目的:经常测量对运动的血压(BP)反应,担心增加是疾病的标志。我们试图描述健康成年人的正常运动血压反应及其与年龄的关系,性别,和健身。
方法:589名参与者(平均年龄46[IQR24-56]岁,81%的男性)接受了反复的心肺运动测试,自动BP测量。根据目前的指南,最大收缩压(SBPmax)被定义为男性≥210mmHg,女性≥190mmHg。个别线性回归分析定义了BP与工作量之间的关系(SBP/W-斜率和DBP/W-斜率)。比较有或没有夸大的SBPmax以及高于或低于中位数SBP/W斜率的参与者。
结果:在51%的男性和64%的女性中发现了夸大的SBPmax,在耐力训练的运动员中更为普遍(男性58%,女性72%,p<0.001)。男性的平均SBP/W斜率(0.24±0.10mmHg/W)低于女性(0.27±0.12mmHg/W),p=0.031。在两性中,峰值摄氧量(VO2peak)与SBP/W斜率呈负相关(p<0.01)。那些具有夸张的SBPmax和低于中位数SBP/W斜率的人年轻10岁,并且VO2peak高20%,平均(p<0.001)。在具有最低VO2峰的老年个体中观察到未夸大的SBPmax和高于中位数的SBP/W斜率。
结论:在一大群健康个体中,夸大的SBPmax是常见的,并且与较高的健康相关.相比之下,与工作量相关的较高SBP与年龄较大有关,较低的健身,和女性性。因此,性别,在评估BP对运动的反应时,应考虑年龄和体能.
我们评估了589名健康个体对运动的血压反应的预测因子。我们证明了有一个强大的,运动时收缩压升高与心肺适应性和运动工作量呈正相关。在剧烈运动中,高最大收缩压在年轻健康个体中比老年人更普遍,不太适合的人。以工作量为指标时,女性的收缩压测量值高于男性。在健康个体中经常超过先前的峰值运动血压的诊断截止值,并且可能具有较差的疾病特异性。因此,以工作负荷为索引的运动血压比峰值运动血压更具信息性。
OBJECTIVE: Blood pressure (BP) responses to exercise are frequently measured, with the concern that greater increases are a marker of disease. We sought to characterize the normal exercise BP response in healthy adults and its relationships with age, sex, and fitness.
METHODS: 589 participants (median age 46 [IQR 24-56] years, 81% male) underwent cardiopulmonary exercise testing with repeated, automated BP measures. An exaggerated maximal systolic BP (SBPmax) was defined from current guidelines as ≥210 mmHg in males and ≥190 mmHg in females. Individual linear regression analyses defined the relationship between BP and workload (SBP/W-slope and DBP/W-slope). Participants with or without an exaggerated SBPmax and above or below median SBP/W-slope were compared.
RESULTS: An exaggerated SBPmax was found in 51% of males and 64% of females and was more prevalent in endurance-trained athletes (males 58%, females 72%, p<0.001). The mean SBP/W-slope was lower in males (0.24±0.10 mmHg/W) than females (0.27±0.12 mmHg/W), p=0.031. In both sexes, peak oxygen uptake (VO2peak) was inversely correlated with SBP/W-slope (p<0.01). Those with an exaggerated SBPmax and below-median SBP/W-slope were 10 years younger and had a 20% higher VO2peak, on average (p<0.001). A non-exaggerated SBPmax and above-median SBP/W-slope was observed in older individuals with the lowest VO2peak.
CONCLUSIONS: In a large cohort of healthy individuals, an exaggerated SBPmax was common and associated with higher fitness. In contrast, higher SBP indexed to workload was associated with older age, lower fitness, and female sex. Thus, sex, age and fitness should be considered when evaluating BP response to exercise.
We evaluated the predictors of blood pressure responses to exercise in 589 healthy individuals. We showed that there is a strong, positive relationship between the increase in systolic blood pressure during exercise with cardiorespiratory fitness and exercise workload.During intensive exercise, high maximal systolic blood pressures are more prevalent in young fit individuals than older, less fit individuals. Systolic blood pressure measures are higher in females than males when indexed to workload.Previous diagnostic cut-offs for peak exercise blood pressure are frequently exceeded in healthy individuals and are likely to have poor disease specificity. Workload-indexed exercise blood pressure is therefore a more informative metric than peak exercise blood pressure.