Jae Sae Young, Fernhall Bo, Heffernan Kevin S, Kang Mira, Lee Moon-Kyu, Choi Yoon Ho, Hong Kyung Pyo, Ahn Eui Soo, Park Won Hah
Exercise and Cardiovascular Research Laboratory, Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, Illinois, USA.
J Hypertens. 2006 May;24(5):881-7. doi: 10.1097/01.hjh.0000222758.54111.e2.
Although an exaggerated systolic blood pressure (SBP) response to exercise is a predictor of future hypertension and cardiovascular mortality, the underlying mechanisms are not fully understood. We tested the hypothesis that an exaggerated SBP response is associated with carotid atherosclerosis in a cross-sectional study of 9073 healthy men (aged 47.8 +/- 8.8 years).
Exaggerated SBP response was defined as an SBP of 210 mmHg or greater during a maximal treadmill test. Carotid atherosclerosis was defined as stenosis greater than 25% or intima-media thickness greater than 1.2 mm using B-mode ultrasonography.
An exaggerated SBP response was present in 375 men (4.1%). The proportion of individuals with carotid atherosclerosis in the group with an exaggerated SBP response to exercise was higher than in the group with a normal SBP response (14.4 versus 5.3%, P < 0.001). In a multivariable logistic regression model, individuals with an exaggerated SBP (>or= 210 mmHg) response to exercise had a 2.02 times [95% confidence interval (CI) 1.33-3.05] increased risk of carotid atherosclerosis compared with individuals with an SBP response of less than 210 mmHg. The highest quartile (> 61 mmHg) group of relative exercise-induced increases in SBP showed a 1.57 (95% CI 1.18-2.08) greater risk of carotid atherosclerosis compared with individuals in the lowest quartile (< 38 mmHg) in the adjusted model.
These results suggest that an exaggerated SBP response to exercise is strongly associated with carotid atherosclerosis, independent of established risk factors in healthy men. It may be an important factor in evaluating hypertension related to target-organ damage.
尽管运动时收缩压（SBP）反应过度是未来高血压和心血管疾病死亡率的一个预测指标，但其潜在机制尚未完全明确。在一项对9073名健康男性（年龄47.8±8.8岁）的横断面研究中，我们检验了SBP反应过度与颈动脉粥样硬化相关的假设。
运动时SBP反应过度定义为在最大平板运动试验期间SBP达到210 mmHg或更高。使用B型超声将颈动脉粥样硬化定义为狭窄大于25%或内膜中层厚度大于1.2 mm。
375名男性（4.1%）存在运动时SBP反应过度。运动时SBP反应过度组中患有颈动脉粥样硬化的个体比例高于SBP反应正常组（分别为14.4%和5.3%，P<0.001）。在多变量逻辑回归模型中，运动时SBP反应过度（≥210 mmHg）的个体相比SBP反应低于210 mmHg的个体，患颈动脉粥样硬化的风险增加了2.02倍[95%置信区间（CI）1.33 - 3.05]。在调整模型中，运动诱导的SBP相对升高最高四分位数组（>61 mmHg）相比最低四分位数组（<38 mmHg）的个体，患颈动脉粥样硬化的风险高1.57倍（95% CI 1.18 - 2.08）。
这些结果表明，运动时SBP反应过度与颈动脉粥样硬化密切相关，独立于健康男性中已确定的危险因素。它可能是评估与靶器官损害相关高血压的一个重要因素。
