Janssens Kristel, Foulkes Stephen J, Mitchell Amy M, Dausin Christophe, Van Soest Sofie, Spencer Luke, Rowe Stephanie J, D'Ambrosio Paolo, Elliott Adrian D, Van Puyvelde Tim, Parr Evelyn B, Willems Rik, Heidbuchel Hein, Claessen Guido, La Gerche Andre
Exercise and Nutrition Research Program, The Mary MacKillop Institute for Health Research, ACU, Level 5, 215 Spring Street, Melbourne, VIC 3000, Australia.
Heart, Exercise and Research Trials (HEART) Lab, St. Vincent's Institute of Medical Research, 9 Princes Street, Fitzroy, Melbourne, VIC 3065, Australia.
Eur J Prev Cardiol. 2025 Jan 6;32(1):43-51. doi: 10.1093/eurjpc/zwae262.
Blood pressure (BP) responses to exercise are frequently measured, with the concern that greater increases are a marker of disease. We sought to characterize the normal exercise BP response in healthy adults and its relationships with age, sex, and fitness.
Five hundred and eighty-nine participants [median age 46 (interquartile range 24-56) years, 81% male] underwent cardiopulmonary exercise testing with repeated, automated BP measures. An exaggerated maximal systolic BP (SBPmax) was defined from current guidelines as ≥210 mmHg in males and ≥190 mmHg in females. Individual linear regression analyses defined the relationship between BP and workload (W; SBP/W-slope and DBP/W-slope). Participants with or without an exaggerated SBPmax and above- or below-median SBP/W-slope were compared. An exaggerated SBPmax was found in 51% of males and 64% of females and was more prevalent in endurance-trained athletes (males 58%, females 72%, P < 0.001). The mean SBP/W-slope was lower in males (0.24 ± 0.10 mmHg/W) than females (0.27 ± 0.12 mmHg/W, P = 0.031). In both sexes, peak oxygen uptake (VO2peak) was inversely correlated with SBP/W-slope (P < 0.01). Those with an exaggerated SBPmax and below-median SBP/W-slope were 10 years younger and had a 20% higher VO2peak, on average (P < 0.001). A non-exaggerated SBPmax and above-median SBP/W-slope was observed in older individuals with the lowest VO2peak.
In a large cohort of healthy individuals, an exaggerated SBPmax was common and associated with higher fitness. In contrast, higher SBP indexed to W was associated with older age, lower fitness, and female sex. Thus, sex, age, and fitness should be considered when evaluating BP response to exercise.
Pro@Heart: NCT05164328, ACTRN12618000716268; ProAFHeart: ACTRN12618000711213; Master@Heart: NCT03711539.
运动时的血压（BP）反应经常被测量，人们担心血压升得更高是疾病的一个标志。我们试图描述健康成年人正常的运动血压反应及其与年龄、性别和体能的关系。
589名参与者[年龄中位数46岁（四分位间距24 - 56岁），81%为男性]接受了心肺运动测试，并进行了多次自动血压测量。根据当前指南，将男性收缩压最大值（SBPmax）≥210 mmHg和女性≥190 mmHg定义为收缩压过度升高。通过个体线性回归分析确定血压与工作量（W；收缩压/工作量斜率和舒张压/工作量斜率）之间的关系。比较了收缩压最大值过度升高和未过度升高以及收缩压/工作量斜率高于或低于中位数的参与者。在51%的男性和64%的女性中发现收缩压最大值过度升高，在耐力训练运动员中更为常见（男性58%，女性72%，P < 0.001）。男性的平均收缩压/工作量斜率（0.24 ± 0.10 mmHg/W）低于女性（0.27 ± 0.12 mmHg/W，P = 0.031）。在男女两性中，峰值摄氧量（VO2peak）与收缩压/工作量斜率呈负相关（P < 0.01）。收缩压最大值过度升高且收缩压/工作量斜率低于中位数的参与者平均年龄小10岁，VO2peak高约20%（P < 0.001）。在VO2peak最低的老年人中观察到收缩压最大值未过度升高且收缩压/工作量斜率高于中位数的情况。
在一大群健康个体中，收缩压最大值过度升高很常见且与较高的体能相关。相比之下，与工作量相关的较高收缩压与年龄较大、体能较低和女性性别有关。因此，在评估运动时的血压反应时应考虑性别、年龄和体能。
Pro@Heart：NCT05164328，ACTRN12618000716268；ProAFHeart：ACTRN12618000711213；Master@Heart：NCT03711539。
