https://doi.org/10.1007/s00392-025-02625-4
1Universitätsklinikum Magdeburg A.ö.R. Klinik für Kardiologie, Angiologie und Pneumologie Magdeburg, Deutschland; 2Universitätsklinik für Neurologie Magdeburg, Deutschland; 3Otto-von-Guericke Universität Magdeburg, Deutschland
Introduction: Hypertensive response to exercise is associated with end-organ damages and can predict adverse cardiovascular outcomes. However, the underlying mechanisms of hypertensive exercise response are still unknown. In this study, we investigate the relationship between arterial stiffness and blood pressure exercise response in young and older adults.
Methods: In this prospective cohort study, we included 20 young (age 25.8 ± 3.5 years, 50% female) and 93 older adults (age 72.0 ± 7.8 years, 43% female) who underwent cardiopulmonary exercise test (CPET) until exhaustion on a bicycle ergometer and measurement of arterial stiffness using pulse wave velocity. Additionally, blood pressure response and individual workload-index (increase in systolic blood pressure per increase in wattage (SBP/Watt)) were calculated as markers of hypertensive exercise response.
Results: Our data demonstrate an increased arterial stiffness in older adults (10.9 ± 2.1 m/s) compared to young adults (7.1 ± 0.69 m/s). Older adults also demonstrated a larger rise in blood pressure (58.6 ± 19.5 vs. 36.2 ± 20.6 mmHg, p < 0.001) and workload-index blood pressure response (0.53 ± 0.20 vs. 0.17 ± 0.10 mmHg/W, p < 0.001) following CPET. Additionally, we found a positive correlation between arterial stiffness and workload-index blood pressure response (r = 0.409, p < 0.001).
Discussion: Arterial stiffness is a central pathophysiological mechanism in hypertension and related end-organ damage. In this regard, our data indicate a potential mechanistic link between arterial stiffness and hypertensive response to exercise. Future studies are needed to investigate the clinical relevance.