Paediatric reference values for the work rate-indexed systolic blood pressure response during exercise

Nordlinder, Johanna Hall; Ekström, Magnus; Brudin, Lars; Elmberg, Viktor; Carlén, Anna; Hedman, Kristofer; Lindow, Thomas

doi:10.1093/eurjpc/zwac023

Cited by 6 publications

(4 citation statements)

References 11 publications

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“…Indexing the increase in SBP during exercise by the increase in work rate (yielding a slope) may be one such methodology, having the advantage that no additional measurements than those already obtained during a standard clinical exercise test are required. We recently published normative values for the SBP/Watt-slope [7,8], which remains to be studied in terms of prognostic capabilities, as previously done for the SBP/MET-slope [9]. Importantly, and as suggested by Mariampillai and colleagues, future studies on the SBP response to exercise and future adverse outcomes should be undertaken in both clinical referral samples as well as in population-based cohorts, and the results should not automatically be translated from one context to another.…”

Section: The Underlying Cardiovascular Function Plays a Keymentioning

confidence: 99%

Blood pressure during moderate or maximal exercise: hardly two sides of the same coin

Mariampillai

Kjeldsen

Gjesdal

et al. 2022

Journal of Hypertension

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Section: The Underlying Cardiovascular Function Plays a Keymentioning

confidence: 99%

Blood pressure during moderate or maximal exercise: hardly two sides of the same coin

Mariampillai

Kjeldsen

Gjesdal

et al. 2022

Journal of Hypertension

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“…Systolic blood pressure (SBP) should increase depending on the workload of the subject 22 , while diastolic should remain stable during the test. A recent study from Sweden suggests an increase in SBP of 36 mmHg per 100 Watt of workload in children 23 .…”

Section: Methodsmentioning

confidence: 97%

“…diastolic should remail stable during the test. A recent study from Sweden suggests an increase in SBP of 36 mmHg per 100 Watt of workload in children [23].…”

Section: Accepted Manuscriptmentioning

confidence: 97%

Practical Aspects of Cardiopulmonary Exercise Testing in Children

Takken,

Hulzebos

2023

Int J Sports Med

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The use of cardiopulmonary exercise testing (CPET) in pediatrics provides critical insights into potential physiological causes of unexplained exercise-related complaints or symptoms, as well as specific pathophysiological patterns based on physiological responses or abnormalities. Furthermore, CPET helps evaluate exercise performance in children with chronic (lung/heart) diseases. For instance, it can ascertain any adverse reaction to exercise and estimate the effects of specific treatment measures. It affords a global assessment of the pathophysiological patterns, responses and abnormalities to exercise that is inadequately reflected by resting lung function and/or cardiac function assessment. Clinical interpretation of the results of a CPET in pediatrics requires specific knowledge regarding pathophysiological responses and interpretative strategies that can be adapted to address concerns specific to the child’s medical condition or disability.

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“…The IET’s were performed for clinical reasons with the indication in most cases being suspect stable coronary syndrome (n=10,306), occupational risk evaluation (n=439), suspect arrhythmia (n=659) or determination of exercise capacity (n=562). This cohort has earlier been used as the basis for reference values for predicted normal peak power output (Wmax) (17) and exercise systolic blood pressure (18, 19), and breathlessness intensity response during IET (12).…”

Section: Study Design and Methodsmentioning

confidence: 99%

Abnormally high exertional breathlessness predicts mortality in people referred for incremental cycle exercise testing

Elmberg,

Zhou,

Lindow

et al. 2024

Preprint

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BackgroundExertional breathlessness is a key symptom in cardiorespiratory disease and can be quantified using incremental exercise testing (IET), but its prognostic significance is unknown.Research questionWe evaluated the ability of abnormally high breathlessness intensity during IET to predict all-cause, respiratory, and cardiac mortality.Study Design and MethodsLongitudinal cohort study of adults referred for cycle IET followed prospectively for mortality assessed using the Swedish National Causes of Death Registry. Abnormally high exertional breathlessness was defined as a breathlessness intensity response (Borg 0-10 scale) > the upper limit of normal (ULN) using published reference equations. Mortality was analyzed using multivariable Cox regression, unadjusted and adjusted for age, sex, and body mass index.ResultsOf the 13,506 people included (46% female, age 59±15 years), 2,867 (21%) had abnormally high breathlessness during IET. Over a median follow up of 8.0 years, 1,687 (12%) people died. No participant was lost to follow-up. Compared to those within normal predicted ranges, people with abnormally high exertional breathlessness had higher mortality from all causes (adjusted hazard ratio [aHR] 2.3, [95% confidence interval] 2.1-2.6), respiratory causes (aHR 5.2 [3.4-8.0]) and cardiac causes (aHR 3.0 [2.5-3.6]). Even among people with normal exercise capacity (defined as peak Watt ≥75% of predicted exercise capacity, n=10,284) those with abnormally high exertional breathlessness were at greater risk of all-cause mortality than people with exertional breathlessness within the normal predicted range (aHR 1.5 [1.2-1.8]).InterpretationAmong people referred for cycle IET, abnormally high exertional breathlessness, quantified using healthy reference values, independently predicted all-cause, respiratory and cardiac mortality.

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Paediatric reference values for the work rate-indexed systolic blood pressure response during exercise

Cited by 6 publications

References 11 publications

Blood pressure during moderate or maximal exercise: hardly two sides of the same coin

Blood pressure during moderate or maximal exercise: hardly two sides of the same coin

Practical Aspects of Cardiopulmonary Exercise Testing in Children

Abnormally high exertional breathlessness predicts mortality in people referred for incremental cycle exercise testing

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