Ambulatory blood pressure and Doppler echocardiographic indexes of borderline hypertensive men presenting an exaggerated blood pressure response during dynamic exercise

Borderline hypertension (BH) has been associated with an exaggerated blood pressure (BP) response during laboratory stressors. However, the incidence of target organ damage in this condition and its relation to BP hyperreacti vity is an unsettled issue. Thus, we assessed the Doppler echocardiographic profile of a group of BH men (N = 36) according to office BP measurements with exaggerated BP in the cycloergometric test. A group of normotensive me n (NT, N = 36) with a normal BP response during the cycloergometric test wa s used as control. To assess vascular function and reactivity, all subjects were submitted to the cold pressor test. Before Doppler echocardiography. the BP profile of all subjects was evaluated by 24-h ambulatory BP monitori ng. All subjects from the NT group presented normal monitored levels of BP. In contrast, 19 subjects from the original BH group presented normal monit ored BP levels and 17 presented elevated monitored BP levels. In the NT gro up all Doppler echocardiographic indexes were normal. All subjects from the original BH group presented normal left ventricular mass and geometrical p attern. However, in the subjects with elevated monitored BP levels, fractio nal shortening was greater, isovolumetric relaxation time longer, and early to late flow velocity ratio was reduced in relation to subjects from the o riginal BH group with normal monitored BP levels (P <0.05). These subjects also presented an exaggerated BP response during the cold pressor test. The se results support the notion of an integrated pattern of cardiac and vascu lar adaptation during the development of hypertension.