Association between elevated ambulatory blood pressure and hypertensive response to exercise in patients with non-obstructive coronary artery disease

Abstract:

Objective Hypertensive response to exercise（HRE） is associated with adverse cardiovascular events，and early identification and proper intervention of HRE is of great importance for the prevention of cardiovascular events. This study aims to investigate the potential association between elevated ambulatory blood pressure（BP） and HRE in patients with non-obstructive coronary artery disease（NOCAD）.Methods A total of 517 patients with suspected coronary heart disease were enrolled in this study，and coronary angiography was performed to observe the degree of coronary artery stenosis. Cardiopulmonary exercise testing（CPET） was performed for the patients with NOCAD，and HRE was diagnosed based on BP records during CPET. The logistic regression model was used to analyze the association between elevated ambulatory BP and HRE.Results Finally，a total of 347 patients with NOCAD were included in the statistical analysis，with a mean age of （61.15±9.14） years，and male patients accounted for 42.4%. Among these patients，51.30% had hypertension and 13.8% suffered from diabetes. The logistic regression analysis showed that elevated ambulatory BP［odds ratio（OR）=2.163，95%CI=1.094-4.275，P=0.026］ was a risk factor for HRE. The subgroup analysis based on sex showed that in the female patients with NOCAD，elevated ambulatory BP（OR=3.310，95%CI=1.387-7.902，P=0.007） was a risk factor for HRE，while in the male patients with NOCAD，elevated ambulatory BP was not found to be associated with HRE （OR=1.154，95%CI=0.370-3.603，P=0.805）.Conclusion Elevated ambulatory BP is associated with HRE in patients with NOCAD，especially in female patients with NOCAD. This finding may help with the early diagnosis of HRE and guide such patients to take proper aerobic exercise during cardiac rehabilitation.