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隐匿性高血压青年男性在最大分级运动试验中的血压和血管功能反应

Blood pressure and vascular function response to maximal graded exercise tests in young men with masked hypertension.

作者信息

Chang Keng-Yu, Pham Jonathan, Liu Zhaoli, Kao Yungfei, Brothers R Matthew, Hwang Chueh-Lung

机构信息

Department of Kinesiology, University of Texas at Arlington, Arlington, Texas, United States.

College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, Texas, United States.

出版信息

Am J Physiol Regul Integr Comp Physiol. 2025 Sep 1;329(3):R459-R467. doi: 10.1152/ajpregu.00007.2025. Epub 2025 Aug 5.

Abstract

Individuals with masked hypertension have out-of-office blood pressure (BP) readings in the hypertensive range, but office BP readings below the hypertensive cutoff, making masked hypertension less likely to be diagnosed. The aim of this study was to determine whether in-laboratory measurements of BP and vascular function in response to exercise can serve as indicators of masked hypertension in young adults. Thirty-three young men with office BP <130/80 mmHg, free of smoking and clinical diseases, were included in this study. All participants underwent 24-h ambulatory BP monitoring for BP classification, as well as in-laboratory BP and vascular assessments at rest and after a maximal graded exercise test on a cycle ergometer. These assessments included peripheral and central BP, arterial stiffness, wave reflection, and endothelial function. Compared to participants without masked hypertension (CON; = 17), those with masked hypertension (MH; = 16) had a higher level of 24-h, daytime, and nighttime systolic BP ( ≤ 0.005), but similar office BP ( ≥ 0.5). No differences between groups were found in peripheral BP and vascular function measurements at baseline ( ≥ 0.2) and in response to exercise ( ≥ 0.2 for group by time interaction effects). Although central systolic BP at rest was similar between groups ( = 0.17), MH had a higher marginal mean of central systolic BP from resting, following exercise, and during recovery (MH vs. CON: 113 ± 2 vs. 108 ± 2 mmHg, = 0.047 for group effect). These findings suggest that in young men, masked hypertension may be associated with an elevated central systolic BP, which could be induced by exercise. We show for the first time that in young men, peripheral blood pressure (BP) and vascular function in response to maximal graded exercise tests were not different between individuals with and without masked hypertension. On the other hand, in young men, masked hypertension may be associated with an elevated central systolic BP, which could be induced by exercise.

摘要

隐匿性高血压患者的诊室外血压读数处于高血压范围,但诊室血压读数低于高血压临界值,这使得隐匿性高血压不太可能被诊断出来。本研究的目的是确定实验室中运动时的血压和血管功能测量是否可作为年轻成年人隐匿性高血压的指标。本研究纳入了33名诊室血压<130/80 mmHg、不吸烟且无临床疾病的年轻男性。所有参与者均接受24小时动态血压监测以进行血压分类,并在静息状态下以及在自行车测力计上进行最大分级运动试验后进行实验室血压和血管评估。这些评估包括外周和中心血压、动脉僵硬度、波反射和内皮功能。与无隐匿性高血压的参与者(对照组;n = 17)相比,有隐匿性高血压的参与者(MH组;n = 16)的24小时、白天和夜间收缩压水平更高(P≤0.005),但诊室血压相似(P≥0.5)。两组在基线时的外周血压和血管功能测量(P≥0.2)以及运动反应方面(组间时间交互效应P≥0.2)均未发现差异。尽管静息时的中心收缩压在两组之间相似(P = 0.17),但MH组在静息、运动后和恢复期间的中心收缩压边际均值更高(MH组与对照组:113±2 vs. 108±2 mmHg,组效应P = 0.047)。这些发现表明,在年轻男性中,隐匿性高血压可能与运动诱发的中心收缩压升高有关。我们首次表明,在年轻男性中,隐匿性高血压患者与无隐匿性高血压患者在最大分级运动试验时的外周血压和血管功能并无差异。另一方面,在年轻男性中,隐匿性高血压可能与运动诱发的中心收缩压升高有关。

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