Biomedical Science Letters (대한의생명과학회지)

The Korean Society for Biomedical Laboratory Sciences (대한의생명과학회)
권호 표지
DOI QR코드

DOI QR Code

The Blood Pressure Response during Graded Exercise Test in Obese Adults

  • Shin, Kyung-A (Department of Clinical Laboratory Science, Shinsung University)
  • Received : 2017.04.25
  • Accepted : 2017.08.09
  • Published : 2017.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Obesity has been directly associated with the development of hypertension and cardiovascular disease. The purpose of this study was to investigate the blood pressure response during graded exercise test in obese adults. 189 subjects (age: $47.96{\pm}10.23$) were assigned to two groups: non-obese group (N=105, BMI: $22.05{\pm}1.57$, waist circumference: $76.90{\pm}6.17$) and obese group (N=84, BMI: $26.96{\pm}2.51$, waist circumference: $88.29{\pm}6.41$). The subjects underwent health screening and exercise treadmill test from January 2012 to December 2014. Graded exercise test was performed according to the Bruce protocol. Exercise duration (P=0.046) and METs (P=0.015) were significantly lower in obese group than non-obese group. There was no difference in the rate of change in blood pressure response between obese group and non-obese group during exercise, and the recovery rate of systolic blood pressure was delayed in the obese group compared to non-obese group in the first recovery period (P=0.020). The significant factors of increasing rate of change in maximum systolic blood pressure was waist (P=0.046) and hip circumference (P=0.008). In conclusion, these results demonstrate that, for hypertension prevention in obese adults, waist and hip circumference levels should be managed within normal range.

Keywords

References

  1. Adams KF, Schatzkin A, Harris TB, Kipnis V, Mouw T, Ballard-Barbash R, Hollenbeck A, Leitzmann MF. Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. New England Journal of Medicine. 2006. 355:763-778. https://doi.org/10.1056/NEJMoa055643
  2. Ajayi EA, Balogun MO, Akintomide OA, Adebayo RA, Ajayi OE, Ikem RT, Ogunyemi SA, Oyedeji AT. Blood pressure response to an exercise treadmill test, and echocardiographic left ventricular geometry in Nigerian normotensive diabetics. Cardiovascular Journal of South Africa. 2010. 21: 93-96.
  3. Allison TG, Cordeiro MA, Miller TD, Daida H, Squires RW, Gau GT. Prognostic significance of exercise-induced systemic hypertension in healthy subjects. American Journal of Cardiology. 1999. 83: 371-375. https://doi.org/10.1016/S0002-9149(98)00871-6
  4. Barone BB, Wang NY, Bacher AC, Stewart KJ. Decreased exercise blood pressure in older adults after exercise training: contributions of increased fitness and decreased fatness. British Journal of Sports Medicine. 2009. 43: 52-56.
  5. Becker Mde M, Barbosa e Silva O, Moreira IE, Victor EG. Arterial blood pressure in adolescents during exercise stress testing. Arquivos Brasileiros de Cardiologia. 2007. 88: 329-333.
  6. Bekkers MB, Brunekreef B, Koppelman GH, Kerkhof M, de Jongste JC, Smit HA, Wijga AH. BMI and waist circumference; cross-sectional and prospective associations with blood pressure and cholesterol in 12-year-olds. Public Library of Science One. 2012. 7: e51801.
  7. Brunner EJ, Shipley MJ, Ahmadi-Abhari S, Tabak AG, McEniery CM, Wilkinson IB, Marmot MG, Singh-Manoux A, Kivimaki M. Adiposity, obesity, and arterial aging: longitudinal study of aortic stiffness in the Whitehall II cohort. Hypertension. 2015. 66: 294-300. https://doi.org/10.1161/HYPERTENSIONAHA.115.05494
  8. Ceylan E, Comlekci A, Akkoclu A, Ceylan C, Itil O, Ergor G, Yesil S. The effects of body fat distribution on pulmonary function tests in the overweight and obese. Southern Medical Journal. 2009. 102: 30-35. https://doi.org/10.1097/SMJ.0b013e31818c9585
  9. Chen X, Du H, Zhang J, Chen X, Luo G, Que X, Zhang N, Bian Z, Guo Y, Li L, Chen Z, Wu X. Adiposity and blood pressure among 55 000 relatively lean rural adults in southwest of China. Journal of Human Hypertension. 2015. 29: 522-529. https://doi.org/10.1038/jhh.2014.129
  10. Choi HM, Chun JM, Park CH, Yoo H, Nho HS, Kim JK. The cardiovascular response in exercise intensity with obese middle aged women. The Korean Journal of Growth and Development. 2010. 18: 187-194.
  11. Despres JP, Lemieux I, Bergeron J, Pibarot P, Mathieu P, Larose E, Rodes-Cabau J, Bertrand OF, Poirier P. Abdominal obesity and the metabolic syndrome: contribution to global cardiometabolic risk. Arteriosclerosis, Thrombosis, and Vascular Biology. 2008. 28: 1039-1049. https://doi.org/10.1161/ATVBAHA.107.159228
  12. Dibeklioglu SE, Cevik BS, Acar B, Ozcakar ZB, Uncu N, Kara N, Cayci S, Cakar N. The association between obesity, hypertension and left ventricular mass in adolescents. Journal of Pediatric Endocrinology and Metabolism. 2017. 30: 167-174.
  13. Filipovsky J, Ducimetiere P, Safar ME. Prognostic significance of exercise blood pressure and heart rate in middle-aged men. Hypertension. 1992. 20: 333-339. https://doi.org/10.1161/01.HYP.20.3.333
  14. Folsom AR, Prineas RJ, Kaye SA, Munger RG. Incidence of hypertension and stroke in relation to body fat distribution and other risk factors in older women. Stroke. 1990. 21: 701-716. https://doi.org/10.1161/01.STR.21.5.701
  15. Jern S, Bergbrant A, Bjorntorp P, Hansson L. Relation of central hemodynamics to obesity and body fat distribution. Hypertension. 1992. 19: 520-527. https://doi.org/10.1161/01.HYP.19.6.520
  16. Kim CG. Effect of health behavior and obesity indices on blood pressure in 20s man. The Journal of the Korea Contents Association. 2011. 11: 231-238.
  17. Kim HJ, Lee WS, Song YB, Ahn JH, Lee SY, Kim SW, Kim TH, Ryu WS. Relationship between exercise-induced blood pressure response and left ventricular hypertrophy in patients with hypertension. Korean Circulation Journal. 2001. 31: 809-814. https://doi.org/10.4070/kcj.2001.31.8.809
  18. Kim JY, Shin HW, Jeong IK, Cho SW, Min SJ, Lee SJ, Park CY, Oh KW, Hong EG, Kim HK, Kim DM, Yu JM, Ihm SH, Choi MG, Yoo HJ, Park SW. The relationship of adiponectin, leptin and ghrelin to insulin resistance and cardiovascular risk factors in human obesity. Korean Journal of Medicine. 2005. 69: 631-641.
  19. Kim YJ. Left ventricular hypertrophy, body composition, and maximal systolic blood pressure during exercise in exerciseinduced hypertension patients accompanied by coronary artery disease. Journal of Sport and Leisure Studies. 2006. 28: 269-279.
  20. Korean Endocrine Society, Korean society for the Study of Obesity. Management of Obesity, 2010 Recommendation. Endocrinology and Metabolism. 2010. 25: 301-304. https://doi.org/10.3803/EnM.2010.25.4.301
  21. Kotsis V, Stabouli S, Papakatsika S, Rizos Z, Parati G. Mechanisms of obesity-induced hypertension. Hypertension Research. 2010. 33: 386-393. https://doi.org/10.1038/hr.2010.9
  22. Landsberg L, Aronne LJ, Beilin LJ, Burke V, Igel LI, Lloyd-Jones D, Sowers J. Obesity-related hypertension: pathogenesis, cardiovascular risk, and treatment: a position paper of The Obesity Society and the American Society of Hypertension. Journal of Clinical Hypertension. 2013. 15: 14-33. https://doi.org/10.1111/jch.12049
  23. Lazarus R, Gore CJ, Booth M, Owen N. Effects of body composition and fat distribution on ventilatory function in adults. American Journal of Clinical Nutrition. 1998. 68: 35-41. https://doi.org/10.1093/ajcn/68.1.35
  24. Lim PO, MacFadyen RJ, Clarkson PB, MacDonald TM. Impaired exercise tolerance in hypertensive patients. Annals of Internal Medicine. 1996. 124: 41-55. https://doi.org/10.7326/0003-4819-124-1_Part_1-199601010-00008
  25. Lund-Johansen P. Blood pressure response during exercise as a prognostic factor. Journal of Hypertension. 2002. 20: 1473-1475. https://doi.org/10.1097/00004872-200208000-00004
  26. McHam SA, Marwick TH, Pashkow FJ, Lauer MS. Delayed systolic blood pressure recovery after graded exercise: an independent correlate of angiographic coronary disease. Journal of the American College of Cardiology. 1999. 34: 754-759. https://doi.org/10.1016/S0735-1097(99)00269-7
  27. Miyai N, Arita M, Miyashita K, Morioka I, Shiraishi T, Nishio I. Blood pressure response to heart rate during exercise test and risk of future hypertension. Hypertension. 2002. 39: 761-766. https://doi.org/10.1161/hy0302.105777
  28. Park SB, Yun KW, Cho SJ. Expression of adipokines in obese adult and correlation with psychosocial factors. Korean Journal of Obesity. 2005. 14: 82-93.
  29. Reisin E. Nonpharmacologic approaches to hypertension. Weight, sodium, alcohol, exercise, and tobacco considerations. Medical Clinics of North America. 1997. 81: 1289-1303. https://doi.org/10.1016/S0025-7125(05)70583-6
  30. Richards RJ, Thakur V, Reisin E. Obesity-related hypertension: its physiological basis and pharmacological approaches to its treatment. Journal of Human Hypertension. 1996. 10: S59-64.
  31. Stewart KJ, Sung J, Silber HA, Fleg JL, Kelemen MD, Turner KL, Bacher AC, Dobrosielski DA, DeRegis JR, Shapiro EP, Ouyang P. Exaggerated exercise blood pressure is related to impaired endothelial vasodilator function. American Journal of Hypertension. 2004. 17: 314-320. https://doi.org/10.1016/S0895-7061(03)01003-3
  32. Stone NJ, Kushner R. Effects of dietary modification and treatment of obesity. Emphasis on improving vascular outcomes. Medical Clinics of North America. 2000. 84: 95-122. https://doi.org/10.1016/S0025-7125(05)70209-1
  33. Sung BH, Wilson MF, Izzo JL Jr, Ramirez L, Dandona P. Moderately obese, insulin-resistant women exhibit abnormal vascular reactivity to stress. Hypertension. 1997. 30: 848-853. https://doi.org/10.1161/01.HYP.30.4.848
  34. Weiss SA, Blumenthal RS, Sharrett AR, Redberg RF, Mora S. Exercise blood pressure and future cardiovascular death in asymptomatic individuals. Circulation. 2010. 121: 2109-2116. https://doi.org/10.1161/CIRCULATIONAHA.109.895292