title: Is hypertensive response in treadmill testing better identified with correction for working capacity? A study with clinical, echocardiographic and ambulatory blood pressure correlates.
abstract: Hypertensive response in treadmill testing is associated with the development of hypertension, but it is still unclear if it is better identified by systolic or diastolic response, and measured directly or corrected by working capacity. We investigated 75 patients with normal office blood pressure through a treadmill testing, ambulatory blood pressure (ABP) monitoring, and two-dimensional Doppler echocardiogram. Characteristics associated with systolic blood pressure (SBP) response corrected by the estimated metabolic equivalent (MET) were identified in multiple linear regression models. SBP response was associated more consistently with age, body mass index (BMI), systolic ABP and left ventricular posterior wall thickness (p < 0.001) than diastolic response in the bivariate analysis, especially when corrected by MET. Age, BMI and nightly SBP were independently associated with SBP response corrected by MET in the multivariate analysis. Individuals from the top tertile of SBP response corrected by MET (> or =11.3 mmHg/MET) were older and had higher BMI, ABP and left ventricular septal and posterior wall thickness than individuals classified in the lower tertiles. These differences were more pronounced than the differences observed between individuals with and without a peak exercise blood pressure higher than 210 mmHg. We concluded that individuals with a high blood pressure response in treadmill testing have higher BMI, left ventricular posterior wall thickness and SBP measured by ABP monitoring than individuals without such a response. These differences were stronger when the variation of blood pressure during exercise was corrected by the amount of work performed.
authors.affiliation: Division of Cardiology, Hospital de Clínicas de Porto Alegre, UFRGS, Brazil. ffuchs@hcpa.ufrgs.br
authors.forename: João Otavio
authors.initials: JO
authors.lastname: Zanettini
authors.forename: Flávio Danni
authors.initials: FD
authors.lastname: Fuchs
authors.forename: Marco Tulio
authors.initials: MT
authors.lastname: Zanettini
authors.forename: Jacira Pisani
authors.initials: JP
authors.lastname: Zanettini
mesh_terms: D000328:Adult; D000367:Age Factors; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D015150:Echocardiography, Doppler; D005080:Exercise Test / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013599:Systole