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The influence of fitness on exercise blood pressure and its association with cardiac structure in adolescence

Huang, Z, Fonseca, R ORCID: 0000-0003-4480-2542, Sharman, JE ORCID: 0000-0003-2792-0811, Park, C, Chaturvedi, N, Howe, LD, Hughes, AD and Schultz, MG ORCID: 0000-0003-3458-1811 2020 , 'The influence of fitness on exercise blood pressure and its association with cardiac structure in adolescence' , Scandinavian Journal of Medicine and Science in Sports, vol. 30, no. 6 , pp. 1033-1039 , doi: 10.1111/sms.13645.

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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.

Item Type: Article
Authors/Creators:Huang, Z and Fonseca, R and Sharman, JE and Park, C and Chaturvedi, N and Howe, LD and Hughes, AD and Schultz, MG
Keywords: adolescent, ALSPAC, blood pressure, exercise, fitness, left ventricle
Journal or Publication Title: Scandinavian Journal of Medicine and Science in Sports
Publisher: Blackwell Munksgaard
ISSN: 0905-7188
DOI / ID Number: 10.1111/sms.13645
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© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

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