Search tips
Search criteria 


Logo of brheartjLink to Publisher's site
Br Heart J. 1989 February; 61(2): 149–154.
PMCID: PMC1216632

Impaired blood pressure response to exercise in patients with coronary artery disease: possible contribution of attenuated reflex vasoconstriction in non-exercising muscles.


Eighteen patients with coronary artery disease were divided into two groups according to whether their blood pressure decreased (eight, group 1) or increased (10, group 2) in response to treadmill exercise testing. Age and the extent and distribution of coronary artery disease were similar in the two groups. At rest, blood pressure, pulmonary artery wedge pressure, cardiac index, forearm vascular resistance, and oxygen consumption were similar in the two groups. During supine leg exercise on a bicycle ergometer mean blood pressure increased in group 2 but did not change in group 1. Increases in cardiac index, pulmonary artery wedge pressure, and oxygen consumption during leg exercise were not significantly different in the two groups but forearm vascular resistance increased less in group 1 than in group 2. There was a positive correlation between the magnitude of the change in mean blood pressure and change in forearm vascular resistance during leg exercise. The impaired response of blood pressure to leg exercise in group 1 was not the result of a failure of the cardiac index to increase. The results suggest the possibility that attenuation of reflex vasoconstriction in non-exercising muscles may contribute to the impaired response of blood pressure to exercise in patients with coronary artery disease.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (934K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Thomson PD, Kelemen MH. Hypotension accompanying the onset of exertional angina. A sign of severe compromise of left ventricular blood supply. Circulation. 1975 Jul;52(1):28–32. [PubMed]
  • Sanmarco ME, Pontius S, Selvester RH. Abnormal blood pressure response and marked ischemic ST-segment depression as predictors of severe coronary artery disease. Circulation. 1980 Mar;61(3):572–578. [PubMed]
  • Anderson RP, Li W, Balfour RI, Horton WG. Surgical management of left main coronary artery stenosis and ischemic left ventricular dysfunction. J Thorac Cardiovasc Surg. 1979 Mar;77(3):369–376. [PubMed]
  • Morris SN, Phillips JF, Jordan JW, McHenry PL. Incidence and significance of decreases in systolic blood pressure during graded treadmill exercise testing. Am J Cardiol. 1978 Feb;41(2):221–226. [PubMed]
  • Mark AL, Kioschos JM, Abboud FM, Heistad DD, Schmid PG. Abnormal vascular responses to exercise in patients with aortic stenosis. J Clin Invest. 1973 May;52(5):1138–1146. [PMC free article] [PubMed]
  • Bruce RA. Exercise testing of patients with coronary heart disease. Principles and normal standards for evaluation. Ann Clin Res. 1971 Dec;3(6):323–332. [PubMed]
  • DODGE HT, SANDLER H, BALLEW DW, LORD JD., Jr The use of biplane angiocardigraphy for the measurement of left ventricular volume in man. Am Heart J. 1960 Nov;60:762–776. [PubMed]
  • WHITNEY RJ. The measurement of volume changes in human limbs. J Physiol. 1953 Jul;121(1):1–27. [PubMed]
  • FOLKOW B, GRIMBY G, THULESIUS O. Adaptive structural changes of the vascular walls in hypertension and their relation to the control of the peripheral resistance. Acta Physiol Scand. 1958 Dec 15;44(3-4):255–272. [PubMed]
  • Hammermeister KE, DeRouen TA, Dodge HT, Zia M. Prognostic and predictive value of exertional hypotension in suspected coronary heart disease. Am J Cardiol. 1983 May 1;51(8):1261–1266. [PubMed]
  • Leon MB, Rosing DR, Bonow RO, Lipson LC, Epstein SE. Clinical efficacy of verapamil alone and combined with propranolol in treating patients with chronic stable angina pectoris. Am J Cardiol. 1981 Jul;48(1):131–139. [PubMed]
  • Irving JB, Bruce RA. Exertional hypotension and postexertional ventricular fibrillation in stress testing. Am J Cardiol. 1977 May 26;39(6):849–851. [PubMed]
  • Levites R, Baker T, Anderson GJ. The significance of hypotension developing during treadmill exercise testing. Am Heart J. 1978 Jun;95(6):747–753. [PubMed]
  • Li YB, Ting N, Chiang BN, Alexander ER, Bruce RA, Grayston JT. Electrocardiographic response to maximal exercise. Treadmill and double master exercise tests in middle-aged Chinese men. Am J Cardiol. 1967 Oct;20(4):541–548. [PubMed]
  • Bevegård BS, Shepherd JT. Reaction in man of resistance and capacity vessels in forearm and hand to leg exercise. J Appl Physiol. 1966 Jan;21(1):123–132. [PubMed]
  • McCloskey DI, Mitchell JH. Reflex cardiovascular and respiratory responses originating in exercising muscle. J Physiol. 1972 Jul;224(1):173–186. [PubMed]
  • Walker JL, Abboud FM, Mark AL, Thames MD. Interaction of cardiopulmonary and somatic reflexes in humans. J Clin Invest. 1980 Jun;65(6):1491–1497. [PMC free article] [PubMed]
  • Thames MD, Peterson MG, Schmid PG. Stimulation of cardiac receptors with veratrum alkaloids inhibits ADH secretion. Am J Physiol. 1980 Dec;239(6):H784–H788. [PubMed]
  • Thorén PN. Characteristics of left ventricular receptors with nonmedullated vagal afferents in cats. Circ Res. 1977 Apr;40(4):415–421. [PubMed]
  • Felder RB, Thames MD. Interaction between cardiac receptors and sinoaortic baroreceptors in the control of efferent cardiac sympathetic nerve activity during myocardial ischemia in dogs. Circ Res. 1979 Dec;45(6):728–736. [PubMed]
  • Thames MD, Abboud FM. Reflex inhibition of renal sympathetic nerve activity during myocardial ischemia mediated by left ventricular receptors with vagal afferents in dogs. J Clin Invest. 1979 Mar;63(3):395–402. [PMC free article] [PubMed]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group