High blood pressure response to stress ergometry could predict future hypertension.
BACKGROUND
Previous studies have shown that exaggerated blood pressure (BP) during exercise is a valid risk predictor for future hypertension in most men and women, yet the use of ergometry as a means of early detection of incipient hypertension still requires confirmation.


OBJECTIVE
To assess the clinical utility of exercise BP measurement for the evaluation of risk for developing new-onset hypertension.


METHODS
Thirty individuals with normal BP were enrolled in this study and were subsequently divided into two groups: 13 persons with in-exercise hypertension were compared with 17 matched persons who were normotensive during ergometry. Their blood pressure was monitored during follow-up of two years.


RESULTS
More individuals in the exercise-hypertensive group developed hypertension after one or two years than those normotensive during the exercise (respectively, one year: 3 vs.0, p=0.03, two years: 10 vs. 1, p<0.0001). Both the systolic and diastolic BPs significantly differed between the two groups. Eighty four percent of those with exaggerated BP (>or=210 mm Hg) during the treadmill exercise developed hypertension after 2 years. The sensitivity and specificity of in-exercise hypertension for predicting its 2 year occurrence were, respectively, 91% and 84%.


CONCLUSIONS
Even in the absence of hypertension, its development during stress ergometry could be considered a predictive marker for the future development of hypertension, and can be a potential tool for identifying normotensive individuals at high risk. These individuals should be followed up and their BP controlled for a long time.
Farah
Raymond
R
Department of Internal Medicine B, Ziv Medical Center, Safed, Israel. raymond.f@ziv.health.gov.il
Shurtz-Swirski
Revital
R
Nicola
Makhoul
M
D000328:Adult; D001794:Blood Pressure; D042241:Early Diagnosis; D016552:Ergometry; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D055815:Young Adult