title: Predictors for coronary artery disease in patients with paradoxical systolic blood pressure elevation during recovery after graded exercise.
abstract: The predictors for coronary artery disease (CAD) in patients with delayed systolic blood pressure (SBP) recovery after graded exercise are unclear. We studied 672 patients with preceding positive symptom-limited exercise treadmill testing (ETT) and underwent their first coronary angiography within 90 days to determine the high-risk profiles for angiographic CAD in patients with paradoxical SBP elevation (the SBP at 3-min of recovery was equal to or higher than that at 1-min of recovery). Among them, 356 patients were diagnosed as CAD, of which 173 were severe CAD. Among 208 patients with paradoxical SBP elevation, 158 (76%) were CAD, and 101 (48.6%) were severe CAD. Multivariate logistic regression analyses identified male gender and hyperlipidemia as positive predictors and maximal heart rate and exercise time as negative predictors for CAD or severe CAD. In conclusion, patients with both positive ETT for ischemia and paradoxical SBP elevation during recovery have a high prevalence of CAD and severe CAD. The high-risk patients for the presence of CAD or severe CAD were those of male, with hyperlipidemia, low achievable maximal heart rate, and short exercise time after graded exercise.
authors.forename: Jung-Cheng
authors.initials: JC
authors.lastname: Hsu
authors.forename: Pei-Song
authors.initials: PS
authors.lastname: Chu
authors.forename: Ta-Chen
authors.initials: TC
authors.lastname: Su
authors.forename: Lian-Yu
authors.initials: LY
authors.lastname: Lin
authors.forename: Wen-Jone
authors.initials: WJ
authors.lastname: Chen
authors.forename: Jing-Shiang
authors.initials: JS
authors.lastname: Hwang
authors.forename: Ming-Fong
authors.initials: MF
authors.lastname: Chen
authors.forename: Chiau-Suong
authors.initials: CS
authors.lastname: Liau
authors.forename: Yuan-Teh
authors.initials: YT
authors.lastname: Lee
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D003327:Coronary Disease / Q000175:diagnosis* / Q000503:physiopathology*; D005080:Exercise Test; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013599:Systole