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Published Online
on February 19, 2008

Hypertension. 2008
Published online before print February 19, 2008, doi: 10.1161/HYPERTENSIONAHA.107.102558
A more recent version of this article appeared on April 1, 2008
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Submitted on October 7, 2007
Revised on October 26, 2007

Nitric Oxide Does Not Significantly Contribute to Changes in Pulse Pressure Amplification During Light Aerobic Exercise

James E. Sharman*; Carmel M. McEniery; Ross Campbell; Pawan Pusalkar; Ian B. Wilkinson; Jeff S. Coombes; and John R. Cockcroft

From the Department of Medicine (J.E.S.), University of Queensland, Brisbane, Australia; School of Human Movement Studies (J.E.S., J.S.C.), Brisbane, Australia; Clinical Pharmacology Unit (C.M.M., I.B.W.), University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom; and the Department of Cardiology (R.C., P.P., J.R.C.), University of Wales College of Medicine, University Hospital, Cardiff, United Kingdom.

* To whom correspondence should be addressed. E-mail: j.sharman{at}uq.edu.au.

Abstract—NO modulates resting blood pressure and wave reflection. The effect of NO on exercise central hemodynamics is unknown but has important implications relating to cardiovascular risk. The aim of this study was to determine the contribution of NO to pulse pressure (PP) amplification and wave reflection during exercise. Twelve healthy men aged 29±1 years (mean±SEM) undertook cycle exercise at 60% of their maximal heart rate. Noninvasive measures of central blood pressure, estimated aortic pulse wave velocity, and wave reflection (augmentation index) were obtained by pulse wave analysis during intravenous infusion of saline (control), NG-monomethyl-L-arginine (a NO-synthase inhibitor), or noradrenaline (control vasoconstrictor). PP amplification was defined as the ratio of peripheral to central PP. Cardiac output and stroke volume were determined by electric bioimpedance. Both NG-monomethyl-L-arginine and noradrenaline caused a significant increase in mean arterial pressure (P<0.01) and augmentation index (P<0.01), as well as reduced ratio of peripheral to central PP (P<0.05) at baseline. Exercise caused a significant increase in the ratio of peripheral to central PP (P<0.001), whereas augmentation index and estimated aortic pulse wave velocity declined (for both P<0.05) during all 3 of the infusion protocols. However, no significant differences were observed in augmentation index, ratio of peripheral to central PP, or estimated aortic pulse wave velocity between infusion procedures (P>0.50) during exercise. Also, heart rate, peripheral vascular resistance, and cardiac output did not differ during exercise between saline, NG-monomethyl-L-arginine, or noradrenaline. Although we cannot rule out other vasodilator mechanisms having adjusted for NO blockade, our results indicate that NO does not solely contribute to systemic arterial stiffness or altered blood pressure amplification during light exercise.


Key words: NO • exercise • radial artery • aorta • hemodynamics