Correlation of exercise hypertension with arteriosclerosis and early renal damage in patients with essential hypertension

  AIM   To investigate the relationship between exercise hypertension and arteriosclerosis and early renal damage in patients with essential hypertension.

  METHODS   A total of 105 patients with essential hypertension were enrolled in the study. According to Bruce’s protocol, the submaximal running table exercise load test was performed and according to their systolic blood pressure (SBP) at submaximal exercise, the patients were divided into exercise hypertension group (SBP during subextreme exercise≥200 mmHg, H group) and the normalexercise blood pressure group (SBP during subextreme exercise<200 mmHg, N group). Blood lipids, kidney function, fasting blood glucose, high-sensitivity C-reactive protein (hs-CRP), brachial-ankle pulse wave velocity (baPWV), intima-media thickness (IMT), urinary albumin-creatinin ration (UACR), baPWV and UACR were detected in all the patients, which served as indicators of arteriosclerosis and early renal damage.

  RESULTS  Compared with group n, BMI (P<0.01), family history of hypertension (P<0.05), smoking history (P<0.05), LDL-C (P<0.01), hs CRP (P<0.05), baPWV (P<0.01), IMT (P<0.05) and UACR (P<0.05) in group H were significantly increased; Compared with group n, resting SBP in group H increased (P<0.05), SBP during submaximal exercise, PP during submaximal exercise, SBP 6 min after exercise and PP 6 min after exercise increased (all P<0.01); The results of binary logistic regression showed that there was a significant positive correlation between resting SBP (P<0.05), smoking history (P<0.05), BMI (P<0.01), hs CRP (P<0.05) and baPWV (P<0.01), and it was an independent risk factor affecting the occurrence of exercise-induced hypertension. SBP was positively correlated with LDL-C (r=0.343, P<0.01), hs CRP (r=0.285, P<0.01), BMI (r=0.294, P<0.01) and baPWV (r=0.371, P<0.01).

  CONCLUSION  Among patients with essential hypertension, patients with exercise hypertension have more significant arteriosclerosis and early renal damage than patients with normal exercise hypertension. Exercise hypertension should be found as soon as possible and actively intervened.