Exercise blood pressure response and 5-year risk of elevated blood pressure in a cohort of young adults: the CARDIA study.
Systolic blood pressure response to exercise has been shown to predict development of hypertension in men, but this association has not been examined in population-based samples of men, or in women or non-whites. This relationship was explored in 3741 normotensive black and white young adults undergoing treadmill testing in the CARDIA study and examined 5 years later for development of hypertension. Exaggerated response to exercise (systolic pressure > or = 210 mm Hg in men and > or = 190 mm Hg in women) was detected in 687 subjects (18%) at baseline, and incident hypertension (blood pressure > or = 140/90 mm Hg or on medication) was detected in 184 subjects (4.9%) at followup. Persons with exaggerated response to exercise at baseline had 5 mm Hg higher systolic and 1 mm Hg higher diastolic pressures at follow-up (P < .005) and were 1.70 times more likely to have developed hypertension than were persons with normal response (P < .001). After adjustment for age, race, sex, clinic, resting systolic pressure, body mass index, heavy activity score, exercise duration, and preexercise systolic pressure, exaggerated response was associated with a 2.14 mm Hg increase in year 5 systolic pressure (P < .0001). These associations did not differ by race or sex. Although the increment in systolic pressure associated with exaggerated exercise response was small (1 to 3 mm Hg), this small increment sustained over time could lead to a substantially increased incidence of hypertension and hypertension-related target organ damage. Determination of factors associated with exaggerated response may provide further insights into the development of hypertension in young adults.(ABSTRACT TRUNCATED AT 250 WORDS)
Manolio
T A
TA
Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, Bethesda, Maryland 20892.
Burke
G L
GL
Savage
P J
PJ
Sidney
S
S
Gardin
J M
JM
Oberman
A
A
D000293:Adolescent; D000328:Adult; D044383:Black People; D001794:Blood Pressure / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D044465:White People