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The influence of fitness on exercise blood pressure and its association with cardiac structure in adolescence


Huang, Z and Fonseca, R and Sharman, JE and Park, C and Chaturvedi, N and Howe, LD and Hughes, AD and Schultz, MG, The influence of fitness on exercise blood pressure and its association with cardiac structure in adolescence, Scandinavian Journal of Medicine and Science in Sports, 30, (6) pp. 1033-1039. ISSN 0905-7188 (2020) [Refereed Article]

Copyright Statement

© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

DOI: doi:10.1111/sms.13645


Purpose: Exaggerated exercise blood pressure (BP) is associated with altered cardiac structure and increased cardiovascular risk. Fitness modifies these associations, but the effect in healthy adolescents is unknown. We performed an observational study to determine the influence of fitness on post-exercise BP, and on its relationship with cardiac structure in adolescents.

Methods: 4835 adolescents from the Avon Longitudinal Study of Parents and Children, (15.4 (0.3) years, 49% male) completed a submaximal cycle test. Fitness was estimated as physical work capacity 170 adjusted for lean body mass and post-exercise BP measured immediately posttest. Cardiovascular structure and function, including left ventricular (LV) mass (n = 1589), left atrium (LA) size (n = 1466), cardiac output (CO, n = 1610), and total peripheral resistance (TPR, n = 1610) were measured at rest by echocardiography 2.4 (0.4) years later.

Results: Post-exercise systolic BP increased stepwise by fitness tertile (131.2 mm Hg [130.4, 132.1]; 137.3 mm Hg [136.5, 138.0]; 142.3 mm Hg [141.5, 143.1]). Each 5 mm Hg of post-exercise systolic BP was associated with 2.46 g [1.91, 3.01] greater LV mass, 0.02 cm [0.02, 0.03] greater LA size, and 0.25 g/m2.7 [0.14, 0.36] greater LV mass index. Adjustment for fitness abolished associations (0.29 g [-0.16, 0.74]; 0.01 cm [-0.001, 0.014] and 0.08 g/m2.7 [-0.001, 0.002]). Similar associations between post-exercise systolic BP and each outcome were found between the lowest and highest fitness thirds. CO increased with fitness third (difference 0.06 L/min [-0.05, 0.17]; 0.23 L/min [0.12, 0.34]) while TPR decreased (difference -0.13 mm Hg·min/L [-0.84,0.59]; -1.08 mm Hg·min/L [-0.1.80, 0.35]).

Conclusions: Post-exercise systolic BP increased with fitness, which modified its association with cardiac structure. Higher CO, but lower TPR suggests a physiologically adapted cardiovascular system with greater fitness, highlighting the importance of fitness in adolescence.

Item Details

Item Type:Refereed Article
Keywords:adolescent, ALSPAC, blood pressure, exercise, fitness, left ventricle
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Huang, Z (Mr Zhiqiang Huang)
UTAS Author:Fonseca, R (Mr Ricardo Fonseca Diaz)
UTAS Author:Sharman, JE (Professor James Sharman)
UTAS Author:Schultz, MG (Dr Martin Schultz)
ID Code:139253
Year Published:2020
Web of Science® Times Cited:3
Deposited By:Menzies Institute for Medical Research
Deposited On:2020-06-03
Last Modified:2021-03-24

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