Impaired training-induced adaptation of blood pressure in COPD patients: implication of the muscle capillary bed

• Published in: International journal of chronic obstructive pulmonary disease 2016-01, Vol.11 (1), p.2349-2357
• Main Authors: Gouzi, Fares, Maury, Jonathan, Bughin, François, Blaquière, Marine, Ayoub, Bronia, Mercier, Jacques, Perez-Martin, Antonia, Pomiès, Pascal, Hayot, Maurice
• Format: Article
• Language: English
• Subjects: Adaptation, Physiological; Aged; angiogenesis; Bicycling; Biopsy; Blood Pressure; Capillaries - physiopathology; Case-Control Studies; Chronic obstructive lung disease; comorbidity; Exercise Test; Exercise Therapy - adverse effects; Exercise Therapy - methods; Exercise Tolerance; Female; Forced Expiratory Volume; France; Human health and pathology; Humans; Hypertension; Hypertension - diagnosis; Hypertension - etiology; Hypertension - physiopathology; Life Sciences; Lung - physiopathology; Male; Medical research; Microcirculation; Middle Aged; Neovascularization, Physiologic; Original Research; Prospective Studies; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - therapy; pulmonary rehabilitation; Pulmonology and respiratory tract; Quadriceps Muscle - blood supply; Regional Blood Flow; Time Factors; Tissues and Organs; Treatment Outcome; Walking
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S113657

Targeting the early mechanisms in exercise-induced arterial hypertension (which precedes resting arterial hypertension in its natural history) may improve cardiovascular morbidity and mortality in COPD patients. Capillary rarefaction, an early event in COPD before vascular remodeling, is a potential mechanism of exercise-induced and resting arterial hypertension. Impaired training-induced capillarization was observed earlier in COPD patients; thus, this study compares the changes in blood pressure (BP) during exercise in COPD patients and matches control subjects (CSs) after a similar exercise training program, in relationship with muscle capillarization. Resting and maximal exercise diastolic pressure (DP) and systolic pressure (SP) were recorded during a standardized cardiopulmonary exercise test, and a quadriceps muscle biopsy was performed before and after training. A total of 35 CSs and 49 COPD patients (forced expiratory volume in 1 second =54%±22% predicted) completed a 6-week rehabilitation program and improved their symptom-limited maximal oxygen uptake (VO : 25.8±6.1 mL/kg per minute vs 27.9 mL/kg per minute and 17.0±4.7 mL/kg per minute vs 18.3 mL/kg per minute; both