Diastolic blood pressure changes during exercise positively correlate withserum cholesterol and insulin resistance

Background-Metabolic factors. including plasma concentrations of cholestero l and insulin resistance, may influence blood pressure through effects on v ascular reactivity. Such effects might influence blood pressure during exer cise more strongly than at rest. Methods and Results-We examined whether there is an association between ser um cholesterol or insulin resistance and change in blood pressure during mi ld exercise. Blood pressure was measured at rest and during fixed low-workl oad bicycle ergometry (50, 75, and 100 W, each for 3 minutes) in 75 healthy active men (age, 18 to 66 years). Blood pressure at rest was not significa ntly correlated with serum cholesterol or insulin resistance (estimated fro m the fasting glucose-insulin product). The change from resting values in d iastolic but not systolic blood pressure during exercise was correlated wit h serum cholesterol (R>0.47, P<0.0001 for each workload) and insulin resist ance (R>0.38, P<0.01 for each workload). Serum cholesterol and insulin resi stance were the only independent predictors of the change in diastolic bloo d pressure during exercise in a stepwise regression model incorporating age , body mass index, serum cholesterol, triglycerides, HDL cholesterol, insul in resistance, and heart rate during exercise. In a further study, the chan ge in diastolic blood pressure during exercise was greater in men with unco mplicated type 2 diabetes (13.6 mm Hg [95% CI, 8.5 to 18.8]; n=10) than in nondiabetic control men (2.7 mm Hg [95% CI, -2.0 to 7.3]; n=10; P=0.002). Conclusions-Changes in diastolic blood pressure during gentle exercise are strongly associated with serum concentrations of total cholesterol and insu lin resistance. This may contribute to development of hypertensive complica tions in dyslipidemic and/or insulin-resistant patients.