Post-Exercise Diastolic Blood Pressure: A Hidden Risk Factor for Heart Health?
New study suggests post-exercise diastolic blood pressure, not systolic, may be a better indicator of future heart problems, especially for those with normal resting BP. Learn more about the findings and their potential impact on cardiovascular health assessments.
DR T S DIDWAL MD
3/25/20244 min read
A large study in the Journal of Clinical Hypertension followed people for over 15 years to see if blood pressure measured right after exercise (post-exercise BP) could predict heart problems. They found that diastolic BP (the bottom number) after exercise, but not systolic BP (the top number), was strongly linked to an increased risk of heart attack, stroke, and even death. This was especially true for people with normal blood pressure at rest. The study suggests that post-exercise diastolic BP may be a useful tool for identifying people at risk, but more research is needed before it can be used routinely.
Key Findings
The study investigated the link between blood pressure right after exercise (post-exercise BP) and future cardiovascular problems.
Key finding: Post-exercise diastolic blood pressure (lower number), but not systolic BP, was a strong predictor of future heart attacks, strokes, and death from any cause.
Especially important for people with normal resting blood pressure, as post-exercise diastolic BP identified them as higher risk.
Possible explanation: abnormal blood vessel response or nerve function in those with high post-exercise diastolic BP despite normal resting BP.
Hypertension group: Post-exercise BP wasn't a strong predictor after considering other risk factors, possibly due to the presence of those factors.
Limitations: Observational study, single BP measurement, focused on young adults.
Future directions: Explore mechanisms behind the findings, track BP changes over time, investigate applicability to older populations, and assess the usefulness of post-exercise BP measurement in clinical practice.
Study Design and Key Findings
The study, a population-based cohort analysis, involved over 2,500 participants and was followed for an average of 16 years. Researchers measured their blood pressure before and after a treadmill exercise test and tracked how many developed cardiovascular issues like heart attack, stroke, or death from any cause during the follow-up period.
Here's a breakdown of the key findings:
Post-exercise diastolic BP, not systolic BP, emerged as a strong predictor of future cardiovascular events (MACE) and death from any cause. This association remained significant even after accounting for factors like age, weight, and diabetes.
The link between post-exercise diastolic BP and MACE was particularly pronounced for individuals with normal baseline blood pressure. This suggests it could identify people at higher risk despite normal resting BP readings.
Baseline blood pressure readings mattered. While the association between post-exercise diastolic BP and MACE weakened slightly for those with hypertension, it remained a significant predictor of death from any cause.
Results
This study investigated the link between blood pressure measured right after exercise (post-exercise BP) and future cardiovascular problems. Over 2,500 participants were followed for an average of 16 years. Here's a summary of the key findings in 500 words:
Participant characteristics:
2581 participants (56% female, 44% male) with an average age of 46.
Nearly half (45%) were black.
The median body mass index (BMI) was 28, indicating overweight.
Baseline blood pressure readings were normal for most participants.
Blood pressure after exercise:
The median post-exercise systolic BP was 141 mmHg, and the diastolic BP was 73 mmHg.
Compared to baseline, systolic BP increased significantly after exercise, while diastolic BP remained similar.
Postexercise blood pressure and cardiovascular risk:
The study found little association between post-exercise systolic BP and future cardiovascular events.
However, post-exercise diastolic BP was strongly linked to an increased risk of:
Major adverse cardiovascular events (MACE) like heart attack or stroke.
Death from any cause.
This association remained significant even after accounting for factors like age, weight, and diabetes.
Baseline blood pressure matters:
When researchers considered participants' baseline BP readings, the link between post-exercise diastolic BP and MACE weakened slightly.
However, it remained a significant predictor of death from any cause.
For people with normal baseline BP, post-exercise diastolic BP became an even stronger predictor of MACE, suggesting it might identify individuals at higher risk despite normal resting BP.
Understanding the Significance
Previous research on BP and cardiovascular risk often focused on changes during peak exercise or recovery phases, with mixed results. This study emphasizes the independent value of measuring BP specifically after exercise, potentially offering a better representation of daily physical stress on the body.
The findings highlight a potential distinction between normal and hypertensive individuals:
Normal BP group: An elevated post-exercise diastolic BP significantly increased the risk of cardiovascular events, suggesting abnormal vasoreactivity or autonomic dysfunction. Early antihypertensive treatment might be beneficial for these individuals.
Hypertension group: post-exercise BP showed no significant association with MACE or death after adjusting for confounding factors. The presence of multiple risk factors in this group and the shorter exercise duration might have masked the role of post-exercise BP.
Further research is needed to explore these contrasting responses and the potential link between high post-exercise BP and future hypertension development in those with normal baseline BP.
Limitations and Future Directions
The study acknowledges several limitations:
Observational design: Residual confounding factors caused by unknown variables are possible.
Self-reported data: The accuracy of some information relied on participant recall.
Single BP measurement: Changes in BP over time weren't considered.
Potential selection bias: Only participants surviving until a specific point were included.
Lack of data on future hypertension diagnosis and exercise heart rate.
Specificity to treadmill exercise and standing BP measurement.
Focus on young adults: The study's applicability to older populations needs exploration.
Despite these limitations, the study sheds light on the potential importance of postexercise diastolic BP as a cardiovascular risk indicator. Future research should address the limitations and explore the following:
Underlying mechanisms: Investigate the physiological reasons behind the contrasting responses observed in normal and hypertensive individuals.
Longitudinal BP monitoring: Track changes in both resting and post-exercise BP over time to understand their impact on cardiovascular risk.
Generalizability: Evaluate the findings in middle-aged and older populations to assess their broader applicability.
Clinical implications: Investigate the feasibility and effectiveness of incorporating post-exercise BP measurements into routine clinical practice for cardiovascular risk assessment.
Conclusion
This study suggests that postexercise diastolic blood pressure, particularly for individuals with normal baseline BP, could be a valuable tool for identifying those at higher risk of cardiovascular events. While further research is needed to confirm these findings and explore their practical applications, the study offers promising insights for improving cardiovascular health assessments and potentially preventing future complications.
Journal Reference
Wang, J. J., Zheng, Z., & Zhang, Y. (2024). Association of postexercise blood pressure with cardiovascular outcomes and mortality: The CARDIA study. Journal of clinical hypertension (Greenwich, Conn.), 10.1111/jch.14796. Advance online publication. https://doi.org/10.1111/jch.14796
Related
https://healthnewstrend.com/hiit-for-elderly-diabetics-can-short-workouts-improve-heart-health
Medical Disclaimer
The information on this website is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.