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J Am Coll Cardiol, 2008; 52:287-292, doi:10.1016/j.jacc.2008.03.052
© 2008 by the American College of Cardiology Foundation
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CLINICAL RESEARCH: EXERCISE HYPERTENSION

Exaggerated Blood Pressure Response to Exercise Is Associated With Augmented Rise of Angiotensin II During Exercise

Chi Young Shim, MD, Jong-Won Ha, MD, PhD*, Sungha Park, MD, PhD, Eui-Young Choi, MD, Donghoon Choi, MD, PhD, Se-Joong Rim, MD, PhD and Namsik Chung, MD, PhD

Cardiology Division, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea.

Manuscript received January 11, 2008; revised manuscript received March 10, 2008, accepted March 10, 2008.

* Reprint requests and correspondence: Dr. Jong-Won Ha, Cardiology Division, Yonsei Cardiovascular Center, Yonsei University College of Medicine, SeodaemunGu 120-752, Seoul, South Korea. (Email: jwha{at}yuhs.ac).

Objectives: The aim of this study was to investigate the association between an exaggerated blood pressure (BP) response to exercise and augmented angiotensin (Ang) II rise during exercise.

Background: Although a central pressor effect of Ang II has been implicated in the pathogenesis of hypertension, the relationship between Ang II and exaggerated BP response to exercise is unclear.

Methods: Thirty-six subjects with an exaggerated BP response to exercise (18 men, age 50 ± 16 years, Group II) were compared with 36 age- and gender-matched control subjects (18 men, age 50 ± 16 years, Group I) with normal BP reactivity. The subjects who had resting BP ≥140/90 mm Hg or were treated with any antihypertensive drugs were excluded. The blood was sampled at rest and immediately after peak exercise for measurement of renin, Ang II, aldosterone, and catecholamine.

Results: At rest, there were no significant differences in BP, renin, aldosterone, and catecholamine levels between the 2 groups. The renin, aldosterone, and catecholamine were increased during exercise, but there were no significant differences between the groups. However, log Ang II at rest (0.78 ± 0.32 vs. 0.98 ± 0.38, p = 0.004) and peak exercise (0.84 ± 0.35 vs. 1.17 ± 0.51, p < 0.001) and the magnitude of the increment of log Ang II with exercise (0.06 ± 0.12 vs. 0.19 ± 0.20, p = 0.003) were significantly higher in the exaggerated BP response group.

Conclusions: An exaggerated BP response to exercise was associated with augmented rise of Ang II during exercise.

Key Words: angiotensin II • catecholamine • blood pressure • exercise

Abbreviations and Acronyms
  Ang = angiotensin
  BP = blood pressure
  Epi = epinephrine
  LV = left ventricle/ventricular
  NE = norepinephrine
  PRA = plasma renin activity
  SV = stroke volume


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J. Am. Coll. Cardiol. 2008 52: A23-A24. [Full Text] [PDF]





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