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. 2022 Jul 1;35(7):664-671.
doi: 10.1093/ajh/hpac040.

Association of Cerebral Oxygenation During Exercise With Target Organ Damage in Middle-Aged Hypertensive and Normotensive Individuals

Georgios A Triantafyllou  1   2 , Areti Triantafyllou  1 , Alexandros Savvas Zafeiridis  1 , Nikolaos Koletsos  1 , Andreas Zafeiridis  3 , Eugenia Gkaliagkousi  1 , Stella Douma  1 , Konstantina Dipla  3
Affiliations

Association of Cerebral Oxygenation During Exercise With Target Organ Damage in Middle-Aged Hypertensive and Normotensive Individuals

Georgios A Triantafyllou et al. Am J Hypertens. .

Abstract

Background: The brain is one of the main target organs affected by hypertension. Impaired cerebral oxygenation during exercise is an indicator of cerebral dysfunction. We aimed to investigate whether cerebral oxygenation during exercise correlates with subclinical markers of early target organ damage in a population of middle-aged, newly diagnosed hypertensive and healthy individuals.

Methods: Carotid intima-media thickness (cIMT) was measured using ultrasound, arterial stiffness was estimated measuring the augmentation index and pulse wave velocity, and retinal vessel diameter was assessed via the central retinal-arteriolar and vein equivalent and retinal-arteriovenous ratio. Participants (n = 93) performed a 3-minute isometric handgrip exercise. Cerebral prefrontal oxygenation was measured continuously using near infrared spectroscopy. The average exercise responses in oxygenated hemoglobin (O2Hb), deoxygenated hemoglobin (HHb), and total hemoglobin (tHb) were assessed. Univariate analyses were performed; partial correlation was used to account for traditional cardiovascular risk factors to identify independent associations between cerebral-oxygenation indices and early markers of target organ damage.

Results: Mean cIMT was negatively correlated with the average exercise response in cerebral oxygenation (rhoO2Hb = -0.348, PO2Hb = 0.001; rhotHb = -0.253, Pthb = 0.02). Augmentation index was negatively correlated with cerebral oxygenation during exercise (rhoO2Hb = -0.374, P < 0.001; rhotHb = -0.332, P = 0.02), whereas no significant correlation was observed between pulse wave velocity and cerebral-oxygenation indices. In the adjusted analysis, cerebral oxygenation was correlated with central retinal arteriolar diameter (CRAE r = 0.233, P = 0.043).

Conclusions: Our novel findings suggest that indices of lower cerebral oxygenation during a submaximal physical task are associated with markers of early, subclinical target organ damage, namely increased cIMT, arterial stiffness, and arteriolar retinal narrowing in newly diagnosed, untreated, hypertensive individuals.

Keywords: arterial stiffness; carotid IMT; cerebral oxygenation; exercise; hypertension; hypertensive retinopathy; near infrared spectroscopy; retinal vessels.

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Figures

None
Graphical abstract
Figure 1.
Figure 1.
Scatter plots showing the correlation between carotid intima–media thickness and oxygenated hemoglobin change during exercise in the study population (A) and in the hypertensive (B) and normotensive (C) groups.
Figure 2.
Figure 2.
Scatterplots showing the correlation between carotid intima–media thickness and regional blood volume change (as reflected by tHb) during exercise in the total population (A) and in the hypertensive (B) and normotensive (C) groups.
Figure 3.
Figure 3.
Scatterplots of the correlation between aortic augmentation index normalized for a heart rate of 75 beats per minute (aortic Ai@75) and oxygenated hemoglobin change during exercise in the total population (A) and in the hypertensive (B) and normotensive (C) groups.
Figure 4.
Figure 4.
Scatterplots showing the correlation between aortic augmentation index normalized for a heart rate of 75 beats per minute (aortic Ai@75) and regional blood volume change (as reflected by total hemoglobin) during exercise in the total population (A) and in the hypertensive (B) and normotensive (C) groups.
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References

    1. Laurent S, Boutouyrie P. The structural factor of hypertension: large and small artery alterations. Circ Res 2015; 116:1007–1021. - PubMed
    1. Ostergaard L, Engedal TS, Moreton F, Hansen MB, Wardlaw JM, Dalkara T, Markus HS, Muir KW. Cerebral small vessel disease: capillary pathways to stroke and cognitive decline. J Cereb Blood Flow Metab 2016; 36:302–325. - PMC - PubMed
    1. Leung LY, Bartz TM, Rice K, Floyd J, Psaty B, Gutierrez J, Longstreth WT Jr, Mukamal KJ. Blood pressure and heart rate measures associated with increased risk of covert brain infarction and worsening leukoaraiosis in older adults. Arterioscler Thromb Vasc Biol 2017; 37:1579–1586. - PMC - PubMed
    1. Debette S, Markus HS. The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ 2010; 341:c3666. - PMC - PubMed
    1. Triantafyllou A, Anyfanti P, Zabulis X, Gavriilaki E, Karamaounas P, Gkaliagkousi E, Petidis K, Pyrpasopoulou A, Girasis C, Aslanidis S, Douma S. Accumulation of microvascular target organ damage in newly diagnosed hypertensive patients. J Am Soc Hypertens 2014; 8:542–549. - PubMed