Blood Pressure Response and Pulse Arrival Time During Exercise Testing in Well-Trained Individuals

Sondre Heimark; Ingrid Eitzen; Isabella Vianello; Kasper G Bøtker-Rasmussen; Asgeir Mamen; Ole Marius Hoel Rindal; Bård Waldum-Grevbo; Øyvind Sandbakk; Trine M Seeberg

doi:10.3389/fphys.2022.863855

Blood Pressure Response and Pulse Arrival Time During Exercise Testing in Well-Trained Individuals

Front Physiol. 2022 Jul 11:13:863855. doi: 10.3389/fphys.2022.863855. eCollection 2022.

Authors

Affiliations

¹ Department of Nephrology, Oslo University Hospital, Oslo, Norway.
² Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
³ Department of Smart Sensors and Microsystems, SINTEF Digital, Oslo, Norway.
⁴ Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
⁵ Kristiania University College, School of Health Sciences, Oslo, Norway.
⁶ Centre for Elite Sports Research, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.

Abstract

Introduction: There is a lack of data describing the blood pressure response (BPR) in well-trained individuals. In addition, continuous bio-signal measurements are increasingly investigated to overcome the limitations of intermittent cuff-based BP measurements during exercise testing. Thus, the present study aimed to assess the BPR in well-trained individuals during a cycle ergometer test with a particular focus on the systolic BP (SBP) and to investigate pulse arrival time (PAT) as a continuous surrogate for SBP during exercise testing. Materials and Methods: Eighteen well-trained male cyclists were included (32.4 ± 9.4 years; maximal oxygen uptake 63 ± 10 ml/min/kg) and performed a stepwise lactate threshold test with 5-minute stages, followed by a continuous test to voluntary exhaustion with 1-min increments when cycling on an ergometer. BP was measured with a standard automated exercise BP cuff. PAT was measured continuously with a non-invasive physiological measurements device (IsenseU) and metabolic consumption was measured continuously during both tests. Results: At lactate threshold (281 ± 56 W) and maximal intensity test (403 ± 61 W), SBP increased from resting values of 136 ± 9 mmHg to maximal values of 219 ± 21 mmHg and 231 ± 18 mmHg, respectively. Linear within-participant regression lines between PAT and SBP showed a mean r ² of 0.81 ± 17. Conclusion: In the present study focusing on the BPR in well-trained individuals, we observed a more exaggerated systolic BPR than in comparable recent studies. Future research should follow up on these findings to clarify the clinical implications of the high BPR in well-trained individuals. In addition, PAT showed strong intra-individual associations, indicating potential use as a surrogate SBP measurement during exercise testing.

Keywords: blood pressure response; continuous cuff-less measurement method; diastolic blood pressure (DBP); endurance athletes; pulse arrival time (PAT); systolic blood pressure (SBP).