Targeting Hypertensive Response to Exercise and the Association of Masked Hypertension With Subclinical Organ Damage: A Mini-Review and Meta-Analysis

Author:

Cuspidi Cesare1ORCID,Gherbesi Elisa2,Faggiano Andrea32ORCID,Sala Carla3,Grassi Guido1,Carugo Stefano32,Tadic Marijana4

Affiliation:

1. Department of Medicine and Surgery, University of Milano-Bicocca , Milano , Italy

2. Department of Cardio-Thoraco-Vascular Diseases, Foundation IRCCS Ca’ Granda Ospedale Maggior Policlinico of Milano , Milano , Italy

3. Department of Clinical Sciences and Community Health, University of Milano , Milano , Italy

4. Department of Cardiology, University Hospital “Dr. DragisaMisovic-Dedinje” , Heroja Milana Tepica 1,11000 Belgrade , Serbia

Abstract

Abstract BACKGROUND Emerging evidence suggests that a hypertensive response to exercise (HRE) during dynamic or isometric stress tests assessing cardiac function is predictive of hypertension and cardiovascular events such coronary artery disease, heart failure and stroke. Whether HRE represents a marker of masked hypertension (MH) in individuals with no prior history of hypertension is still unclear. This is also the case for the association between MH and hypertension-mediated organ damage (HMOD) in the HRE setting. METHODS We addressed this issue through a review and a meta-analysis of studies providing data on this topic in normotensive individuals undergone both to dynamic or static exercise and to 24-h blood pressure monitoring (ABPM). A systematic search was performed using Pub-Med, OVID, EMBASE and Cochrane library databases from inception up to February 28th 2023. RESULTS Six studies including a total of 1,155 untreated clinically normotensive individuals were considered for the review. Data provided by the selected studies can be summarized as follows: (i) HRE is a BP phenotype linked to a high prevalence of MH (27.3% in the pooled population); (ii) MH is, in turn, associated with a greater, consistent likelihood of echocardiographic left ventricular hypertrophy (OR: 4.93, CI: 2.16–12.2, P < 0.0001) and vascular organ damage, as assessed by pulse wave velocity, (SMD: 0.34 ± 0.11, CI: 0.12–0.56, P = 0002). CONCLUSIONS On the basis of this, albeit limited, evidence, the diagnostic work-up in individuals with HRE should primarily be addressed to look for MH as well as for markers of HMOD, a highly prevalent alteration in MH.

Publisher

Oxford University Press (OUP)

Subject

Internal Medicine

Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Resting Blood Pressure is an Essential Determinant of Blood Pressure Response to Exercise;International Journal of Applied & Basic Medical Research;2024-07

2. Prevention and treatment of hypertensive left ventricular hypertrophy;Current Opinion in Cardiology;2024-03-05

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