Artery Research

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Volume 20, Issue C, December 2017, Pages 47 - 47

1.2 MASKED HYPERTENSION IS REVEALED BY EXAGGERATED SUBMAXIMAL EXERCISE BLOOD PRESSURE AMONG ADOLESCENTS FROM THE AVON LONGITUDINAL STUDY OF PARENTS AND CHILDREN (ALSPAC)

Authors
Zhengzheng Huang1, James Sharman1, Chloe Park2, John Deanfield2, Marietta Charakida3, Abigail Fraser3, Laura Howe3, Debbie Lawlor3, Nish Chaturvedi2, George Smith3, Alun Hughes2, Martin Schultz1
1Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
2The UCL Institute of Cardiovascular Science, University College London, London, UK
3MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
Available Online 6 December 2017.
DOI
10.1016/j.artres.2017.10.016How to use a DOI?
Abstract

Objectives: Masked hypertension (MH) is associated with hypertension-related markers of organ damage, but is undetectable by clinic (resting) BP. Exaggerated systolic BP response to submaximal exercise reveals MH in adults, but it is unknown whether this is the case during adolescence. We aimed to determine if exercise BP was raised in adolescents with MH, and associations with markers of organ damage.

Methods: 585 adolescents (aged 17.7 ± 0.3 years; 41.9% male) from the Avon longitudinal study of parents and children (ALSPAC), completed a step-exercise test with post-exercise BP, resting (clinic) BP and 24-hour ambulatory BP (ABP). MH was defined on the basis of guideline adult thresholds as clinic BP ≤ 140/90 mmHg and 24 h ABP ≥ 130/80 mmHg, or paediatric thresholds (age, sex and height percentiles). Assessment of markers of organ damage including left-ventricular mass (LVM) and carotid-femoral pulse wave velocity (PWV) was also undertaken.

Results: 45 (7.7%) participants were classified with MH. Resting and post-exercise SBP were higher in those with MH vs. normotensives (126.1 ± 7.3 mmHg vs. 114.7 ± 10.0 mmHg, p < 0.001; 152.2 ± 17.3 vs 141.1 ± 15.1 mmHg, p = 0.001). A post-exercise SBP threshold of 150 mmHg revealed MH (AUC = 0.69, 95% CI: 0.61–0.76, p < 0.001) and was associated with greater LVM index (30.2 ± 6.5 vs. 27.6 ± 5.8 g/m2.7, p < 0.001) and PWV (5.9 ± 0.6 vs. 5.7 ± 0.7 m/s, p = 0.01).

Conclusions: This is the first study within adolescents demonstrating post-exercise SBP can reveal MH and an association with markers of organ damage. Exaggerated exercise BP might be a warning signal of underlying high BP and increased cardiovascular risk undetected by clinic BP.

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This is an open access article distributed under the CC BY-NC license.

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Journal
Artery Research
Volume-Issue
20 - C
Pages
47 - 47
Publication Date
2017/12/06
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2017.10.016How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

risenwbib
TY  - JOUR
AU  - Zhengzheng Huang
AU  - James Sharman
AU  - Chloe Park
AU  - John Deanfield
AU  - Marietta Charakida
AU  - Abigail Fraser
AU  - Laura Howe
AU  - Debbie Lawlor
AU  - Nish Chaturvedi
AU  - George Smith
AU  - Alun Hughes
AU  - Martin Schultz
PY  - 2017
DA  - 2017/12/06
TI  - 1.2 MASKED HYPERTENSION IS REVEALED BY EXAGGERATED SUBMAXIMAL EXERCISE BLOOD PRESSURE AMONG ADOLESCENTS FROM THE AVON LONGITUDINAL STUDY OF PARENTS AND CHILDREN (ALSPAC)
JO  - Artery Research
SP  - 47
EP  - 47
VL  - 20
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2017.10.016
DO  - 10.1016/j.artres.2017.10.016
ID  - Huang2017
ER  -