Pujowaskito, Prihati and Johanes Nugroho and Soemantri, Djoko (2007) Exercise Diastolic Blood Pressure as an Indicator of Endothelial Function among Subjects with Normal and Low Ankle-Brachial Index. Folia Medica Indonesiana, 43 (2). pp. 78-86. ISSN 0303-7932

Preview	Text (Fulltext) karil3.exercise-oke.pdf Download (1MB) | Preview
	Text (Peerreview) peerreview3.ExerciseDiastolic.pdf Restricted to Registered users only Download (1MB) | Request a copy

Abstract

Clinically, endothelium dysfunction in atherosclerosis has primarily been defined by impairment of endothelial- dependent vasodilatation. It becomes a targeted catalyst, ultimately promoting and perpetuating atherosclerosis in the lower-extremity arteries. Peripheral arterial disease (PAD) can be determined by a simple non-invasive method (Ankle- brachial index). The low ABI (<0.9) indicates that PAD exists and reflects the systemic atherosclerosis process seemingly to be involved at all vascular beds. Hence, to reduce the heavy burden of cardiovascular disease, early identification of endothelial dysfunction sh ould be routinely taken place. We assu me that a simple mode of exercise test/treadmill could be used to predict the existing of endothe lial dysfunction. Effects of acute dynamic exercise are net vasodilatation and leads to a reduction in muscular vessel resistance, with a fall in diastolic pressure. These effects are affected by intrinsic circumstances, such as an endothelial dysfunction in atherosclerotic vessels. Unfortunately, the current method of assessing the endothelial function is techniquely invasive, costly and complicated, making them unsuitable for routine clinical application. We evaluated the endothelial function with simple mode of treadmill test on atherosclerotic subject which was determined by existing PAD. The objective of this study was to assess the difference of diastolic blood pressure response to exercise (ExDBP) between subject with normal and low ABI. This was a cross- sectional study at Dr. Soetomo General Hospital Surabaya, February 2006 - May 2006. A total of 35 subjects aged 50 years or older with 1 or more risk factors of atherosclerosis were evaluated by measurement of ABI and followed by treadmill test on phase I of Bruce Protocol. Results showed that a number of 18 men and 17 women were studied, the mean age was 59.3 ± 6.39 years, and the mean BMI was 24.8 ± 3.27. The presence of low ABI was found in 15 (42.86%) patients. The mean of ExDBP of these patients were found to be higher than in subjects with normal ABI (92.67 ± 13.34 mmHg versus 78.0 ± 11.52 mmHg; p=0.001). The mean increase of ExDBP during 3 minutes treadmill among subject with Low ABI was 11.34 mmHg. The ExDBP during 3 minutes treadmill among subjects with normal ABI decreased as much as 2.5 mmHg. The ExDBP between su bject with low and normal ABI was significantly different (p < 0.002). In conclusions, response of diastolic blood pressure during acut e exercise is strongly different between subjects with normal and low ABI. This difference probably reflects an impairment of endothelial-dependent vasodilatation in atherosclerotic subjects.

Actions (login required)

View Item