Regular physical activity attenuates the blood pressure response to public speaking and delays the development of hypertension

Objectives The objective of this study was to investigate the effect of regular physical activity on the haemodynamic response to public speaking and to evaluate the long-term effect of exercise on development of hypertension. Participants We assessed 75 sedentary and 44 active participants screened for stage 1 hypertension with consistent activity habits and 63 normotensive individuals as control. Methods The blood pressure (BP) response to public speaking was assessed with beat-to-beat noninvasive recording. Definition of incident hypertension was based either on clinic or 24-h BP measurement. Results The BP response to public speaking was greater in the hypertensive than the normotensive participants (P = 0.018/0.009). Among the former, sedentary participants showed increased BP reactivity to the speech test (45.2 +/- 22.6/22.2 +/- 11.5 mmHg, P < 0.01/<0.001 versus controls), whereas physically active participants had a response similar to that of controls (35.4 +/- 18.5/18.5 +/- 11.5 mmHg, P = not significant). During a median follow-up of 71 months, ambulatory BP did not virtually change in the active participants (-0.9 +/- 7.8/-0.0 +/- 4.7 mmHg) and increased in their sedentary peers (2.8 +/- 9.8/3.2 +/- 7.4 mmHg, P = 0.08/0.003 versus active). Active participants were less likely to develop incident hypertension than sedentary ones. After controlling for several confounders including baseline heart rate, the hazard ratio was 0.53 [95% confidence interval (CI) 0.31-0.94] for clinic hypertension and 0.60 (95% CI 0.37-0.99) for ambulatory hypertension. Inclusion of BP response to public speaking into the Cox model influenced the strength of the association only marginally [hazard ratio = 0.55 (95% CI 0.30-0.97) and hazard ratio = 0.59 (95% CI 0.36-0.99), respectively]. Conclusion Regular physical activity attenuates the BP reaction to psychosocial stressors. However, this mechanism seems to be only partially responsible for the long-term effect of exercise on BP. J Hypertens 28: 1186-1193 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.