD exists in normotensive subjects with abnormal SBP(mtt). In hypertensives with abnormal SBP(mtt) an additional impairment of FMD exists when compared to hypertensives with normal SBP(mtt). Abnormal SBP(mtt) should be taken into account in global cardiovascular risk assessment.

Abstract in Croatian

Cilj ovog istraživanja bio je utvrditi odnos između sistoličkog krvnog tlaka za vrijeme maksimalnog testa opterećenja i o protoku ovisne dilatacije. Pretjerani porast SKTmtt je fenomen čest u hipertoničara ali se može pojaviti i kod normotoničara također. U ispitivanje smo uključili 199 ispitanika. Formirane su četiri grupe: hipertoničari s abnormalnim porastom SKTmtt (Grupa A), hipertoničari s normalnim porastom SKTmtt (grupa B), normotoničari s abnormalnim porastom SKTmtt (Grupa C) i normotoničari s normalnim porastom SKTmtt (Grupa D). Porast SKTmtt preko 200 mm Hg smatrao se abnormalan. Jednostavnom linearnom regresijskom analizom nađena je statistički značajna negativna ovisnost između SKTmtt i FMD (F=20.2036, p<0.001, R2=0.0956). Srednja vrijednost indeksa FMD u pojediniom grupama bila je najniža u hipertoničara s abnormalnim porasto SKTmtt (3.56±5.17) (Grupa A), izad njih su bili normotoničari s abnormalnim vrijednostima SKTmtt (4.19±5.14) (Grupa B), zatim hipertoničari s normalnim vrijednostima SKTmtt (6.81±8.43) (Grupa C) i najviše vrijednosti su postignute u normotoničara s normalnim porastom SKTmtt 10.92±7.48 (Grupa D). Multivarijatnom regresijskom analizom FMD je pokazao značajnu povezanost s abnormalnim SKTmtt (p<0.001) koju su slijedili dijametar brahijalne arterije (p<0.001), spol (p<0.001) ali ne i hipertenzija (p=0.073), BMI (p=0.137) i ukupni kolesterol (p=0.23). Oštećenje FMD postoji u normotoničara s abnormalnim SKTmtt. U hipertoničara s abnormalnim SKTmtt postoji dodatno oštećenje FMD u odnosu na hipertoničare s normalnim SKTmtt. Abnormalan SKTmtt bi se trebao uzeti u obzir u globalnoj procijeni kardiovaskularnog rizika.

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