Patients with type 2 diabetes have exaggerated brachial and central exercise blood pressure: Relation to left ventricular relative wall thickness
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BACKGROUND: A hypertensive response to exercise has prognostic significance. Patients with type 2 diabetes have vascular abnormalities which may predispose to exaggerated brachial and central blood pressure (BP) during exercise. This study aimed to test this hypothesis and to determine the clinical significance of high exercise BP by examining its relation to left ventricular (LV) mass. METHODS: Brachial and central BP were recorded at rest and in response to maximal exercise in 73 diabetic patients (aged 54 +/- 10 years) and 73 controls (aged 53 +/- 12 years). Brachial BP was recorded using mercury sphygmomanometry and LV mass using 2D-echocardiography. Central BP was estimated by radial tonometry using an exercise-validated generalized transfer function. RESULTS: At rest there were no significant (P > 0.05) differences between groups in brachial or central BP. The diabetic patients had significantly increased exercise brachial systolic BP (SBP: 199 +/- 25 mm Hg vs. 185 +/- 21 mm Hg; P = 0.002) and central SBP (158 +/- 17 mm Hg vs. 149 +/- 15 mm Hg; P = 0.002). There was a significantly higher prevalence of an exaggerated exercise BP response (> or =210/105 mm Hg; men and > or =190/105 mm Hg; women) in the diabetic patients (51% vs. 22%; P < 0.01). Compared with those with normal exercise BP, LV relative wall thickness (RWT) was significantly higher (0.41 +/- 0.09 vs. 0.36 +/- 0.08; P < 0.05) and LV hypertrophy was more prevalent (35% vs. 16%; P < 0.05) in those with a hypertensive response. After accounting for other confounding variables, exercise central SBP remained independently associated with LV RWT (beta = 0.22; P = 0.006). CONCLUSION: Diabetic patients are more likely to exhibit exaggerated exercise BP. Regardless of disease status, high exercise central SBP may contribute to cardiovascular risk via adverse cardiac remodeling.
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Exaggerated exercise blood pressure (EEBP) recorded during clinical exercise testing is independently associated with blood pressure-related cardiovascular disease (CVD) outcomes.
“Exaggerated exercise blood pressure recorded during clinical exercise testing is independently associated with blood pressure -related cardiovascular disease outcomes”
From Cardiorespiratory Fitness, Workload, and the Blood Pressure Response to Exercise Testing (2022) · cites this paper as [11]
Several studies have shown relationships between EEBP and adverse cardiac structure and function, indicative of hypertensive heart disease.
“Several studies have also shown relationships between EEBP and adverse cardiac structure [33,34,35,36] and function [37], indicative of hypertensive heart disease.”
From The Identification and Management of High Blood Pressure Using Exercise Blood Pressure: Current Evidence and Practical Guidance (2022) · cites this paper as [33]
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- Authors
- Scott, J. A., Coombes, J. S., Prins, J. B., Leano, R. L., Marwick, T. H., & Sharman, J. E.
- Affiliations
- The University of Queensland (AU)
- Corresponding author
- Scott, J. A.
- Venue
- American Journal of Hypertension
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-06-01
- Volume
- 21
- Issue
- 6
- Pages
- 715-721
- ISSN
- 0895-7061 (ISSN-L)
- 1941-7225
- OpenAlex
- W2036198864
- Cited by
- 82
- References
- 42
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 8 · 2020: 2 · 2019: 6 · 2018: 2 · 2017: 3 · 2016: 6 · 2015: 7 · 2014: 6 · 2013: 5 · 2012: 5
- FWCI
- 2.43
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Licence
- cc-by
- Locations
- American Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- eCite Digital Repository (University of Tasmania) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- type 2 diabetes, blood pressure response to exercise, central blood pressure, brachial blood pressure, left ventricular hypertrophy, cardiac remodeling, radial tonometry, generalized transfer function, cardiovascular risk
- MeSH terms
- Blood Pressure, Brachial Artery, Central Venous Pressure, Diabetes Mellitus, Type 2, Echocardiography, Physical Exertion, Female, Heart Ventricles, Humans, Male, Middle Aged, Ventricular Remodeling
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