Association of elevated blood pressure during exercise with cerebral white matter lesions

Figures & data

Figure 1. Representative figure of deep white matter lesion (A) and periventricular white matter lesion (B) on a fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging.

Table 1. Clinical, laboratory and treadmill exercise data for subjects with and without WMLs.

	With WMLs (n = 42)	Without WMLs (n = 88)	p value
Clinical and laboratory data
Age (years)	58 ± 8	49 ± 10	<.01
Male	28 (67%)	58 (66%)	1.00
Hypertension	15 (36%)	14 (16%)	.01
Diabetes mellitus	5 (12%)	4 (5%)	.15
Smoking	10 (24%)	13 (15%)	.23
Hyperlipidemia	8 (19%)	17 (8%)	.08
BMI (kg/m2)	24.2 ± 2.9	23.6 ± 3.4	.37
Baseline SBP (mmHg)	132 ± 10	121 ± 14	<.01
Baseline DBP (mmHg)	82 ± 10	75 ± 12	.01
Baseline PP (mmHg)	50 ± 7	46 ± 6	.01
Fasting glucose (mg/dl)	100 ± 18	94 ± 14	.06
Total cholesterol (mg/dl)	194 ± 39	186 ± 33	.30
Triglyceride (mg/dl)	113 ± 48	114 ± 63	.70
HDL-cholesterol (mg/dl)	52 ± 14	53 ± 14	.89
LDL-cholesterol (mg/dl)	116 ± 33	111 ± 29	.41
Treadmill exercise test
Resting SBP (mmHg)	128 ± 12	119 ± 17	<.01
Resting DBP (mmHg)	85 ± 9	81 ± 12	.16
Resting PP (mmHg)	44 ± 12	38 ± 12	.01
Resting HR (beats/min)	73 ± 11	75 ± 12	.28
Peak exercise SBP (mmHg)	178 ± 22	159 ± 24	<.01
Peak exercise DBP (mmHg)	80 ± 13	74 ± 13	.03
Peak exercise PP (mmHg)	98 ± 24	85 ± 21	.01
Peak exercise HR (beats/min)	152 ± 17	158 ± 18	.12
Difference of SBP (peak-resting)	50 ± 23	40 ± 20	.03
Difference of DBP (peak-resting)	−5 ± 12	−8 ± 9	.56
Total exercise time (minutes)	8.9 ± 1.8	9.5 ± 1.4	.35
Exercise capacity (METs)	10.9 ± 1.8	11.2 ± 1.5	.42

WMLs: white matter lesions; BMI: body mass index; SBP: systolic blood pressure; DBP: diastolic blood pressure; PP: pulse pressure; HDL: high-density lipoprotein; LDL: low-density lipoprotein; HR: heart rate.

Table 2. Logistic regression analysis of potential risk factors for WMLs.

Variables	Univariate Analysis		Multivariate Analysis
	OR (95% CI)	p value	OR (95% CI)	p value
Age	1.127 (1.064–1.207)	<.01	1.112 (1.034–1.212)	<.01
Gender	1.056 (0.439–2.650)	.90	0.833 (0.226–3.014)	.78
Hyperlipidemia	3.173 (0.966–10.753)	.06
Baseline SBP	1.074 (1.031–1.128)	<.01	1.065 (1.019–1.123)	<.01
Baseline PP	1.099 (1.021–1.194)	.02
Peak exercise SBP	1.036 (1.017–1.059)	<.01
Peak exercise PP	1.037 (1.017–1.058)	<.01

WMLs: white matter lesions, SBP: systolic blood pressure; PP: pulse pressure.

Table 3. Clinical, laboratory and treadmill exercise data for normotensive subjects with and without WMLs.

	With WMLs (n = 25)	Without WMLs (n = 63)	p value
Clinical and laboratory data
Age (years)	57 ± 8	48 ± 10	<.01
Male	14 (56%)	44 (70%)	.23
Diabetes mellitus	2 (8%)	2 (3%)	.32
Smoking	5 (20%)	11 (18%)	.77
Hyperlipidemia	6 (24%)	4 (6%)	.03
BMI (kg/m2)	23.0 ± 2.6	23.1 ± 3.3	.94
Baseline SBP (mmHg)	129 ± 10	118 ± 14	<.01
Baseline DBP (mmHg)	80 ± 8	73 ± 12	.03
Baseline PP (mmHg)	49 ± 6	45 ± 7	.08
Treadmill exercise test
Resting SBP (mmHg)	124 ± 8	112 ± 12	<.01
Resting DBP (mmHg)	84 ± 8	78 ± 11	.02
Resting PP (mmHg)	40 ± 7	34 ± 11	<.01
Peak exercise SBP (mmHg)	178 ± 24	153 ± 22	<.01
Peak exercise DBP (mmHg)	80 ± 14	70 ± 11	<.01
Peak exercise PP (mmHg)	98 ± 25	83 ± 21	.01
Difference of SBP (peak-resting)	54 ± 23	41 ± 22	.03
Difference of DBP (peak-resting)	−4 ± 14	−8 ± 9	.55
Total exercise time (minutes)	9.3 ± 1.0	9.6 ± 1.4	.50
Exercise capacity (METs)	11.2 ± 1.4	11.2 ± 1.6	.89

WMLs: white matter lesions; BMI: body mass index; SBP: systolic blood pressure; DBP: diastolic blood pressure; PP: pulse pressure.

Table 4. Logistic regression analysis of potential risk factors for WMLs in normotensive individuals.

Variables	Univariate Analysis		Multivariate Analysis
	OR (95% CI)	p value	OR (95% CI)	p value
Age	1.124 (1.052–1.221)	<.01	1.079 (0.995–1.186)	.08
Gender	0.762 (0.274–2.161)	.60	0.353 (0.077–1.430)	.16
Hyperlipidemia	3.750 (1.001–14.046)	.05	3.437 (0.578–24.358)	.19
Baseline SBP	1.067 (1.018–1.129)	.01
Baseline PP	1.067 (1.010–1.126)	.02
Peak exercise SBP	1.049 (1.023–1.081)	<.01	1.093 (1.031–1.175)	<.01
Peak exercise PP	1.053 (1.023–1.083)	<.01	0.950 (0.888–1.007)	.10

WMLs: white matter lesions; SBP: systolic blood pressure; PP: pulse pressure.