KE. North*, TK. Waddell, JD. Cameron, CD. Gatzka, BP. McGrath, GL. Jennings, AM. Dart, BA. Kingwell.

Baker Medical Research Institute, Prahran, Victoria, Australia.

Objective:  Stiffening of the large arteries is thought to underlie isolated systolic hypertension (ISH).  We have previously shown that 4 weeks of moderate exercise increase large artery compliance and reduces systolic blood pressure in previously sedentary normotensive individuals.  This study sought to characterise large artery properties in ISH patients and to determine the efficacy of aerobic exercise training to modify these,

Design and Methods:  Thirteen patients with borderline ISH (SBP>150mmHg, DBP<90mmHg; 7 male, 6 female; mean age ± SEM, 60 ± 3 years) and 13 age and gender matched normotensive controls (CON, 60 ± 3 years) were recruited.  Whole body arterial compliance (WBAC), aortic pulse wave velocity (PWV) and aortic input impedance were assessed non-invasively.  Ten ISH patients (5 male, 5 female) were enrolled in a randomised, cross‑-over study comparing 8 weeks of moderate cycling performed 3 times per week at 65% of maximum capacity (T), with 8 weeks of sedentary activity (S).

Results:  In male ISH patients compared to controls, WBAC was lower (ISH: 0.38±0.04, CON: 0.61±0.08 ACU; P=0.03) and aortic input impedance, higher (ISH: 2.6±0.4, CON: 1.4±0.2mmHg/s/cm; P=0.03).  Interestingly there was no difference between WBAC (ISH: 0.29±0.03, CON: 0.29±0.06 ACU) and aortic impedance (ISH: 2.7±0.3, CON: 2.8±0.3) in female ISH patients, however aortic PWV was higher (ISH: 11.1±0.9, CON: 8.8±0.3 m/s; P=0.03).  Exercise training increased VO₂max (S: 21.4±1.5, T: 24.3±2.2 ml/min/kg, P=0.04), but did not alter arterial mechanical properties, brachial or carotid blood pressure or cardiac structure or function.

Conclusion:  Moderate exercise has no efficacy in elevating arterial compliance or reducing systolic blood pressure in older populations with ISH.

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