The exercise presser reflex and changes in radial arterial pressure and heart rate during walking in patients with arteriosclerosis obliterans

Little is known about the time course and extent of the changes in radial a rterial pressure and heart rate taking place in patients with arteriosclero sis obliterans during walking, as well their subtending mechanisms. For thi s reason the authors measured these variables in 23 patients with arteriosc lerosis obliterans and in nine normal subjects (control group), during trea dmill walking and several tests. In the patients a rapid and marked increas e in radial arterial pressure was recorded during walking, whereas the same parameter either fell abruptly or persisted at elevated levels during reco very. This pattern markedly differed from that recorded in normal subjects, and it was mainly brought about by the activation of the exercise presser reflex. The following findings suggested that the exercise presser reflex w as activated: the conditions required for activation of the reflex were pre sent in our patients; the pressure changes observed during walking tightly paralleled the changes due to this reflex activation; the hypertensive resp onse to walking was enhanced by increases in severity of disease and in wal king speed and duration; the reflex activity persisted during recovery; and the pressure pattern during walking was reproduced by walking with arreste d blood circulation to a lower limb. On the contrary, the behavior of heart rate was similar in patients and normal subjects both during walking and r ecovery because it was not influenced by the exercise presser reflex.