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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_4012_Библиотеки_им_академика_М_И_Перельмана
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Higher Arterial Stiffness Related to Blood Pressure Overresponse …
147
even though the investigated exercise was isometric. On the other hand,
Kawano et al. have reported that blood pressure elevations during 40–80%
1RM of dynamic leg press exercise were lower in middle-aged individuals
(41–58 years) than in young individuals (21–25 years) [15]. The discrepancy
between the results of Kawano et al. and those obtained in the present study
may be due to the different age groups studied. Resting muscle sympathetic
nervous activity is known to be higher in elderly individuals (65.0 years) than
in young ones (23.5 years), and this activity reserve decreases with age [16];
the lower blood pressure response observed by Kawano et al. in middle–aged
individuals [15] might thus be a result of age-related reductions in sympathetic
nerve activity reserve. However, the steep increase in pulse pressure observed
after late middle age suggests that age-related arterial stiffening accelerates
[17]. The relationship between arterial compliance and RPP during aerobic
exercise was stronger in individuals aged ≥70 years, with arterial stiffness
markedly more pronounced than that in individuals aged 60-70 years [4].
Thus, accelerated age-related stiffening of central arteries after late middle age
may be the cause of exaggerated SBP and RPP responses in both aerobic and
resistance exercise.
The major determinants of blood pressure are blood flow and arterial load.
Blood flow is influenced by exercise intensity and economy (i.e., oxygen cost
at standardized submaximal workloads). In the present study, we accounted for
relative exercise intensity by 1RM normalization. Moreover, Kemi et al. have
reported that there was no difference in blood flow between high and low
exercise economy groups during single-joint exercises such as the arm curl
[18]. Hence, the differences in SBP and RPP responses among the subjects are
likely the result of different arterial loads. According to the two-element
Windkessel model, arterial load is characterized by vascular resistance and
arterial compliance. Vascular resistance contributes more to arterial load at
rest than arterial compliance, but the contribution of arterial compliance
increases during exercise [1, 2]. Consequently, arterial load is increased via a
reduction in arterial compliance during exercise, even though vascular
resistance is reduced. These changes in arterial compliance and vascular
resistance result in maintaining ventricular-vascular coupling and increasing
blood flow to active muscles, respectively. Therefore, a transient reduction in
arterial compliance (i.e., an increase in arterial stiffness) during exercise would
be an essential adaptation for regulating the cardiovascular system. However,
in elderly individuals, marked stiffening of the arteries seems to lead to
excessive SBP and RPP responses to resistance exercise.
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Takeshi Otsuki and Takahiro Kotato
148
Table 7. Stepwise regression analysis to identify independent predictors of
rate-pressure product during arm curl exercise
Rate-pressure product during arm curl exercise
20% 1RM
40% 1RM
60% 1RM
n
45
45
44
R2
0.828
0.824
0.724
P
< 0.0001
< 0.0001
< 0.0001
Age (years)
RC
[ excluded ]
[ excluded ]
[ excluded ]
SE
β
P
Pulse wave velocity
(m/s)
RC
2.863
3.685
5.169
SE
0.910
1.037
1.880
β
0.267
0.315
0.351
P
0.003
0.001
0.009
Cardiovagal BRS
(ms/mmHg)
RC
[ excluded ]
[ excluded ]
[ excluded ]
SE
β
P
Rate-pressure product at
rest (bpm mmHg)
RC
1.052
0.985
0.775
SE
0.125
0.145
0.244
β
0.712
0.611
0.381
P
< 0.001
< 0.001
0.003
Body mass index
(kg/m2)
RC
[ excluded ]
203.2
289.3
SE
60.1
101.7
β
0.229
0.256
P
0.002
0.007
Sex (male = 0, female =
1)
RC
[ excluded ]
[ excluded ]
-2082
SE
724
β
-0.276
P
0.007
Excluded variables
Use of antihypertensive medication (no = 0, yes = 1)
1RM, one-repetition maximum; BRS, baroreceptor reflex sensitivity; RC, regression
coefficient.
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Higher Arterial Stiffness Related to Blood Pressure Overresponse …
149
Table 8. Stepwise regression analysis to identify independent predictors of
systolic blood pressure during leg press exercise
Systolic blood pressure during leg press exercise
20% 1RM
40% 1RM
60% 1RM
n
45
45
41
R
2
0.665
0.647
0.566
P
<0.0001
<0.0001
<0.0001
Age (years)
RC
[ excluded ]
0.930
[ excluded ]
SE
0.419
β
0.261
P
0.032
Pulse wave velocity
(m/s)
RC
0.041
0.042
[ excluded ]
SE
0.011
0.014
β
0.407
0.381
P
0.001
0.004
Cardiovagal BRS
(ms/mmHg)
RC
[ excluded ]
[ excluded ]
[ excluded ]
SE
β
P
Systolic blood
pressure at rest
(mmHg)
RC
0.677
0.454
0.688
SE
0.145
0.168
0.176
β
0.510
0.315
0.458
P
< 0.001
0.01
< 0.001
Sex (male = 0,
female = 1)
RC
[ excluded ]
[ excluded ]
-16.25
SE
7.07
β
-0.274
P
0.02
Use of
antihypertensive
medication (no = 0,
yes = 1)
RC
[ excluded ]
[ excluded ]
35.34
SE
9.60
β
0.411
P
0.001
Excluded variables
Body mass index (kg/m
2
).
1RM, one-repetition maximum; BRS, baroreceptor reflex sensitivity; RC, regression
coefficient.
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Takeshi Otsuki and Takahiro Kotato
150
Table 9. Stepwise regression analysis to identify independent predictors of
rate-pressure product during leg press exercise
Rate-pressure product during leg press
exercise
20% 1RM
40% 1RM
60% 1RM
n
45
45
41
R
2
0.644
0.510
0.470
P
< 0.0001
< 0.0001
< 0.0001
Age (years)
RC
[ excluded ]
[ excluded ]
[ excluded ]
SE
β
P
Pulse wave velocity
(m/s)
RC
10.25
13.77
12.99
SE
1.22
2.06
2.71
β
0.773
0.714
0.570
P
< 0.001
< 0.001
< 0.001
Cardiovagal BRS
(ms/mmHg)
RC
[ excluded ]
[ excluded ]
[ excluded ]
SE
β
P
Body mass index
(kg/m
2
)
RC
238.5
[ excluded ]
[ excluded ]
SE
92.4
β
0.238
P
0.01
Use of
antihypertensive
medication (no = 0,
yes = 1)
RC
[ excluded ]
[ excluded ]
5471
SE
2076
β
0.314
P
0.01
Excluded variables
Rate-pressure product at rest (bpm mmHg),
sex (male = 0, female = 1).
1RM, one-repetition maximum; BRS, baroreceptor reflex sensitivity; RC, regression
coefficient.
Cardiovagal BRS was correlated with SBP and RPP during resistance
exercise. Arterial stiffness may be related to blood pressure overresponse to
exercise not only directly, but also indirectly, by affecting the stretch-sensitive
baroreceptors embedded in the aortic and carotid arterial wall. However, the
stepwise regression analysis did not identify cardiovagal BRS as a predictor of
SBP and RPP during exercise. Further investigations are needed to clarify this
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Higher Arterial Stiffness Related to Blood Pressure Overresponse …
151
point. For example, measurement of cardiovagal BRS during exercise may be
of significance.
The present study demonstrated that SBP and RPP during resistance
exercise are higher in individuals with increased arterial stiffness. When
elderly individuals commence resistance training, it may be preferable to
employ certain strategies to attenuate the SBP and RPP responses. For
example, lifestyle modifications such as increasing daily physical activity and
improving dietary habits can reduce arterial stiffness. Gando et al. reported
that, in individuals aged >60 years, light physical activity (even <3.0 metabolic
equivalents) in daily living was associated with reduced arterial stiffness [19].
In our previous studies, we found that a Chlorella-derived dietary supplement,
which included multicomponent nutrients, decreased arterial stiffness [20, 21].
Apart from lifestyle modifications, we recommend that elderly individuals
perform warm-up exercises to induce transient vasorelaxation prior to
resistance exercise. Arterial stiffness is known to transiently decrease after
aerobic exercise [22, 23] and after static exercise with whole body vibration
[24], thus such warm-up exercises may be suitable for elderly individuals who
wish to engage in resistance training.
CONCLUSION
We demonstrated that SBP during resistance exercise is correlated with
age, independently of resting SBP. This greater elevation in SBP during
resistance exercise in elderly individuals may be associated with age-related
increase in arterial stiffness.
ACKNOWLEDGMENT
This work was supported by JSPS KAKENHI Grant Number 23650437
and the Uehara Memorial Foundation. We thank Ryugasaki City for
supporting our study based on partnership agreement between Ryugasaki City
and Ryutsu Keizai University (Ryu Ryu Renkei).
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Takeshi Otsuki and Takahiro Kotato
152
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Higher Arterial Stiffness Related to Blood Pressure Overresponse …
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(2015) Association between plasma sLOX-1 concentration and arterial
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Takeshi Otsuki and Takahiro Kotato
154
[21] Otsuki T., Shimizu K., Iemitsu M., Kono I. (2013) Multicomponent
supplement containing Chlorella decreases arterial stiffness in healthy
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BIOGRAPHICAL SKETCH
Name:
Takeshi Otsuki, Ph. D.
Affiliation:
Faculty of Sport and Health Sciences, Ryutsu Keizai University
Education:
Ph. D (Health and Sport Science)
Doctoral Program in Health and Sport Sciences, University of Tsukuba,
March 2004
Research and Professional Experience:
April 2014—present
Professor, Faculty of Sport and Health Sciences, Ryutsu Keizai University
April 2010—March 2014
Associate professor, Faculty of Sport and Health Sciences, Ryutsu Keizai
University
April 2008—March 2010
Full-time lecturer, Faculty of Health and Welfare Human Services, St.
Catherine University
July 2007—March 2008
Full-time lecturer, Faculty of Social Welfare, St. Catherine University
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Higher Arterial Stiffness Related to Blood Pressure Overresponse …
155
August 2006—June 2007
Postdoctoral fellow, Kyoto Prefectural University of Medicine
April 2004—July 2006
Postdoctoral fellow, Center for Tsukuba Advanced Research Alliance,
University of Tsukuba
Honors:
Travel grant award (2013), the 13th International Conference on
Endothelin
Poster presentation first prize (2005), the 8th Asian Federation of
Sports Medicine Congress
Publications Last 3 Years:
Otsuki T. and Ishii N. (in press) Association between blood pressure
changes during self-paced outdoor walking and air temperature. Clin. Physiol.
Funct. Imaging, DOI: 10.1111/cpf.12280.
Otsuki T., Maeda S., Mukai J., et. al. (2015) Association between plasma
sLOX-1 concentration and arterial stiffness in middle-aged and older
individuals. J. Clin. Biochem. Nutr., 57: 151-5.
Otsuki T., Shimizu K., Maeda S. (2015) Changes in arterial stiffness and
nitric oxide production with Chlorella-derived multicomponent
supplementation in middle-aged and older individuals. J. Clin. Biochem. Nutr.,
57: 228-32.
Otsuki T. and Ohashi C. (2014) Participation in physical activity and
arterial stiffness in males with autism spectrum disorder. Artery Res., 8: 110-
114.
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