Effects of physical activity and aerobic exercise capacity on aortic stiffness in patients with untreated hypertension

Background and Objectives: High aerobic exercise capacity and sport-related physical activity are reported to be inversely associated with arterial stiffness in healthy young adults. However, it is unknown whether increased physical activity and/or high aerobic exercise capacity attenuate arterial stiffness in patients with untreated hypertension. Subjects and Methods: We studied subjects with never-treated hypertension {n=84 (55 males); mean age ± SD, 49±7 years; age range, 36-65 years}. We excluded subjects with a history of diabetes, angina, myocardial infarction, major arrhythmia, or cerebrovascular diseases and those who were taking any cardiovascular medications, including lipid-lowering agents. Carotid intima-media thickness (IMT) and heart-femoral pulse wave velocity (hfPWV) were measured before exercise testing was performed. Physical activity was estimated using a modified Baecke questionnaire. Aerobic exercise capacity was measured with maximal cardiopulmonary exercise testing (maximum oxygen uptake, Vo₂max). Results: Linear regression analysis showed a significant inverse correlation between sport-index and hfPWV (r=-0.404; p<0.001), which multiple linear regression analysis showed to be independent of the individual variables of age, gender, body mass index, mean arterial pressure, total cholesterol, fasting blood glucose, and heart rate (beta=-0.277; p=0.004). However, the work- and leisure-indices and Vo₂max were not associated with hfPWV (p> 0.05). Carotid IMT was not associated with physical activity indices or Vo₂max. Conclusion: In patients with untreated hypertension, increased sport activity was associated with lower aortic stiffness, but high aerobic exercise capacity was not. These results suggest that regular daily exercise, but not exercise capacity, is an important determinant of aortic stiffness in patients with untreated hypertension.