Hypertensive women with dyspnea exhibit an unfavorable central blood pressure response to exercise

Limited exercise tolerance and dyspnea in patients with uncomplicated hypertension may pose a diagnostic challenge, particularly when blood pressure is normal and assessment results do not support a diagnosis of heart failure. The purpose of this study was to assess the differences in central blood pressure (cBP) response to exercise between females with hypertension and good exercise tolerance (non-dyspneic females, nDFs; n = 27) and those with dyspnea on exertion (dyspneic females, DFs; n = 25). We also investigated the relations of cBP and its dynamics with peak oxygen consumption (peak VO2) and peak heart rate (peak HR) assessed by cardiopulmonary exercise test (CPET) and peak cardiac output (peak CO) assessed by impedance cardiography. Fifty-two females (mean age 54.5 +/- 8.2 years) underwent applanation tonometry during CPET to assess the augmentation index (AIx), cBP, and central pulse pressure (cPP) before exercise (REST), at minute 3-rd of exercise (Ex), and at minutes: 1-st (R1) and 4-th of post-exercise rest (R2). In comparison with nDFs, DFs showed significantly higher cPP_Ex, AIx_Ex, and AIx_R1. The two subgroups showed no differences in cPP or Alx values either before exercise or at R2. In comparison with nDFs, the DFs had a less pronounced change in AIx values during post-exercise rest. There were negative correlations between peak HR and: AIx_R1, AIx_R2, change in AIx (R1-R2), between peak VO2 and: AIx_R1, AIx_R1-R2; between peak CO and: AIx_R1, AIx_R2, AIx_R1-R2. DFs presented a different cBP response to exercise than nDFs. Assessing cBP via applanation tonometry may prove useful in identifying hemodynamic abnormalities associated with limited exercise tolerance.