Sex-Based Differences in Peak Exercise Blood Pressure Indexed to Oxygen Consumption Among Competitive Athletes.

Details

Serval ID
serval:BIB_15340698E4D3
Type
Article: article from journal or magazin.
Collection
Publications
Title
Sex-Based Differences in Peak Exercise Blood Pressure Indexed to Oxygen Consumption Among Competitive Athletes.
Journal
Clinical therapeutics
Author(s)
Petek B.J., Gustus S.K., Churchill T.W., Guseh J.S., Loomer G., VanAtta C., Baggish A.L., Wasfy M.M.
ISSN
1879-114X (Electronic)
ISSN-L
0149-2918
Publication state
Published
Issued date
01/2022
Peer-reviewed
Oui
Volume
44
Number
1
Pages
11-22.e3
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Although exercise testing guidelines define cutoffs for an exaggerated exercise systolic blood pressure (SBP) response, SBPs above these cutoffs are not uncommon in athletes given their high exercise capacity. Alternately, guidelines also specify a normal SBP response that accounts for metabolic equivalents (METs; mean [SD] of 10 [2] mm Hg per MET or 3.5 mL/kg/min oxygen consumption [V˙o <sub>2</sub> ]). SBP and V˙o <sub>2</sub> increase less during exercise in females than males. It is not clear if sex-based differences in exercise SBP are related to differences in V˙o <sub>2</sub> or if current recommendations for normal increase in SBP per MET produce reasonable estimates using measured METs (ie, V˙o <sub>2</sub> ) in athletes. We therefore examined sex-based differences in exercise SBP indexed to V˙o <sub>2</sub> in athletes with the goal of defining normative values for exercise SBP that account for fitness and sex.
Using prospectively collected data from a single sports cardiology program, normotensive athlete patients were identified who had no relevant cardiopulmonary disease and had undergone cardiopulmonary exercise testing with cycle ergometry or treadmill. The relationship between ΔSBP (peak - rest) and ΔV˙o <sub>2</sub> (peak - rest) was examined in the total cohort and compared between sexes.
A total of 413 athletes (mean [SD] age, 35.5 [14] years; 38% female; mean [SD] peak V˙o <sub>2</sub> , 46.0 [10.2] mL/kg/min, 127% [27%] predicted) met the inclusion criteria. The ΔSBP correlated with unadjusted ΔV˙o <sub>2</sub> (cycle: R <sup>2</sup> = 0.18, treadmill: R <sup>2</sup> = 0.12; P < 0.0001). Female athletes had lower mean (SD) peak SBP (cycle: 161 [15] vs 186 [24] mm Hg; treadmill: 165 [17] vs 180 [20] mm Hg; P < 0.05) than male athletes. Despite lower peak SBP, mean (SD) ΔSBP relative to unadjusted ΔV˙o <sub>2</sub> was higher in female than male athletes (cycle: 25.6 [7.2] vs 21.1 [7.3] mm Hg/L/min; treadmill: 21.6 [7.2] vs 17.0 [6.2] mm Hg/L/min; P < 0.05). When V˙o <sub>2</sub> was adjusted for body size and converted to METs, female and male athletes had similar mean (SD) ΔSBP /ΔMET (cycle: 6.0 [2.1] vs 5.8 [2.0] mm Hg/mL/kg/min; treadmill: 4.7 [1.8] vs 4.8 [1.7] mm Hg/mL/kg/min).
In this cohort of athletes without known cardiopulmonary disease, observed sex-based differences in peak exercise SBP were in part related to the differences in ΔV˙o <sub>2</sub> between male and female athletes. Despite lower peak SBP, ΔSBP/unadjusted ΔV˙o <sub>2</sub> was paradoxically higher in female athletes. Future work should define whether this finding reflects sex-based differences in the peripheral vascular response to exercise. In this athletic cohort, ΔSBP/ΔMET was similar between sexes and much lower than the ratio that has been proposed by guidelines to define a normal SBP response. Our observed ΔSBP/ΔMET, based on measured rather than estimated METs, provides a clinically useful estimate for normal peak SBP range in athletes.
Keywords
Adult, Blood Pressure/physiology, Cohort Studies, Exercise/physiology, Exercise Test, Female, Humans, Male, Oxygen Consumption/physiology, Athletes, Exercise testing, Hypertension, Systolic blood pressure
Pubmed
Web of science
Open Access
Yes
Create date
07/12/2022 12:03
Last modification date
24/02/2024 8:34
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