Delayed blood pressure recovery ratio might indicate increased arterial stiffness in hypertensive patients with reduced aerobic exercise capacity

Background: Cardiopulmonary fitness is associated with reduced cardiovascular risk. Abnormal systolic blood pressure (SBP) response during recovery has been found to have diagnostic role for detecting cardiovascular risk. Aim of the study was to determine whether increased arterial stiffness associates with reduced aerobic exercise capacity after maximal cardiopulmonary exercise test (CPET) in a cohort of recently diagnosed hypertensive patients with a delayed decline in SBP during recovery. Methods: Eighty-four hypertensive patients with recently diagnosed I-II essential hypertension and under treatment with RAAS antagonists +/- HCTZ, underwent pulse wave velocity (PWV) estimation and a maximal CPET. Fifty-four healthy normotensive subjects served as a control group. Blood pressure recovery ratio (BPRR) was defined as the SBP after 3 min recovery divided by SBP at peak exercise. Results: PWV was significantly increased in hypertensives vs normotensives (p < 0.001). A non-independent, reverse association between PWV and VO2PEAK was revealed in hypertensives with delayed BPRR (r = -0.49, p < 0.05). Age and sex independently predicted VO2PEAK in hypertensives with delayed BPRR. Conclusions: Delayed blood pressure response detected during recovery in treated hypertensives implies a reverse relationship between any given impaired aerobic exercise capacity and expected persistent peripheral vascular resistance during exercise.