The influence of fitness on exercise blood pressure and its association with cardiac structure in adolescence
Year: 2020
Type: article
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 posttest. 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 stepwise by fitness tertile (131.2 mm Hg [130.4, 132.1]; 137.3 mm Hg [136.5, 138.0]; 142.3 mm Hg [141.5, 143.1]). Each 5 mm Hg of post‐exercise systolic BP was associated with 2.46 g [1.91, 3.01] greater LV mass, 0.02 cm [0.02, 0.03] greater LA size, and 0.25 g/m2.7 [0.14, 0.36] greater LV mass index. Adjustment for fitness abolished associations (0.29 g [−0.16, 0.74]; 0.01 cm [−0.001, 0.014] and 0.08 g/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 0.06 L/min [−0.05, 0.17]; 0.23 L/min [0.12, 0.34]) while TPR decreased (difference −0.13 mm Hg·min/L [−0.84,0.59]; −1.08 mm Hg·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.
DOI: 10.1111/sms.13645
Language: English
Subfield: Complementary and alternative medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Early Life determinants of Blood pressure patterns in young Adults (ELBA Study)., G1564672023, G1605161196, G1829613114, G2191403233, The Avon Longitudinal Study of Parents and Children (ALSPAC): A multi- generation, longitudinal resource focusing on life course health and well- being., The Avon Longitudinal Study for Parents and Children: An international resource for population genomic and lifecourse epidemiology. Core programme support 2014-2019., G5470336846, EXERTION: the EXERcise stress Test collaboratION, G6689231961, G6935211943, G7194418384, G7417775661, G801210579, G935946464
OpenAlex ID: W3006952263