Blood Pressure And Vascular Function Response To Maximal Exercise In Young Adults With Masked Hypertension

Masked hypertension is a risk factor for cardiovascular diseases. One out of every three young adults (18-35 years) have masked hypertension. However, the underlying mechanisms remain unknown. PURPOSE: The purpose of this study is to compare vascular function at rest and in response to maximal exercise testing in young adults with masked hypertension and normal blood pressure. METHODS: Young men with normal office blood pressure (BP, <130/80 mmHg), free of smoking and clinical disease, were included in this study. Masked hypertension is defined as 24-hr average BP ≥125/75 mmHg, daytime BP ≥130/80 mmHg, or nighttime BP ≥110/65 mmHg. All subjects underwent a comprehensive vascular assessment including: 1) brachial and aortic BP; 2) arterial stiffness measured as carotid to femoral pulse wave velocity (PWV); 3) wave reflection measured as augmented pressure (AP), backward pressure (Pb), and reflection magnitude (RM); and 4) endothelial function measured as brachial artery flow-mediated dilation (FMD). All measurements were performed in the supine position after a 10-min rest and after a maximal graded exercise test on a cycle ergometer. RESULTS: Compared to normotensive controls (CON, n = 15), participants with masked hypertension (MHTN, n = 15) had a higher 24-hr, daytime, and nighttime ambulatory systolic and diastolic BP (P < 0.001 for all), with no difference in office BP, age, and body mass index (P ≥ 0.2 for all). No differences between CON and MHTN were found in supine BP, PWV, AP, Pb, RM, and FMD at rest and after the exercise tests (P ≥ 0.3 for all). In addition, no difference was found in peak BP (P ≥ 0.4). CONCLUSIONS: Our findings indicate that young adults with masked hypertension had similar supine BP and vascular function at rest and following maximal exercise testing as normotensive young adults. These findings suggest that in-laboratory measurements cannot differentiate between normal BP and masked hypertension in young adults. These findings highlight the importance and implication of ambulatory BP monitoring in young adults to identify masked hypertension.