Systolic blood pressure reactivity during submaximal exercise and acute psychological stress in youth

Background Studies in youth show an association between systolic blood pressure (SBP) reactivity to acute psychological stress and carotid artery intima-media thickness (CIMT). Submaximal exercise produces similar cardiovascular responses as acute psychological stress and may be a valuable tool to assess SBP reactivity in youth. However, it has not yet been determined whether SBP reactivity during submaximal exercise in youth is associated with CIMT, as it is during psychological stress. Methods Fifty-four adolescents aged 13-16 years completed 3 visits. On one visit, adolescents completed three, 4-minute stages of increasing intensity on a treadmill. On another visit, adolescents completed measures of acute psychological stress reactivity (star tracing, speech preparation, speech). On a third visit, adolescents completed an ultrasound scan to measure CIMT. Results SBP reactivity during lower-(β = 0.29, P = 0.03) and higher-intensity (β = 0.31, P = 0.02) submaximal exercise was associated with greater CIMT. SBP reactivity during higher-intensity submaximal exercise was positively associated with SBP reactivity during star tracing (β = 0.34, P = 0.01), speech preparation (β = 0.37, P = 0.007), and speech (β = 0.41, P = 0.003). Conclusions Greater SBP reactivity during submaximal exercise in healthy adolescents was associated with greater CIMT, similar to SBP reactivity during acute psychological stress. Adolescents who had greater SBP reactivity during exercise also demonstrated greater SBP reactivity during the psychological stress tasks. Given that exercise testing can be standardized for comparison across studies, submaximal exercise tests may be a valuable tool to assess SBP reactivity in youth.