P.081 Hypertensive Subjects with an Exaggerated Blood Pressure Exercise Response are Characterized by a State of Inflammatory Activation, Impaired Thrombosis/Fibrinolysis System and Arterial Stiffening

Abstract

Purpose

To examined the correlations between hypertensive response to exercise (HRE), high-sensitivity C-reactive protein (hs-CRP), plasminogen-activator inhibitor type 1 (PAI-1) and arterial stiffening, in essential hypertensives.

Methods

84 newly diagnosed untreated non-diabetic hypertensive subjects [58 men, mean age 52 years, office BP = 145/93 mmHg] with a negative treadmill exercise test were divided into those with HRE (n =24) (peak systolic BP >210 mmHg in men and >190 in women) and to those without HRE (n = 60). Moreover, in all subjects venous blood samples were drawn for estimation of hs-CRP and PAI-1 levels, whereas arterial stiffness was evaluated on the basis of carotid to femoral pulse wave velocity (PWV).

Results

Patients with HRE compared to those without HRE were older and had greater 24-h systolic BP. Although groups did not differ regarding metabolic profile patients with HRE as compared to those without HRE exhibited significantly higher levels of c-f PWV (8.7±1.6 vs 7.7±13 m/s), hs-CRP (5.1±1.2 vs 2.1±0.8mg/l) and PAI-1 (38.6±8.5 vs 18.9±2.6 ng/ml). In the total population, peak systolic BP was related to 24-h systolic BP (r = 0.238, p < 0.05), PWV (r = 0.288, p < 0.005) and hs-CRP (r = 0.439, p < 0.0001), whereas there was no association with PAI-1 levels (p =NS). By analysis of covariance it was revealed that PWV, hs-CRP and PAI-1 values remained significantly different between groups after adjustment for confounders (p < 0.05).

Conclusions

Hypertensives with an HRE exhibit augmented hs-CRP, PAI-1 and PWV values. These findings suggest that impaired thrombosis/fibrinolysis system, arterial stiffening and microinflammation may be mechanisms that contribute to exercise hypertension and associated increase risk.