Association between Exercise-Induced Hypertension and Heart Rate Variability, Arterial Stiffness

Abstract

PURPOSE: Exercise-induced hypertension (EIH) affects future cardiovascular disease (CAD) events. We evaluated the association between EIH and heart rate variability (HRV), which reflects autonomic nervous system activity and arterial stiffness. METHODS: The study participants were 202 adults aged 30–60 years (151 men and 51 women) who visited the National Fitness Center in South Korea, a health examination institution, from October 2023 to June 2024. During exercise testing, participants were classified into the EIH group (n=49) and the normal group (n=153) based on a systolic blood pressure (SBP) of ≥210 and ≥190 mmHg for men and women, respectively. HRV was analyzed for total power (TP), low-frequency (LF), and high-frequency (HF). Arterial stiffness was evaluated using brachial-ankle pulse wave velocity (ba-PWV). In this study, arteriosclerosis was defined as a ba-PWV≥1,400 m/s. RESULTS: There were no significant differences in HRV indicators (TP, LF, HF, and LF/HF) between the groups; however, the EIH group showed a significantly higher ba-PWV than the normal group (p<.001). There was no significant difference in the correlation between peak SBP and HRV indicators. However, there was a significant correlation between the peak SBP and ba-PWV (R=0.152, p<.05). The relative risk of atherosclerosis, which was adjusted for confounding factors, was 3.13 times higher in the EIH group than in the normal group (95% confidence interval [CI], 1.52–6.65, p<.01). CONCLUSIONS: EIH, which reflects CAD prognosis, is related to ba-PWV, an index of arterial stiffness.