Blood Pressure Responses to Exercise in Females: Impact of race

Purpose: A primary risk factor for cardiovascular disease (CVD) is hypertension, which impacts ~50% of individuals in the United States >18 years of age. Although resting blood pressure (BP) measures are informative, an exaggerated BP response to exercise, termed exercise-induced hypertension, has emerged as a strong predictor of future hypertension and subsequent CVD risk. In the United States, race/ethnicity-related health disparities persist. For example, Black females (BF) have an ~20% higher prevalence of hypertension and CVD relative to White females (WF). However, whether there are differences in the BP response during exercise between these populations remains unclear. Accordingly, in this preliminary study, we tested the hypothesis that BF have an exaggerated BP response during exercise relative to WF. Methods: 14 females (7 Black and 7 White, age 18-27 yrs, BMI 21.3-30.1 kg/m2), free from CVD or other health conditions, participated. All participants underwent a staged maximal exercise test on a cycle ergometer. Each stage was 2 min in duration and were based on individualized predicted maximal oxygen consumption (VO2peak). BP (Tango stress monitor), heart rate (3 lead EKG), and VO2 (Parvo metabolic cart) were collected during the final minute of each stage of the exercise protocol. The BP increase during exercise was evaluated as change in mean arterial pressure (delta MAP) and change in systolic BP (delta SBP) from rest to peak exertion. The SBP response for any given increase in workload was further analyzed as the slope of the relationship between SBP and metabolic equivalents (MET; SBP/MET). Results: Blood pressure responses during exercise were not different between groups; delta MAP (BF: 10 +/- 3 mmHg and WF: 20 +/- 3 mmHg; p=0.06) delta SBP (BF: 42 +/- 7 and WF: 48 +/- 6; p=0.49). Likewise, the SBP/MET slope (BF: 7.8 +/- 5.9 mmHg/MET and WF: 6.5 +/- 1.8 mmHg/MET; p=0.66) and exercise capacity as identified by VO2peak were not different between groups (BF: 2 +/- 0.1 L/min and WF: 2.2 +/- 0.2 L/min; p=0.46). Conclusions: These preliminary data suggest that the BP response during peak exercise is similar between relatively young and healthy Black and White females. Further investigation with more participants is warranted.