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Impaired baroreflex sensitivity, carotid stiffness, and exaggerated exercise blood pressure: a community-based analysis from the Paris Prospective Study III

Sharman, JE ORCID: 0000-0003-2792-0811, Boutouyrie, P, Perier, M-C, Thomas, F, Guibout, C, Khettab, H, Pannier, B, Laurent, S, Jouven, X and Empana, J-P 2017 , 'Impaired baroreflex sensitivity, carotid stiffness, and exaggerated exercise blood pressure: a community-based analysis from the Paris Prospective Study III' , European Heart Journal, vol. 39, no. 7 , pp. 599-606 , doi: 10.1093/eurheartj/ehx714.

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Abstract

Aims: People with exaggerated exercise blood pressure (BP) have adverse cardiovascular outcomes. Mechanisms are unknown but could be explained through impaired neural baroreflex sensitivity (BRS) and/or large artery stiffness. This study aimed to determine the associations of carotid BRS and carotid stiffness with exaggerated exercise BP.Methods and results: Blood pressure was recorded at rest and following an exercise step-test among 8976 adults aged 50 to 75years from the Paris Prospective Study III. Resting carotid BRS (low frequency gain, from carotid distension rate, and heart rate) and stiffness were measured by high-precision echotracking. A systolic BP threshold of>_150 mmHg defined exaggerated exercise BP and >_140/90 mmHg defined resting hypertension (±antihypertensive treatment). Participants with exaggerated exercise BP had significantly lower BRS [median (Q1; Q3) 0.10 (0.06; 0.16) vs. 0.12 (0.08; 0.19) (ms2/mm) 2x108>; PPP=0.04 and high-normal BP; OR, 1.19 (95% CI 1.07; 1.32), P=0.001} after adjustment for age, sex, body mass index, smoking, alcohol, total cholesterol, high-density lipoprotein cholesterol, resting heart rate, and antihypertensive medications. Conclusion: Impaired BRS, but not carotid stiffness, is independently associated with exaggerated exercise BP even among those with well controlled resting BP. This indicates a potential pathway from depressed neural baroreflex function to abnormal exercise BP and clinical outcomes.

Item Type: Article
Authors/Creators:Sharman, JE and Boutouyrie, P and Perier, M-C and Thomas, F and Guibout, C and Khettab, H and Pannier, B and Laurent, S and Jouven, X and Empana, J-P
Keywords: Exercise tests, cardiopulmonary tests, treadmill, aerobic exercise, physical exertions, haemodynamic, epidemiology, cohort
Journal or Publication Title: European Heart Journal
Publisher: W B Saunders Co Ltd
ISSN: 0195-668X
DOI / ID Number: 10.1093/eurheartj/ehx714
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