Insulin resistance is associated with an exaggerated blood pressure response to ischemic rhythmic handgrip exercise in nondiabetic older adults

Norio Hotta, Amane Hori, Yukiko Okamura, Reizo Baba, Hidehiro Watanabe, Jun Sugawara, Wanpen Vongpatanasin, Jijia Wang, Han Kyul Kim, Rie Ishizawa, Gary A. Iwamoto, Jere H. Mitchell, Scott A. Smith, Masaki Mizuno

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Insulin resistance is associated with an exaggerated blood pressure response to ischemic rhythmic handgrip exercise in nondiabetic older adults. J Appl Physiol 129: 144 –151, 2020. First published June 25, 2020; doi:10.1152/japplphysiol.00247.2020.—Patients with type 2 diabetes display an exaggerated pressor response to exercise. However, evidence supporting the association between the magnitude of the pressor response to exercise and insulin resistance-related factors including hemoglobin A1c (HbA1c) or homeostatic model assessment of insulin resistance (HOMA-IR) in nondiabetic subjects has remained sparse and inconclusive. Thus we investigated the relationship between cardiovascular responses to exercise and insulin resistance-related factors in nondiabetic healthy men (n = 23) and women (n = 22) above 60 yr old. We measured heart rate (HR) and blood pressure (BP) responses during: isometric handgrip (IHG) exercise of 30% maximal voluntary contraction, a period of skeletal muscle ischemia (SMI) induced by tourniqueting the arm after IHG, and rhythmic dynamic handgrip (DHG) exercise during SMI. Greater diastolic BP (DBP) responses to DHG with SMI was associated with male sex (r = 0.44, P = 0.02) and higher HbA1c (r = 0.33, P = 0.03), heart-ankle pulse wave velocity (haPWV) (r = 0.45, P < 0.01), and resting systolic BP (SBP) (r = 0.36, P = 0.02). HbA1c persisted as a significant determinant explaining the variance in the DBP response to DHG with SMI in multivariate models despite adjustment for sex, haPWV, and resting SBP. It was also determined that the DBP response to DHG with SMI in a group in which HOMA-IR was abnormal (Δ33 ± 3 mmHg) was significantly higher than that of groups in which HOMA-IR was at intermediate (Δ20 ± 4 mmHg) and normal (Δ23 ± 2 mmHg) levels. These data suggest that even in nondiabetic older adults, insulin resistance is related to an exaggerated pressor response to exercise especially when performed under ischemic conditions. NEW & NOTEWORTHY The diastolic blood pressure response to rhythmic dynamic handgrip exercise under ischemic conditions was demonstrated to be correlated with insulin resistance-related factors in nondiabetic older adults. This finding provides important insight to the prescription of exercise in this particular patient population as the blood pressure response to exercise, especially under ischemic conditions, could be exaggerated to nonsafe levels.

Original languageEnglish (US)
Pages (from-to)144-151
Number of pages8
JournalJournal of applied physiology
Volume129
Issue number1
DOIs
StatePublished - Jul 2020

Keywords

  • Exercise pressor reflex
  • Muscle mechanoreflex
  • Muscle metaboreflex
  • Postexercise muscle ischemia
  • Prediabetic state

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

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