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Association of oxygen uptake at ventilatory threshold with risk of incident hypertension: a long-term prospective cohort study

Journal of Human Hypertension volume 31, pages 654–656 (2017)Cite this article

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Peak oxygen uptake (peak VO 2 ) has been suggested as a causal risk factor for future hypertension. Oxygen uptake at ventilatory threshold (VO 2 at VT), is a proxy for peak VO 2 , but its relationship with incident hypertension has not been previously investigated. VO 2 at VT was determined at baseline during submaximal exercise testing using respiratory gas analyzers in the Kuopio Ischemic Heart Disease cohort of 1360 middle-aged men without hypertension, and its relationship with incident hypertension risk was assessed. During a median follow-up of 25.1 years, there were 217 incident cases of new-onset hypertension. This study suggested that in middle-aged Caucasian men, VO 2 at VT is inversely associated with future risk of hypertension.

Peak VO2, a measure of cardiorespiratory fitness, is considered the gold standard index of aerobic capacity.1 Peak VO2 has been consistently shown to be inversely and independently associated with incident cardiovascular disease (CVD), as well as CVD mortality.2, 3 Emerging evidence from large-scale epidemiological cohorts also demonstrate peak VO2 to be consistently associated with future hypertension risk, and it has been suggested to be a causal risk factor.4, 5 Hypertension is an established risk factor for CVD and is included in the standard cardiovascular risk-assessment panel.6 VO2 at VT, another cardiopulmonary exercise testing (CPX) parameter and often referred to as the anaerobic threshold, is assessed at submaximal levels of CPX.7 VO2 at VT is considered as a measure of cardiovascular fitness and a reliable index of aerobic capacity,1 and has been suggested to be predictive of fatal cardiovascular outcomes as well as all-cause mortality.8 Previous findings have suggested VO2 at VT to be a suitable proxy for peak VO2.8 Though peak VO2 is a gold standard measure of aerobic capacity, some individuals are unable to achieve this VO2 level due to exercise-related limitations such as musculoskeletal problems. In such instances, VO2 at VT, which can be assessed safely at submaximal exercise levels, may be used as a suitable replacement for the assessment of maximal VO2. To our knowledge, the nature of the relationship between VO2 at VT and future hypertension risk in general populations has not been previously investigated. We aimed to assess the nature and magnitude of the association between VO2 at VT and incident hypertension using the established Kuopio Ischemic Heart Disease (KIHD) population-based cohort comprising healthy middle-aged men from eastern Finland.

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Authors and Affiliations

  1. School of Clinical Sciences, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK

    S K Kunutsor

  2. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland

    S Kurl & J A Laukkanen

  3. Internal Medicine, Central Finland Central Hospital, Jyväskylä, Finland

    J A Laukkanen

Authors
  1. S K Kunutsor
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  2. S Kurl
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  3. J A Laukkanen
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Correspondence to S K Kunutsor.

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Kunutsor, S., Kurl, S. & Laukkanen, J. Association of oxygen uptake at ventilatory threshold with risk of incident hypertension: a long-term prospective cohort study. J Hum Hypertens 31, 654–656 (2017). https://doi.org/10.1038/jhh.2017.39

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