Background: Elevated blood pressure is an important feature of the metabolic syndrome (MetS). Exercise-induced hypertension (EIH), which can be encountered during treadmill test, is related to future hypertension and is associated with a higher risk of cardiovascular disease. The aim of this study was to evaluate blood pressure (BP) responses to exercise as well as EIH prevalence in subjects with MetS.
Methods: A total of 214 normotensive men with MetS free of any medications were evaluated. Baseline BP and heart rate (HR) were assessed in the fasted state one week prior exercise testing. Thereafter, subjects underwent a maximal symptom-limited treadmill test using the Bruce protocol. BP and HR were measured after 5 minutes rest (anticipatory), every 3 minutes during exercise and during the recovery period at 2 and 4 minutes. EIH was defined as maximum systolic blood pressure (SBP) >=220 mmHg and/or maximum diastolic blood pressure (DBP) >=100 mmHg.
Results: Among all participants, 103 (48%) presented EIH. Resting BP, even within normal limit in both group, was higher in the group with EIH (127 +/- 10/82 +/- 7 mmHg vs 120 +/- 8/80 +/- 6 mmHg; P = .01) Maximal exercise BP was 232 +/- 18/100 +/- 13 mmHg in EIH participants and 198 +/- 15/83 +/- 10 mmHg in subjects with normal response to exercise (NRE) (P < .001). Anticipatory SBP and DBP were higher in the group with EIH (147 +/- 12/85 +/- 12 mmHg vs 134 +/- 11/80 +/- 10 mmHg, P = .001). Increment in both SBP and DBP was higher in the group of subjects with EIH (84 +/- 17 vs 62 +/- 14 and 15 +/- 13 vs 5 +/- 11 mmHg for delta SBP and DBP, respectively; P < .001). Recovery SBP and DBP was also higher in subjects with EIH at both 2 and 4 minutes (219 +/- 19/91 +/- 12 vs 184 +/- 15/85 +/- 12 mmHg and 184 +/- 18/85 +/- 11 vs 164 +/- 14/79 +/- 10 mmHg, at 2 and 4 minutes, respectively; all P +/- .01). Resting, anticipatory, maximal and recovery HR were comparable between the 2 groups. HR recuperation was lower in the group with EIH at 2 and 4 minutes (52 +/- 12 vs 57 +/- 11; P = .04 and 66 +/- 16 vs 72 +/- 17; P = .06 at 2 and 4 minutes, respectively).
Conclusions: EIH is quite prevalent in subjects with the MetS. Patient with EIH exhibited higher resting, anticipatory and recovery SBP and DBP. They also presented higher increase in BP during stress and blunted HR recovery. These hemodynamic changes during exercise in subjects with MetS and EIH reflect higher cardiovascular risk in these subjects.