Exaggerated blood pressure response to exercise in athletes: dysmetabolism or altered autonomic nervous system modulation?

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Background: The importance of exercise-induced exaggerated blood pressure (BP) response in endurance athletes is not known.Objective: To assess the hemodynamic parameters and metabolic profile in athletes with an exaggerated BP response to exercise.Methods: Forty-four endurance athletes underwent a maximal exercise test, a 24-h ambulatory blood pressure monitoring, a 24-h Holter assessment, and sampling of blood on two occasions: (a) during intense training and (b) following 3 weeks without training.Results: During the training period, 11 athletes showed an exaggerated BP response to exercise, whereas seven of these 11 athletes also showed an exaggerated BP response during the resting period. Elevation in systolic BP was greater in athletes with an exaggerated BP response than athletes with a normal BP response to exercise (resting: 84 ± 22 vs. 60 ± 18 mmHg, P = 0.02; training: 100 ± 21 vs. 70 ± 18 mmHg, P = 0.004). During the training period, athletes with an exaggerated BP response to exercise showed higher systolic BP values on 24-h ambulatory blood pressure monitoring (136 ± 15 vs. 118 ± 8 mmHg, P = 0.02). During the resting period, athletes with an exaggerated BP response to exercise had lower apolipoprotein-A1 (1.3 ± 0.1 vs. 1.5 ± 0.2 g/l, P = 0.009), and higher SDNN (259 ± 47 vs. 209 ± 52 ms, P = 0.03) and pNN50 (0.4 ± 0.1 vs. 0.3 ± 0.1%, P = 0.05).Conclusion: These observations may represent the first sign of a slight metabolic disturbance associated with vascular wall abnormalities, although the parameters remain within normal values.Trial registration: ClinicalTrials.gov NCT00686491.

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