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Angiotensin II mediates exercise-induced hypertension (EIH), which adversely impacts future cardiovascular health. There is paucity of data on the association between EIH and angiotensin II in well-trained middle-aged marathoners. Therefore, we investigated the renin-angiotensin-aldosterone-system and total nitric oxide activity in middle-aged marathoners with EIH.Seventy middle-aged marathoners were divided into 3 groups: normal blood pressure ([NBPG] [n = 21]), EIH group ([EIHG] [n = 35]), and complex hypertension group ([CHG] [n = 14]). We defined NBPG as resting systolic BP/diastolic BP (SBP/DBP) of ≤140/90 mm Hg and maximal exercise SBP of ≤210 mm Hg, EIHG as resting SBP/DBP ≤140/90 mm Hg and maximal exercise SBP of ≥210 mm Hg, and CHG as resting SBP/DBP ≥140/90 mm Hg and maximal exercise SBP of ≥210 mm Hg. Renin-angiotensin-aldosterone-system and NO levels were measured before and 30 minutes after the graded exercise test.Renin level was elevated while angiotensin level was reduced after 30 minutes of graded exercise test. There was no change in angiotensin I and angiotensin converting enzyme levels. Comparing the groups, renin level was only elevated in the CHG during recovery, while aldosterone level was higher than the baseline level in the recovery phase in all groups. Angiotensin I level remained unchanged in all groups. Angiotensin II level reduced significantly in the NBPG group but remained at the baseline in the EIHG and CHG groups. NO level was unchanged in the NBPG group but reduced in the EIHG and CHG groups after exercise. At 3 minutes of recovery, SBP was the highest in the NBPG group, followed by the EIHG and CHG groups (P < .05).In conclusion, angiotensin II activity and reduced NO level are associated with EIH in middle-aged long-distance runners. Angiotensin II inhibitors may; therefore, be the more appropriate antihypertensive medication for runners with EIH.

Marathon runners demonstrate a high incidence of coronary artery plaque; however, studies on runners with exercise-induced hypertension (EIH) are sparse. We aimed to investigate the prevalence of coronary artery plaque among marathon runners with EIH.Veteran male marathon runners (≥40 and <60 years) underwent an exercise stress test. They were divided into 2 groups: normal blood pressure group (NBPG, n = 22), with resting systolic blood pressure (SBP)/diastolic blood pressure <140/90 mm Hg and maximal exercise SBP <210 mm Hg, and EIH group (EIHG, n = 28), with resting blood pressure <140/90 mm Hg and maximal exercise SBP ≥210 mm Hg. Coronary artery plaque and stenosis were compared using multi-detector computed tomography.The proportion of subjects with a coronary artery calcium (CAC) score ≥10 or ≥100 units, 1 or ≥2 plaques, or plaques in ≥2 blood vessels was higher in the EIHG than in the normal blood pressure group (NBPG) (P<.05). The absolute CAC score was higher in the EIHG (42.6 ± 67.8) than in the NBPG (2.8 ± 6.0; P < .05). The CAC score distribution was higher in the EIHG (5-300 units) than in the NBPG (P < .05). The prevalence of coronary plaques and maximal luminal artery stenosis was higher in the EIHG than in the NBPG (P < .05). The EIHG showed 12 cases of stenosis, whereas the NBPG showed only 1 case (P < .05).In marathon runners, EIH was associated with increased prevalence of coronary artery plaques and could be a new risk factor for coronary artery plaque formation. Therefore, preventive measures and EIH monitoring using an exercise stress test, alongside multi-detector computed tomography, are recommended.

Background: Excessive exercise may induce arrhythmia, and this risk is higher in middle-aged people. The study aim was to compare the exercise characteristics of middle-aged runners participating in excessive endurance exercise., Methods: The subjects of this study were 552 runners (mean age; 49.0±7.4years) without structural heart disease who performed exercise at least twice per week, had consistently exercised for at least three years, and had finished at least five marathons. The arrhythmia runner group (ARG, n=14) and normal runner group (NRG, n=538) were compared with regard to hemodynamic response, cardiorespiratory fitness level, training history, number of finished races, finishing times, and exercise habits., Results: The mean resting systolic (134.0±15.8mmHg) and diastolic (85.8±10.9mmHg) blood pressure values indicated pre-hypertension, while the mean maximal SBP (213.7±27.4mmHg) values indicated exercise-induced hypertension. The VO2max was significantly higher and the maximal DBP was significantly lower in the ARG than in the NRG (p<0.05). Training history was significantly longer in the ARG than in the NRG (p<0.05), while the number of finished marathons, the finishing times in marathons and the exercise frequency per week didn't differ significantly between the two groups. Exercise intensity was significantly higher in the ARG than in the NRG (p<0.01)., Conclusions: Middle-aged long-distance runners showed pre-hypertension and exercise-induced hypertension, and the ARG had higher VO2max values, greater exercise intensities, and longer training histories than the NRG., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Runners with exercise-induced high blood pressure have recently been reported to exhibit higher levels of cardiac markers, vasoconstrictors, and inflammation. The authors attempted to identify correlations between exercise-related personal characteristics and the levels of biochemical/cardiac markers in marathon runners in this study. Forty healthy runners were enrolled. Blood samples were taken both before and after finishing a full marathon. The change in each cardiac/biochemical marker over the course of the marathon was determined. All markers were significantly (P<.001) increased immediately after the marathon (creatine kinase-MB [CK-MB]: 7.9 ± 2.7 ng/mL, cardiac troponin I (cTnI): 0.06 ± 0.10 ng/mL, N-terminal pro-B-type natriuretic peptide (NT-proBNP): 95.7 ± 76.4, endothelin-1: 2.7 ± 1.16, high-sensitivity C-reactive protein [hs-CRP]: 0.1 ± 0.09, creatine kinase [CK]: 315.7 ± 94.0, lactate dehydrogenase [LDH]: 552.8 ± 130.3) compared with their premarathon values (CK-MB: 4.3 ± 1.3, cTnI: 0.01 ± 0.003, NT-proBNP: 27.6 ± 31.1, endothelin-1: 1.11 ± 0.5, hs-CRP: 0.06 ± 0.07, CK: 149.2 ± 66.0, LDH: 399 ± 75.1). In middle-aged marathon runners, factors related to increased blood pressure were correlated with marathon-induced increases in cTnI, NT-proBNP, endothelin-1, and hs-CRP. These correlations were observed independent of running history, records of finishing, and peak oxygen uptake. [ABSTRACT FROM AUTHOR]