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Pulse Pressure During Exercise Diagnoses Heart Disease

By HospiMedica staff writers
Posted on 26 Sep 2001
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A study has demonstrated that high pulse pressure—the difference between systolic blood pressure and diastolic pressure—during exercise is associated with a dysfunction of the endothelial cells lining the blood vessels and is a more accurate marker of heart disease than pulse pressure at rest. Conducted by researchers at The Johns Hopkins University School of Medicine, the study was presented at the annual meeting of the American Association of Cardiovascular and Pulmonary Rehabilitation in Minneapolis, MN (USA).

The researchers evaluated 35 adults, aged 55-75, who had untreated mild hypertension but were otherwise healthy. Pulse pressure was measured during four or five visits at least one week apart, and those measurements were compared to measurements of pulse pressure during maximal-effort treadmill tests. The researchers also used ultrasound to measure how well the vessels in the subjects' arms would expand in response to stress. .

Endothelial cells control the ability of the blood vessels to dilate, which allows more blood to flow during periods of stress. Increased pulse pressure is also an indicator of blood-vessel stiffening, which can be a marker of early heart disease. Recent studies have shown that high pulse pressure is the leading risk factor for cardiovascular disease in the elderly.

"The higher the pulse pressure in response to exercise, the more likely the patient was to have blood vessels that did not expand,” said Kerry J. Stewart, Ed. D., lead author of the study and director of cardiac rehabilitation and clinical exercise physiology at Hopkins.




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