Exercise blood pressure predicts cardiovascular mortality in middle-aged men.

Abstract

The outcome of 1999 apparently healthy men aged 40 to 59 years investigated from 1972 through 1975 was ascertained after 16 years to determine whether systolic blood pressure measured with subjects in the sitting position during a bicycle ergometer exercise test adds prognostic information on cardiovascular mortality beyond that of casual blood pressure measured after 5 minutes of supine rest. During a total follow-up of 31 984 patient years, 278 patients died, 150 from cardiovascular causes. Casual blood pressure and pulse pressure as well as peak exercise systolic blood pressure during 6 minutes on the starting workload of 600 kpm/min (approximately 100 W, 5880 J/min) were all related to cardiovascular mortality. The relative risk (RR) of dying from cardiovascular causes associated with an increment of 48.5 mm Hg (=2 SD) in systolic blood pressure at 600 kilopondmeter (kpm)/min was significant (RR=1.5, 95% confidence interval [CI] = 1.1-2.3, P=.O4O) even when adjusting for a large number of variables measured in the present study, including age, exercise capacity, smoking habits, and casual blood pressures. The influence of blood pressure at 600 kpm/min was so

Exercise blood pressure response is related to left ventricular mass

“…Thus, we cannot completely rule out the possibility of a true gender difference in the relation of LV mass with exercise BP. Other studies with negative results in men differed from our study in that BP change with the handgrip exercise that was used, 11 or the study was conducted in young men only. 12 There are some limitations to this study.…”

“…Although highly experienced observers measured exercise BP, its reproducibility has not been evaluated in this study. Previous studies 7,9,11 have also demonstrated the value of BP responses to submaximal exercise as a predictor of future hypertension. The present study was not specifically planned to examine submaximal BP at fixed or relative workloads, but evaluation of these responses as predictors of LV mass is worthy of future investigation.…”

“…4 An exaggerated BP response to exercise is a known marker for future hypertension [5][6][7][8] and increased mortality. [9][10][11] Since BP during exercise reflects cardiac load during a period of high demand for cardiac output, it may be a more sensitive predictor of LV mass than resting BP. Several studies have addressed the importance of BP responses to exercise in relation to LV mass.…”

Effect of moderate weight reduction on resting and exercise blood pressure in overweight subjects

“…However, exercise BP is of interest as systolic exercise BP was shown to predict end organ damage and cardiovascular mortality. [8][9] Results from resting BP cannot be generalized to exercise BP since physiological mechanisms of the two entities are dissimilar. 10 We, therefore, assessed the effect of a moderate weight reduction using dietary restriction on lowering exercise BP in a group of overweight volunteers.…”

Blood pressure determinants of left ventricular wall thickness and mass index in hypertension: comparing office, ambulatory and exercise blood pressures

“…36 We have previously reported that up to a third of treated hypertensives with 'controlled' OBP continue to exhibit uncontrolled levels of BP during a 3-min step test. 37 Indeed, the prognostic value of the submaximal ExSBP as a better predictor of cardiac death than OBP has been confirmed in a few large retrospective studies, [38][39][40] and a prospective study is currently on-going. 41 Furthermore, the ExSBP is a better marker than OBP in defining sustained hypertension 42 and we have also recently reported that apparently healthy hypertensives with a raised ExSBP had prolonged maximum heart rate corrected QT interval independent of LV mass.…”