ASSOCIATION BETWEEN HYPERTENSIVE RESPONSE TO EXERCISE AND CAROTID ARTERY HEMODYNAMICS IN PATIENTS WITHOUT CAROTID PLAQUES

Objective: Hypertensive response (HTR) to exercise has been reported to be associated with cardiovascular outcomes. The presence of carotid artery disease is also a significant factor indicating a higher likelihood of accompanying cardiovascular disease. In this study, we analyzed the parameters of carotid Doppler in patients exhibiting a hypertensive response. Design and method: A total of 422 participants without a history of coronary artery disease, who underwent carotid Doppler ultrasound and supine bicycle exercise echocardiography, were enrolled in this study. Among them, 149 had carotid plaques, and we analyzed the remaining 273 participants without carotid plaques. HTR was defined as peak systolic blood pressure >=210 mmHg for men and >=190 mmHg for women during exercise. Parameters of interest included peak systolic (PSV) and end-diastolic velocities (EDV), resistive indices (RI) of the carotid arteries, and plaque measurements. Results: The mean age of the study population was 64±9 years. Among 273 participants, 34.9% were women, 79.2% had a history of hypertension, and 27.5% had diabetes. HTR was observed in 21.5% (32/273) of patients. In the HTR (+) group, the right external carotid artery (ECA) PSV (83.96 ± 28.39 vs. 75.67 ± 27.70 cm/s, p = 0.032) and EDV (15.45 ± 7.60 vs. 13.64 ± 5.73 cm/s, p = 0.037) were significantly higher compared to the HTR (-) group. In the HTR (+) group, total arterial compliance was reduced, while effective arterial elastance and end-diastolic elastance were significantly higher compared to the HTR (-) group. Total arterial compliance was negatively correlated with right CCA RI (r=-0.169, p=0.005), right ICA RI (r=-0.135, p=0.026), left ECA RI (r=-0.154, p=0.011), left VA RI (r=-0.206, p=0.012), right ECA PSV (r=-0.021, p=0.046), right ECA RI (r=-0.225, p<0.001), left ICA PSV (r=-0.125, p=0.039), left ECA PSV (r=-0.149, p=0.014), left VA PSV (r=-0.210, p=0.011). Conclusions: We observed differences in hemodynamic indices of the carotid artery between patients with and without a hypertensive response in the absence of plaques. Furthermore, total arterial compliance, an indicator of arterial stiffness, was found to correlate with the velocity and resistance index of the carotid artery.