Hypertensive Response to Maximal Exercise Test in Young and Middle Age Hypertensive on Blood Pressure Lowering Medication: Monotherapy vs. Combination Therapy

Background: Hypertensive response during maximal exercise test provides important information on the level of blood pressure control and evaluation of treatment. Method: A single center retrospective descriptive study was conducted among 117 young (aged 20 to 40) and middle age (aged 40 to 65) hypertensive patients, who underwent treadmill stress test. Currently on maintenance frontline medication either monotherapy (Angiotensin-converting enzyme inhibitor/Angiotensin receptor blocker [ACEi/ARB], Calcium channel blocker [CCB], Diuretic - Hydrochlorthiazide [HCTZ]) or combination therapy (ARB+CCB, ARB+HCTZ), who attained a maximal exercise on treadmill stress test (TMST) with hypertensive response (systolic blood pressure: male >210 mm Hg, female >190 mm Hg, diastolic blood pressure >100 mmHg, or increase of >10 mm Hg at any time during the test), on Bruce and Modified Bruce protocol. Exaggerated blood pressure response during exercise (systolic [SBP] and diastolic [DBP]), peak exercise blood pressure (SBP and DBP), recovery period (SBP and DBP) and test for ischemia and their antihypertensive medication/s were investigated. Analysis of variance and chi-square test were used for statistical analysis. Results: Hypertensive responses on maximal exercise test were seen mostly among female population (P < 0.000) and middle age (P < 0.000) patients. Exaggerated diastolic blood pressure responses were significantly lower in patients who were taking CCB (P < 0.004). A longer recovery period that showed a delayed decline in SBP was observed in patients taking ARB+HCTZ (P < 0.036). There were no significant differences in the level of exaggerated systolic blood pressure response and during peak exercise (both systolic and diastolic) in patients using either monotherapy or combination antihypertensives. Conclusion: Calcium channel blockers provided lower exaggerated diastolic BP response during maximal exercise test in hypertensive middle age patients. Patients on combination therapy using ARB+HCTZ exhibited a longer recovery period of systolic blood pressure.

Bronchospasm Analysis Following the Implementation of a Program of Maximum Aerobic Exercise in Active Men

Exercise-induced bronchospasm (EIB) is a transitory condition of airflow obstruction that is associated with physical activities. It is noted that high ventilation can lead to an increase in the heat and reduce in the moisture in airways resistance of trachea. Also causes of pathophysiological mechanism are EIB. Accordingly, studying some parameters of pulmonary function (FVC, FEV1) among active people seems quintessential. The aim of this study was to analyze bronchospasm following the implementation of a program of maximum aerobic exercise in active men at Chamran University of Ahwaz. Method: In this quasi-experimental study, the population consisted of all students at Chamran University. Among from 55 participants, of which, 15 were randomly selected as the experimental group. In this study, the size of the maximum oxygen consumption was initially measured, and then, based on the maximum oxygen consumed, the active individuals were identified. After five minutes’ warm-up, Strand treadmill exercise test was taken (one session) and pulmonary parameters were measured at both pre- and post-tests (spirometer). After data normalization using KS and non-normality of the data, the Wilcoxon test was used to analyze the data. The significance level for all statistical surveys was considered p≤0/05. Results: The results showed that the ventilation factors and bronchospasm (FVC, FEV1) in the pre-test and post-test resulted in no significant difference among the active people (p≥0/05). Discussion and conclusion: Based on the results observed in this study, it appears that pulmonary indices in active individuals increased after aerobic test. The increase in this indicator in active people is due to increased volume and elasticity of the lungs as well. In other words, pulmonary index is affected by rib muscles. It is considered that progress over respiratory muscle strength and endurance has raised FEV1 in the active cases.

Cardiopulmonary Exercise Testing in Young Asthmatic Children Ages 6-10 Years Old

The aim of this study was to establish the feasibility of a minute incremental exercise testing protocol in young asthma children. Twenty-two children with clinically diagnosed mild to moderate asthma volunteered to participate. The maximum incremental exercise test was performed using a cycle ergometer with an electromagnetic braking. A warm-up unloaded for 2 minutes then the workload was started at 40 watts for 2 minutes, and then stepwise increments of 8 watts per 2 minutes were applied. The pedaling frequency was set at 50 rpm. Ventilation and gas exchange were measured with a breath-by-breath automatic metabolic measurement system. Results showed that this test was well tolerated by all asthmatic children. Most of the children reached the VO2 plateau and satisfied the criteria for maximal respiratory exchange ratio of ≥ 1. This Study demonstrated that this testing protocol was suitable for young asthmatic children.

Association between Serum Concentrations of Anabolic Hormones and their Binding Proteins in Response to Graded Exercise in Male Athletes

We investigated the response of testosterone (T), growth hormone (GH), cortisol (C), steroid hormone binding globulin (SHBG), insulin-like growth factor (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), and some anaboliccatabolic indexes, i.e.: T/C, T/SHBG, and IGF-1/IGFBP-3 to maximal exercise in endurance-trained athletes (TREN) and untrained subjects (CG). The baseline concentration of IGF-1 was higher in athletes (TREN) when compared to the CG (p