The relationship between arterial stiffness and increase in blood pressure during exercise in normotensive persons

Background: Arterial stiffness is increased in hypertension, even at an earlier stage. The blood pressure (BP) response to exercise reflects the future risk of developing hypertension. We investigated the relationship between the pulse wave velocity (PWV) and the BP response to exercise to evaluate whether arterial stiffness is increased in normotensive persons with higher exercise BPs. Methods: The participants of the study were adults with normal BP (SBP < 120 mmHg and DBP < 80 mmHg) without history of clinical cardiovascular diseases, who had undergone health screening. Treadmill exercise tests were done by modified Bruce protocol, and brachial-ankle PWV (baPWV) was measured. Results: The participants were 2156 men and women (69 : 31%) with mean age of 52 ± 5 years. The baPWV correlated significantly to variables such as age, sex, baseline SBP and DBP, pulse pressure, maximal oxygen consumption (VO _2max), SBP at stage 1, at stage 2 and peak exercise and hemoglobin A1c (HbA1c). In multiple regression model, SBP at stage 1 had a significant association with baPWV after an adjustment with age, sex, VO2max and SBP at rest, current smoking and HbA1c. For every 10 mmHg increase in exercise SBP, baPWV increased by 18 ± 0.3 cm/s (P < 0.001). Conclusion: In normotensive individuals, increased arterial stiffness, as reflected by baPWV, is accompanied by higher SBP at the early stage of treadmill exercise test. This finding suggests that arterial stiffening processes are present even in the normotensive setting and are correlated with BP changes during exercise.