Exercise blood pressure and the risk of future hypertension

Abstract

The aim of this prospective cohort study was to identify which blood pressure measurement during exercise is the best predictor of future hypertension. Further we aimed to create a risk chart to facilitate the evaluation of blood pressure reaction during exercise testing. A number (n ¼ 1047) of exercise tests by bicycle ergometry, performed in 1996 and 1997 were analysed. In 2007 --2008, 606 patients without hypertension at the time of the exercise test were sent a questionnaire aimed to identify current hypertension. The response rate was 58% (n ¼ 352). During the 10 --12 years between exercise test and questionnaire, 23% developed hypertension. The strongest predictors of future hypertension were systolic blood pressure (SBP) before exercise (odds ratios (OR) 1.63 (1.31 --2.01) for 10 mm Hg difference) in combination with the increase of SBP over time during exercise testing (OR 1.12 (1.01 --1.24) steeper increase for every 1 mm Hg min À1 ). A high SBP before exercise and a steep rise in SBP over time represented a higher risk of developing hypertension. A risk chart based on SBP before exercise, increase of SBP over time and body mass index was created. SBP before exercise, maximal SBP during exercise and SBP at 100 W were significant single predictors of future hypertension and the prediction by maximal SBP was improved by adjusting for time/ power at which SBP max was reached during exercise testing. Recovery ratio (maximal SBP/SBP 4 min after exercise) was not predictive of future hypertension.

Seven-Year Increase in Exercise Systolic Blood Pressure at Moderate Workload Predicts Long-Term Risk of Coronary Heart Disease and Mortality in Healthy Middle-Aged Men

“…[1][2][3][4][5] Exercise blood pressure (BP) may also predict future hypertension, potentially reveal masked hypertension, [6][7][8][9] and improve CV disease risk stratification. 4,[10][11][12][13][14] SBP measured at low or moderate exercise intensity seems to be more closely associated with future risk of CV disease and mortality than SBP measured at maximum effort.…”

Ocena przydatności testu Hand Grip we wczesnej profi laktyce nadciśnienia tętniczego wśród młodzieży szkół ponadgimnazjalnych w regionie południowo-wschodniej Polski — badanie przekrojowe

“…The results obtained so far have not been conclusive. They demonstrate both the lack of preventive meaning of blood pressure reaction to the tests used [4] and to positive correlations which confirm that an excessive BP increased during physical exertion allows to predict the development of arterial hypertension [2,3,11].…”

“…Among cases of HT within the group of higher risk are those characterized with hyperkinetic blood circulation [1]. As a reaction to stress, persons with hyperactive circulation system react with a substantial stimulation of the sympathetic system, which results in a rise of blood pressure (BP), which may lead to a constant HT [2]. The literature on the subject suggests that an increased, BP improper reaction to a stimulus, including physical exertion, is a sign of a propensity to the development of HT.…”

2013 Esh/Esc Guidelines for the Management of Arterial Hypertension

“…У жен-щин оно выражено несколько сильнее, чем у муж-чин, а у тренированных лиц -меньше, чем у не тре-нированных [123][124][125][126][127]. Большинство исследований (но не все) показали, что избыточное повышение АД во время физической нагрузки является предикто-ром развития АГ у нормотоников, независимо от значения АД в покое [123,124,128]. Однако про-водить пробы с физической нагрузкой для прогно-зирования будущего развития АГ не рекомендуется в связи с рядом ограничений, таких как отсутствие стандартизации методики и определений.…”