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Hypertensive response to exercise: a marker of altered metabolism in endurance athletes?
  1. J Turmel1,
  2. V Bougault2,
  3. L P Boulet1,
  4. P Poirier1
  1. 1Institut universitaire de cardiologie et de pneumologie de Quebec, Quebec, Canada
  2. 2Universite Droit et Sante de Lille 2, Lille, France


Background Inappropriate high blood pressure response to exercise in non athletes is known to be a predictor for future resting systemic hypertension. However, the relevance of exercise hypertension in endurance athletes is not known.

Objective Assess the differences in heart rate variability (HRV), 24-h ambulatory blood pressure monitoring (ABPM) and lipid profile in athletes with an hypertensive response to exercise, and athletes with normal response to exercise.

Design This study was a prospective cross-sectional study. 47 provincial and national athletes without previous diagnosis of systemic hypertension or other cardiovascular disease, training at least 10 h/week were consecutively recruited. 38 athletes completed the study. Intervention: Athletes underwent an ABPM, a 24-h HRV assessment (Holter), a maximal exercise test and blood samples. Hypertensive response to exercise was defined as systolic blood pressure (SBP) ≥220 mm Hg or diastolic blood pressure (DBP) > 100 mm Hg.

Results Two athletes had systemic hypertension (SBP: 139 ± 3, DBP: 81 ± 8 mm Hg) on 24 h-ABPM and 14 athletes showed hypertensive response to exercise (SBP: 243 ± 20, DBP: 77 ± 13 mm Hg). Lower values of high density lipoprotein (HDL) (1.27 ± 0.19 vs 1.51 ± 0.23 g/L, p=0.04) and Apo-A1 (1.31 ± 0.14 vs 1.56 ± 0.15 g/L, p=0.003) were observed in athletes with hypertensive responses to exercise. The latter also had higher values of night time SBP on ABPM compared to athletes with a normal response to exercise (116 ± 6 vs 106 ± 8 mm Hg, p=0.02). No difference was found between both groups regarding HRV indices.

Conclusion Higher values of night time SBP on ABPM and lower values of HDL and Apo-A1 were observed in athletes with hypertensive response to exercise. These observations may be the first sign of minor metabolic disturbance in endurance athletes, although parameters remain within de normal values.

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