Prognostic significance of exercise versus resting blood pressure in patients with chronic heart failure.
BACKGROUND
Results on the prognostic value of exercise blood pressure differ among studies; this may be related to the characteristics of the studied population.


OBJECTIVE
To assess the prognostic significance of blood pressure measured during exercise in patients with chronic heart failure being considered for heart transplantation.


METHODS
Symptom-limited bicycle exercise testing with measurement of blood pressure and respiratory gas analysis was performed in 274 potential candidates for heart transplantation. They were then followed up for mortality and cardiovascular events.


RESULTS
Results are given as the mean +/- SD. The age of the patients was 51.5+/-11.0 years, the resting blood pressure was 114+/-20/75+/-12 mmHg, the peak work load was 91+/-33 W and the peak oxygen uptake was 15.1+/-5.0 ml/min per kg. The systolic blood pressure increased to 128+/-21 mmHg at 30 W and to 133+/-23 mmHg at 50% of the peak work load. During the total follow-up time of 513 years, 55 patients died and 145 suffered at least one cardiovascular event. After controlling for age, gender and body mass index, mortality and incidence of events were inversely related to the systolic pressure at 30 W or at 50% of the peak work load, or to both (P < 0.05). The inverse associations of outcome with the systolic pressure at 50% of the peak work load persisted after additional adjustment for resting pressure and for peak oxygen uptake.


CONCLUSIONS
The data indicate that a lower exercise systolic pressure, particularly at 50% of the peak work load, is associated with a higher mortality and a greater incidence of cardiovascular events.
Fagard
R
R
Department of Molecular and Cardiovascular Research, Faculty of Medicine, University of Leuven KULeuven, Belgium. robert.fagard@uz.kuleuven.ac.be
Pardaens
K
K
Vanhaecke
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002303:Cardiac Output, Low / Q000401:mortality / Q000503:physiopathology*; D002908:Chronic Disease; D015444:Exercise; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011379:Prognosis; D012146:Rest; D013599:Systole