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Factors mediating the effect of exercise on blood pressure in young elite athletes
Volume Number
110 3
INCREASED LEFT VENTRICULAR MASS PREDICTS FUTURE HIGH BP: THE MUSCATINE STUDY Larry T. Mahoney, M.D., F.A.A.P.*, Richard M. Schleken, M.D., F.A.A.P., Willlam R. Clarke, Ph.D., Ronald M. Lauer, M.D., F.A.A.P., University of Iowa, Iowa City, IA Increased left ventricular mass (LVM) is an important predictor of coronary heart disease in adults. To define the Dredictors of LVM and to explore whether initial‘ LVM predicts subsequent BP, echocardiograms in approximately 250 children, ages 5-16 years, whose systolic blood pressures were high, middle and low range, were studied. All echo variables were age, sex and body size adjusted. Spearman correlations between repeated echo measurements over 4 years were significant. Correlations of initial SBP, LVM and LVDd with values 4 years later were 0.50, 0.45 and 0.48 (p
FACTORS MEDIATING THE EFFECT OF EXERCISE ON BLOOD PRESSURE IN YOUNG ELITE ATHLETES Steven D. Golan*, Stephen P. Sanders, The Children’s Hospital, Boston, MA Athletes participating in sports such as weight lifting are commonly noted to have hypertension, whereas runners often have lowered blood pressure (BP). It is unclear if this reflects direct alterations in the cardiovascular system, autonomic nervous system adaptations, or other factors. We have therefore investigated three groups of elite young (12-24 years) athletes (14 long distance runners, 26 swimmers, and 15 power lifters) and an agematched group of 55 normal controls using multiole regression analysis to explore the determkants df systolic (8 and diastolic (D) BP. In each group, SBP was most significantly correlated to body surface area (BSA) with no further reduction in variance bv inclusion of additional variables. In contrast DBP was significantly determined by both age and BSA as independent variables. In the combined data from all subiects. SBP correlated with BSA with r=.54 and DkP wk determined by BSA and age with multiple r=.59. The regression equations in-each group were not different from control or combined data. Thus, the increase or decrease in blood pressure associated with athletic participation is be to alterations in body mass in a fashion parallel to that seen in the normal population and does not reflect a unique effect of athletic participation.
AAP Program and Abstracts INCREASED BAROREFLEX SENSITIVITY IN CHILDREN WITH HIGH BLOOD PRESSURE: THE MUSCATINE STUDY Larry T. Mahoney, M.D., F.A.A.P.*, Julia Lee, M.D., F.A.A.P., William R. Clarke, Ph.D., Ronald t!. Lauer, M.D., F.A.A.P., Univet,rity of
Iowa, Iowa City,
IA
Hvoertensive adults demonstrate altered baroreflex sensitivity. We investi ated cardiopulmonary (CP! and carotid (C 4 baroreflex activity in children with persistent 'levels of hiqh BP (N=6) and low BP (N=6!. Graded lower body negative pressure produces incremental inhibition of CP resulting in a reflex decrease in forearm blood flow and an increase in forearm vascular resistance and heart rate Tachycardia and forearm vasoconitriction (HR). were similai in both groups. Positive (PP) or negative (NP) pressure, via a variable-pressure neck chamber, results in inhibition or stimulation of C. In both groups, PP increased HR and BP; converseiy, NP decreased HR and BP. The slope of the HR response was qreater for the hiah BP arouo dur;ng NP (p<0.05) but did not differ-during PP. The slope of the BP response was greater for the high BP group during PP (p
CARDIAC AND NON-CARDIAC MALFORMATIONS: ASSOCIATIONS BY REASON OR BY CHANCE. Charlotte -.Fere"C!Z, MD, MPH, FAAP*, Judith n. Rubin,, MPH, FAAP, Joan" A. Bouqhman, Ph.D., Joel I. Brenner, NID, FAAP, Catherine A. Neill, MD, E, Lowell W. Perry, MD,-, z.em_r_ml, Hepner, MD, FAAP, John W. wwninq, MD. i)epartment of Epidemioloqy and Preventive Mef*icine, University of Maryland and the BaltinoreWashinqton Infant Studv Group, Baltimore, Maryland 21201. The frequency and type of non-cardiac, ahnormalities was evaluated in 1056 infants with conqenital cardiovascular malformation: (CCVM) and in 1388 controls representative of the hirth cohort. No case-control differences were reported for non-syndromal cleft ii" an> palate (0.19 & 0.148) skeletal anomalies, (1.4 & 0.93%), abdominal wall defects and hernias (0.85 & 0.79%) indicatinq their association with CVM by chance. The case frequencv OF chromosomal lesions (12.4%) and Mendellan syndromes (5.9%) was ten times that of controls. No chromosomal abnormality occurred in 3 or L-transpositions (TGA) (n=68) or in an'; right sided lesion (n=144); the rate for left sided obstructive lesions was 5.0%: ventricu;ar neptal defect 6.3%: tetraloqy Of Fallot ln.4%: atria1 septal defect 18.7% and endncar~li~l cushion defects 73%. vendelian lesions did not occur in TGA; for the other qrnups the frequency varied between 4-8% These v-iristions in the presence and absence of n,>"cardiac lesions are indicative of etloio4ic heteroqeneity of CCVM. NHLBI HL 25629
709
110 3
INCREASED LEFT VENTRICULAR MASS PREDICTS FUTURE HIGH BP: THE MUSCATINE STUDY Larry T. Mahoney, M.D., F.A.A.P.*, Richard M. Schleken, M.D., F.A.A.P., Willlam R. Clarke, Ph.D., Ronald M. Lauer, M.D., F.A.A.P., University of Iowa, Iowa City, IA Increased left ventricular mass (LVM) is an important predictor of coronary heart disease in adults. To define the Dredictors of LVM and to explore whether initial‘ LVM predicts subsequent BP, echocardiograms in approximately 250 children, ages 5-16 years, whose systolic blood pressures were high, middle and low range, were studied. All echo variables were age, sex and body size adjusted. Spearman correlations between repeated echo measurements over 4 years were significant. Correlations of initial SBP, LVM and LVDd with values 4 years later were 0.50, 0.45 and 0.48 (p
FACTORS MEDIATING THE EFFECT OF EXERCISE ON BLOOD PRESSURE IN YOUNG ELITE ATHLETES Steven D. Golan*, Stephen P. Sanders, The Children’s Hospital, Boston, MA Athletes participating in sports such as weight lifting are commonly noted to have hypertension, whereas runners often have lowered blood pressure (BP). It is unclear if this reflects direct alterations in the cardiovascular system, autonomic nervous system adaptations, or other factors. We have therefore investigated three groups of elite young (12-24 years) athletes (14 long distance runners, 26 swimmers, and 15 power lifters) and an agematched group of 55 normal controls using multiole regression analysis to explore the determkants df systolic (8 and diastolic (D) BP. In each group, SBP was most significantly correlated to body surface area (BSA) with no further reduction in variance bv inclusion of additional variables. In contrast DBP was significantly determined by both age and BSA as independent variables. In the combined data from all subiects. SBP correlated with BSA with r=.54 and DkP wk determined by BSA and age with multiple r=.59. The regression equations in-each group were not different from control or combined data. Thus, the increase or decrease in blood pressure associated with athletic participation is be to alterations in body mass in a fashion parallel to that seen in the normal population and does not reflect a unique effect of athletic participation.
AAP Program and Abstracts INCREASED BAROREFLEX SENSITIVITY IN CHILDREN WITH HIGH BLOOD PRESSURE: THE MUSCATINE STUDY Larry T. Mahoney, M.D., F.A.A.P.*, Julia Lee, M.D., F.A.A.P., William R. Clarke, Ph.D., Ronald t!. Lauer, M.D., F.A.A.P., Univet,rity of
Iowa, Iowa City,
IA
Hvoertensive adults demonstrate altered baroreflex sensitivity. We investi ated cardiopulmonary (CP! and carotid (C 4 baroreflex activity in children with persistent 'levels of hiqh BP (N=6) and low BP (N=6!. Graded lower body negative pressure produces incremental inhibition of CP resulting in a reflex decrease in forearm blood flow and an increase in forearm vascular resistance and heart rate Tachycardia and forearm vasoconitriction (HR). were similai in both groups. Positive (PP) or negative (NP) pressure, via a variable-pressure neck chamber, results in inhibition or stimulation of C. In both groups, PP increased HR and BP; converseiy, NP decreased HR and BP. The slope of the HR response was qreater for the hiah BP arouo dur;ng NP (p<0.05) but did not differ-during PP. The slope of the BP response was greater for the high BP group during PP (p
CARDIAC AND NON-CARDIAC MALFORMATIONS: ASSOCIATIONS BY REASON OR BY CHANCE. Charlotte -.Fere"C!Z, MD, MPH, FAAP*, Judith n. Rubin,, MPH, FAAP, Joan" A. Bouqhman, Ph.D., Joel I. Brenner, NID, FAAP, Catherine A. Neill, MD, E, Lowell W. Perry, MD,-, z.em_r_ml, Hepner, MD, FAAP, John W. wwninq, MD. i)epartment of Epidemioloqy and Preventive Mef*icine, University of Maryland and the BaltinoreWashinqton Infant Studv Group, Baltimore, Maryland 21201. The frequency and type of non-cardiac, ahnormalities was evaluated in 1056 infants with conqenital cardiovascular malformation: (CCVM) and in 1388 controls representative of the hirth cohort. No case-control differences were reported for non-syndromal cleft ii" an> palate (0.19 & 0.148) skeletal anomalies, (1.4 & 0.93%), abdominal wall defects and hernias (0.85 & 0.79%) indicatinq their association with CVM by chance. The case frequencv OF chromosomal lesions (12.4%) and Mendellan syndromes (5.9%) was ten times that of controls. No chromosomal abnormality occurred in 3 or L-transpositions (TGA) (n=68) or in an'; right sided lesion (n=144); the rate for left sided obstructive lesions was 5.0%: ventricu;ar neptal defect 6.3%: tetraloqy Of Fallot ln.4%: atria1 septal defect 18.7% and endncar~li~l cushion defects 73%. vendelian lesions did not occur in TGA; for the other qrnups the frequency varied between 4-8% These v-iristions in the presence and absence of n,>"cardiac lesions are indicative of etloio4ic heteroqeneity of CCVM. NHLBI HL 25629
709