Brachial BP-waveform-derived PWV independently predicts exercise blood pressure response; ambulatory 24-h PWV shows stronger associations with exercise BP behaviour than single-time-point office PWV, and fitness-corrected SBP outperforms conventional uncorrected measures.
Exercise SBP indexed to peak VO2 (fitness-corrected) was much more strongly associated with PWV than uncorrected exercise SBP.
Fitness-corrected submaximal and peak exercise SBP increased stepwise across 24-h PWV tertiles, and this gradient was attenuated without fitness correction.
24-h ambulatory PWV remained an independent predictor of fitness-corrected exercise BP response after multivariable adjustment, whereas office PWV did not.
Brachial BP-waveform-derived PWV independently predicts exercise blood pressure response, and 24-h PWV is more strongly associated with exercise BP behaviour than single-time-point office PWV.
The study enrolled adults with controlled BP irrespective of hypertension diagnosis, excluding those with coronary artery disease, valvular disease, or heart failure.
This study looked at how stiff the arteries are, as estimated from a blood pressure cuff that records pulse waveforms, and how that relates to how much blood pressure rises during exercise. It included 228 adults around age 53 whose blood pressure was well controlled, some with and some without a hypertension diagnosis. They had office and 24-hour blood pressure monitoring with pulse wave analysis, an exercise test measuring fitness, and a heart ultrasound. The researchers found that exercise blood pressure made more sense when it was adjusted for a person's aerobic fitness. Adjusted for fitness, exercise blood pressure was strongly linked to arterial stiffness (r = 0.64), while unadjusted values were only weakly linked (r = 0.15). Arterial stiffness averaged over 24 hours also predicted exercise blood pressure response independently of age, sex, blood pressure, body mass index, and heart structure and function. A single office measurement did not do so after adjustment. This research suggests that cuff-based 24-hour stiffness measurements may better capture the vascular load that shapes blood pressure during exercise than a one-time office reading, and that accounting for fitness may make exercise blood pressure easier to interpret. The study was observational and in a specific group of adults, so it shows association rather than proving cause.
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Upload Your LabsZachwyc J, Sharman J, Kosowski W, Przewlocka-Kosmala M, Kosmala W. (2026). Association of ambulatory waveform-derived pulse wave velocity with blood pressure response to exercise: role of fitness correction.. Journal of hypertension. https://doi.org/10.1097/HJH.0000000000004427