UNIVERSITAS AIRLANGGA



Detail Article

Folia Medica Indonesiana

ISSN 0303-7932

Vol. 43 / No. 2 / Published : 2007-04

Order : 4, and page :78 - 86

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Original Article :

Exercise diastolic blood pressure as an indicator of endothelial function among subjects with normal and low ankle-brachial index

Author :

  1. Prihati Pujowaskito*1
  2. J Nugroho*2
  3. Djoko Soemantri*3
  1. Department of Cardiology, Dustira Hospital, Cimahi, West Java
  2. Department of Cardiology Airlangga University School of Medicine Dr Soetomo Teaching Hospital, Surabaya

Abstract :

Clinically, endothelium dysfunction in atherosclerosis has primarily been defined by impairment of endothelialdependent vasodilatation. It becomes a targeted catalyst, ultimately promoting and perpetuating atherosclerosis in the lower-extremity arteries. Peripheral arterial disease (PAD) can be determined by a simple non-invasive method (Anklebrachial index). The low ABI (<0.9) indicates that PAD exists and reflects the systemic atherosclerosis process seemingly to be involved at all vascular beds. Hence, to reduce the heavy burden of cardiovascular disease, early identification of endothelial dysfunction should be routinely taken place. We assume that a simple mode of exercise test/treadmill could be used to predict the existing of endothelial dysfunction. Effects of acute dynamic exercise are net vasodilatation and leads to a reduction in muscular vessel resistance, with a fall in diastolic pressure. These effects are affected by intrinsic circumstances, such as an endothelial dysfunction in atherosclerotic vessels. Unfortunately, the current method of assessing the endothelial function is techniquely invasive, costly and complicated, making them unsuitable for routine clinical application. We evaluated the endothelial function with simple mode of treadmill test on atherosclerotic subject which was determined by existing PAD. The objective of this study was to assess the difference of diastolic blood pressure response to exercise (ExDBP) between subject with normal and low ABI. This was a crosssectional study at Dr. Soetomo General Hospital Surabaya, February 2006 - May 2006. A total of 35 subjects aged 50 years or older with 1 or more risk factors of atherosclerosis were evaluated by measurement of ABI and followed by treadmill test on phase I of Bruce Protocol. Results showed that a number of 18 men and 17 women were studied, the mean age was 59.3 ± 6.39 years, and the mean BMI was 24.8 ± 3.27. The presence of low ABI was found in 15 (42.86%) patients. The mean of ExDBP of these patients were found to be higher than in subjects with normal ABI (92.67 ± 13.34 mmHg versus 78.0 ± 11.52 mmHg; p=0.001). The mean increase of ExDBP during 3 minutes treadmill among subject with Low ABI was 11.34 mmHg. The ExDBP during 3 minutes treadmill among subjects with normal ABI decreased as much as 2.5 mmHg. The ExDBP between subject with low and normal ABI was significantly different (p < 0.002). In conclusions, response of diastolic blood pressure during acute exercise is strongly different between subjects with normal and low ABI. This difference probably reflects an impairment of endothelial-dependent vasodilatation in atherosclerotic subjects.

Keyword :

endothelial function, ABI, and exercise diastolic blood pressure,


References :

F Akhras,(1985) Increased diastolik blood pressure response to exercise testing when coronary artery disease is suspected. an indication of severity
no info : British Heart Journal

J Upward,(1985) Increased diastolik blood pressure response to exercise testing when coronary artery disease is suspected. an indication of severity
no info : British Heart Journal

G Jackson,(1985) Increased diastolik blood pressure response to exercise testing when coronary artery disease is suspected. an indication of severity
no info : British Heart Journal

M Ali,(2002) Receptor pada endothel dan otot di sistem kardiovaskuler
Malang : Brawijaya University

SE Brett,(2000) Diastolic blood pressure changes during exercise positively correlate with serum cholesterol and insulin resistance no info : Circulation

JM Ritter,(2000) Diastolic blood pressure changes during exercise positively correlate with serum cholesterol and insulin resistance no info :



Archive Article

Cover Media Content

Volume : 43 / No. : 2 / Pub. : 2007-04
  1. Detection Of Mycobacterium Leprae Dna In Blood Of The Subclinical Leprosy
  2. Correlation Between Mutant P53 Protein Expression And Histopathological Grading In Astrocytoma Patients
  3. Histopathological Feature Of The Tumor Of Central Nervous System At Airlangga University School Of Medicine, Dr Soetomo Hospital, Surabaya, In 2001-2003
  4. Exercise Diastolic Blood Pressure As An Indicator Of Endothelial Function Among Subjects With Normal And Low Ankle-brachial Index
  5. Effect Of Artificial Unilateral Ureter Total Obstructon On Serum Cystatin-c Levels In Oryctalagus Cuniculus
  6. The Determination Antipyrine On Plasma By Spectrophotometer Ultra Violet-visible
  7. Lumbar Microdiscectomy: Technique, Advantages And Outcomes. Surabaya Experience On 83 Patients
  8. Case Report: Successful Treatment Of Stevens Johnson Syndrome-toxic Epidermal Necrolysis With Intravenous Immunoglobulin
  9. Review Article: Hysterosalpingography As A Diagnostic Test Of Female Infertility
  10. Review Article: Heart Rate Variability. A Remarkable Tool To Assess Sympathovagal Balance
  11. Review Article And Clinical Experience: Hypertension In Diabetic Nephropathy. The Five “satan Circles”, Dha-licoar, The Roles Of Valsartan

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