Submaximal exercise blood pressure and cardiovascular structure in adolescence

Martin G. Schultz*, Chloe Park, Abigail Fraser, Laura D. Howe, Siana Jones, Alicja Rapala, George Davey Smith, James E. Sharman, Deborah A. Lawlor, Nish Chaturvedi, John Deanfield, Alun D. Hughes

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

2 Citations (Scopus)
227 Downloads (Pure)


Purpose: Dynamic exercise results in increased systolic blood pressure (BP). Irrespective of resting BP, some individuals may experience exaggerated rise in systolic BP with exercise, which in adulthood is associated with risk of hypertension, and cardiovascular (CV) disease. It is unknown if exercise BP is associated with markers of CV structure during adolescence. We examined this question in a large adolescent cohort taking account of the possible confounding effect of body composition and BP status. Methods: 4036 adolescents (mean age 17.8 ± 0.4 years, 45% male), part of a UK population-based birth cohort study completed a sub-maximal step-test with BP immediately post-exercise. Sub-samples underwent comprehensive echocardiography for assessment of cardiac structure; arterial structure including aortic pulse wave velocity (PWV) and carotid intima-media thickness; and assessment of body composition by dual-energy X-ray absorptiometry (DXA). Results: Each 5 mm Hg higher post-exercise systolic BP was associated with CV structure, including 0.38 g/m2.7 (95% CI: 0.29, 0.47) greater left-ventricular mass index (LVMI), and 0.04 m/s (95% CI: 0.03, 0.04) greater aortic PWV. Adjustment for age, total body fat, lean mass and BP status attenuated, but did not abolish associations with LVMI (0.14 g/m2.7 per 5 mm Hg of post-exercise systolic BP; 95% CI 0.21, 0.39) or aortic PWV (0.03 m/s per 5 mm Hg of post-exercise systolic BP; 95% CI: 0.02, 0.04). Conclusion: Submaximal exercise systolic BP is associated with markers of CV structure in adolescents. Given the clinical relevance of exercise BP in adulthood, such associations may have implications for CV disease screening in young people and risk in later life.

Original languageEnglish
Pages (from-to)152-157
Number of pages6
JournalInternational Journal of Cardiology
Early online date19 Oct 2018
Publication statusPublished - 15 Jan 2019


  • Adolescent
  • Body composition
  • Echocardiography
  • Exercise
  • Hypertension

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