Post-exercise Differential Response Of Central And Brachial Blood Pressure In Patients With Coronary Artery Disease

Brachial post-exercise hypotension is consistently observed in hypertensive and normotensive individuals but may be absent in patients with coronary artery disease (CAD). This attenuated response may be influenced by inter-individual variability and warrants exploration of exercise's distinct impact on central and brachial blood pressure (BP). Central BP, reflecting vital organ strain, holds promise for sensitively detecting post-exercise changes and abnormalities. PURPOSE: To determine central and brachial BP overall and individual responses 5, 15 and 30-min after combined exercise of different intensities in participants with and without CAD METHODS: Seventeen participants with stable CAD and eighteen aged-matched controls (52-81 years) completed an acute bout of high and moderate-intensity combined aerobic and resistance exercise. Brachial (bSBP) and central systolic (cSBP) pressure were assessed via oscillometry and carotid tonometry, respectively. Group mean changes were examined with linear mixed models and post-exercise BP individual responsiveness quantified via the region of practical equivalence (ROPE) and highest density interval (HDI), a Bayesian method. Those with HDIs exceeding the ROPE (-3.20 to 3.20 mmHg) were considered post-exercise responders RESULTS: Regardless of exercise intensity, cSBP was persistently increased during recovery in participants with CAD (difference 30-baseline (d30-bas) = 10, 95% CI: 4 to 17 mmHg, p = 0.001) but was reduced in controls (d30-bas = -13, 95% CI: -19 to -7 mmHg, p = 0.003). bSBP was unchanged (CAD: d30-bas = -1, 95% CI: -6 to 4 mmHg, p = 0.956; controls: d30-bas = -4, 95% CI: -9 to 2 mmHg, p = 0.326). Individual response analyses confirmed overall trends. CONCLUSIONS: Post-exercise cSBP differed from bSBP, independent of exercise intensity. Furthermore, patients with CAD exhibited post-exercise central hypertension, an altered BP response consistent with higher risk. Central BP provides different information than brachial BP following exercise, which may impact risk assessment.