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. 2020 Jun;8(12):e14462.
doi: 10.14814/phy2.14462.

Increased aortic stiffness and elevated blood pressure in response to exercise in adult survivors of prematurity

Christopher R Barnard  1 , Matthew Peters  1 , Amy L Sindler  1 , Emily T Farrell  2 , Kim R Baker  3 , Mari Palta  4 , Harald M Stauss  1   5 , John M Dagle  6 , Jeffrey Segar  6 , Gary L Pierce  1 , Marlowe W Eldridge  2   7   8   9 , Melissa L Bates  1   6
Affiliations

Increased aortic stiffness and elevated blood pressure in response to exercise in adult survivors of prematurity

Christopher R Barnard et al. Physiol Rep. 2020 Jun.

Abstract

Objectives: Adults born prematurely have an increased risk of early heart failure. The impact of prematurity on left and right ventricular function has been well documented, but little is known about the impact on the systemic vasculature. The goals of this study were to measure aortic stiffness and the blood pressure response to physiological stressors; in particular, normoxic and hypoxic exercise.

Methods: Preterm participants (n = 10) were recruited from the Newborn Lung Project Cohort and matched with term-born, age-matched subjects (n = 12). Aortic pulse wave velocity was derived from the brachial arterial waveform and the heart rate and blood pressure responses to incremental exercise in normoxia (21% O2 ) or hypoxia (12% O2 ) were evaluated.

Results: Aortic pulse wave velocity was higher in the preterm groups. Additionally, heart rate, systolic blood pressure, and pulse pressure were higher throughout the normoxic exercise bout, consistent with higher conduit artery stiffness. Hypoxic exercise caused a decline in diastolic pressure in this group, but not in term-born controls.

Conclusions: In this first report of the blood pressure response to exercise in adults born prematurely, we found exercise-induced hypertension relative to a term-born control group that is associated with increased large artery stiffness. These experiments performed in hypoxia reveal abnormalities in vascular function in adult survivors of prematurity that may further deteriorate as this population ages.

Keywords: hypertension; hypoxia; preterm; pulse wave velocity; vascular function.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Heart rate during normoxic (21% oxygen) and hypoxic (12% oxygen) incremental exercise tests to volitional exhaustion in term‐born (n = 12) and preterm (n = 10) adults. Data are represented as mean ± SE and were analyzed with a repeated measures, nested multivariate model with the group (term vs. preterm), gas (normoxia vs. hypoxia), resting normoxic value, and an interaction (group × gas) included as factors. Statistical information is given in Table 4
FIGURE 2
FIGURE 2
Systolic and diastolic blood pressure during normoxic (21% oxygen) and hypoxic (12% oxygen) incremental exercise tests to volitional exhaustion in term‐born (n = 12) and preterm (n = 10) adults. Data are represented as mean ± SE and were analyzed with a repeated measures, nested multivariate model with the group (term vs. preterm), gas (normoxia vs. hypoxia), resting normoxic value, and an interaction (group × gas) included as factors. Statistical information is given in Table 4
FIGURE 3
FIGURE 3
Mean arterial pressure and pulse pressure during normoxic (21% oxygen) and hypoxic (12% oxygen) incremental exercise tests to volitional exhaustion in term‐born (n = 12) and preterm (n = 10) adults. Data are represented as mean ± SE and were analyzed with a repeated measures, nested multivariate model with the group (term vs. preterm), gas (normoxia vs. hypoxia), resting normoxic value, and an interaction (group × gas) included as factors. Statistical information is given in Table 4. Mean arterial pressure was measured directly by averaging the brachial artery waveform
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