Heart Rate from Progressive Volitional Cycling Test Is Associated with Endothelial Dysfunction Outcomes in Hypertensive Chilean Adults

Cristian Alvarez; Marcelo Tuesta; Álvaro Reyes; Francisco Guede-Rojas; Luis Peñailillo; Igor Cigarroa; Jaime Vásquez-Gómez; Johnattan Cano-Montoya; Cristóbal Durán-Marín; Oscar Rojas-Paz; Héctor Márquez; Mikel Izquierdo; Pedro Delgado-Floody

doi:10.3390/ijerph20054236

Heart Rate from Progressive Volitional Cycling Test Is Associated with Endothelial Dysfunction Outcomes in Hypertensive Chilean Adults

Int J Environ Res Public Health. 2023 Feb 27;20(5):4236. doi: 10.3390/ijerph20054236.

Authors

Affiliations

¹ Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile.
² Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Los Ángeles 4440000, Chile.
³ Centro de Investigación de Estudios Avanzados del Maule (CIEAM), Universidad Católica del Maule, Talca 3460000, Chile.
⁴ Laboratorio de Rendimiento Humano, Universidad Católica del Maule, Talca 3460000, Chile.
⁵ Escuela de Kinesiología, Facultad de Odontología y Ciencias de La Rehabilitación, Universidad San Sebastián, Valdivia 8420524, Chile.
⁶ Physical Therapy, Faculty of Rehabilitation Sciences Carrera de Kinesiología, Universidad Andres Bello, Concepción 4260000, Chile.
⁷ Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, 31006 Pamplona, Spain.
⁸ CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28220 Madrid, Spain.
⁹ Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Temuco 4811230, Chile.

Abstract

Background: A progressive volitional cycling test is useful in determining exercise prescription in populations with cardiovascular and metabolic diseases. However, little is known about the association between heart rate during this test and endothelial dysfunction (EDys) parameters in hypertensive (HTN) patients.

Objective: To investigate the association between EDys markers (flow-mediated dilation [FMD], pulse wave velocity of the brachial artery [PWVba], and carotid-intima media thickness [cIMT]) and heart rate during a cycling test in HTN adults. A secondary aim was to characterize cardiovascular, anthropometric, and body composition outcomes in this population.

Methods: This was a descriptive clinical study in which adults (men and women) were assigned to one of three groups: HTN, elevated blood pressure (Ele), or a normotensive control group (CG), and completed a progressive cycling test. The primary outcomes were FMD, PWVba, cIMT, and heart rate (HR) at 25-50 watts (HR_25-50), 50-100 watts (HR_50-100), and 75-150 watts (HR_75-150) of the Astrand test. Secondary outcomes included body mass index (BMI), waist circumference, body fat percentage (BF%), skeletal muscle mass (SMM), resting metabolic rate (RMR), and estimated body age, as measured by a bio-impedance digital scale.

Results: Analyses of the associations between FMD, PWV, and HR_25-50, HR_50-100, and HR_75-150 watts revealed no significant association in the HTN, Ele, and CG groups. However, a significant association was found between cIMT and HR_75-150 watts in the HTN group (R² 47.1, β -0.650, p = 0.038). There was also a significant trend (p = 0.047) towards increasing PWVba in the CG, Ele, and HTN groups.

Conclusion: Heart rate during a progressive cycling test is associated with the EDys parameters cIMT in HTN patients, with particularly strong predictive capacity for vascular parameters in the second and third stages of the Astrand exercise test compared to normotensive control.

Keywords: arterial hypertension; carotid-intima media thickness; endothelial dysfunction; exercise test; flow-mediated dilation; pulse wave velocity; vasculature.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Carotid Intima-Media Thickness*
Chile
Dilatation, Pathologic
Female
Heart Rate
Humans
Hypertension*
Male
Pulse Wave Analysis

Grants and funding

This research was funded by Direccion General de Investigación, Vicerrectoria de Investigación y Doctorado, Concurso de Ciencias Biomédicas y Clínicas, Universidad Andres Bello 2022 Código N° DI-01-CBC/22.