4.5 Article

The dynamic adjustment of mean arterial pressure during exercise: a potential tool for discerning cardiovascular health status

Journal

JOURNAL OF APPLIED PHYSIOLOGY
Volume 130, Issue 5, Pages 1544-1554

Publisher

AMER PHYSIOLOGICAL SOC
DOI: 10.1152/japplphysiol.00057.2021

Keywords

blood flow; exercise hemodynamics; exercise pressor response; hypertension; kinetics

Funding

  1. National Institutes of Health [T32HL007576, T32HL139451]
  2. NIH [R01HL142603]
  3. Rehabilitation Research and Development Career Development [IK2RX001215]
  4. Senior Research Career Scientist Awards [E9275-L]
  5. American Heart Association [14S-DG-18850039]
  6. Veterans Affairs Clinical Science Research and Development Merit Award [I01CX001999]

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The study investigated the kinetics of mean arterial pressure (MAP) during transitions from unloaded to loaded exercise, finding that MAP increased in a first-order dynamic manner with doubled amplitude during heavy-intensity exercise. There was no difference in speed between moderate and heavy-intensity exercise. Preliminary findings in hypertensive and age-matched normotensive participants suggested exaggerated MAP responses in older groups but slowed response only in hypertensive patients.
The regulation of mean arterial pressure (MAP) during exercise has important physiological and clinical implications. Kinetics analysis on numerous physiological variables following the transition from unloaded-to-loaded exercise has revealed important information regarding their control. Surprisingly, the dynamic response of MAP during this transition remains to be quantified. Therefore, ten healthy participants (5/5 M/F, 24 +/- 3 yr) completed repeated transitions from unloaded to moderate- and heavy-intensity dynamic single-leg knee-extensor exercise to investigate the on-kinetics of MAP. Following the transition to loaded exercise, MAP increased in a first-order dynamic manner, subsequent to a time delay (moderate: 23 +/- 10; heavy: 19 +/- 9 s, P > 0.05) at a speed (s, moderate: 59 +/- 30; heavy: 66 +/- 19 s, P > 0.05), which did not differ between intensities, but the MAP amplitude was doubled during heavy-intensity exercise (moderate: 12 +/- 5; heavy: 24 +/- 8 mmHg, P < 0.001). The reproducibility [coefficient of variation (CV)] during heavy intensity for unloaded baseline, amplitude, and mean response time, when assessed as individual transitions, was 7 +/- 1%, 18 +/- 2%, and 25 +/- 4%, respectively. Averaging two transitions improved the CVs to 4 +/- 1%, 8 +/- 2%, and 13 +/- 3%, respectively. Preliminary findings supporting the clinical relevance of evaluating MAP kinetics in middle-aged hypertensive (n = 5) and, age-matched, normotensive (n = 5) participants revealed an exaggerated MAP response in both older groups (P < 0.05), but the MAP response was slowed only for the patients with hypertension (P < 0.05). It is concluded that kinetics modeling of MAP is practical for heavy-intensity knee-extensor exercise and may provide insight into cardiovascular health and the effect of aging. NEW & NOTEWORTHY Kinetics analysis of physiological variables following workload transitions provides important information, but this has not been performed on mean arterial pressure (MAP), despite the clear clinical importance of this variable. This investigation reveals that kinetic modeling of MAP following unloaded-to-loaded knee-extensor exercise is practical and repeatable. Additional preliminary findings in hypertensive and, age-matched, normotensive subjects suggest that MAP kinetics may provide insight into cardiovascular health and the effect of aging.

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