title: Exercise blood pressure and the risk of future hypertension.
abstract: The aim of this prospective cohort study was to identify which blood pressure measurement during exercise is the best predictor of future hypertension. Further we aimed to create a risk chart to facilitate the evaluation of blood pressure reaction during exercise testing. A number (n=1047) of exercise tests by bicycle ergometry, performed in 1996 and 1997 were analysed. In 2007-2008, 606 patients without hypertension at the time of the exercise test were sent a questionnaire aimed to identify current hypertension. The response rate was 58% (n=352). During the 10-12 years between exercise test and questionnaire, 23% developed hypertension. The strongest predictors of future hypertension were systolic blood pressure (SBP) before exercise (odds ratios (OR) 1.63 (1.31-2.01) for 10 mm Hg difference) in combination with the increase of SBP over time during exercise testing (OR 1.12 (1.01-1.24) steeper increase for every 1 mm Hg min(-1)). A high SBP before exercise and a steep rise in SBP over time represented a higher risk of developing hypertension. A risk chart based on SBP before exercise, increase of SBP over time and body mass index was created. SBP before exercise, maximal SBP during exercise and SBP at 100 W were significant single predictors of future hypertension and the prediction by maximal SBP was improved by adjusting for time/power at which SBP max was reached during exercise testing. Recovery ratio (maximal SBP/SBP 4 min after exercise) was not predictive of future hypertension.
authors: Department of Emergency and Cardiovascular Medicine, Institute of Medicine, Sahlgrenska University Hospital/Ostra, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden. lina.holmqvist@vgregion.se
authors: L
authors: L
authors: Holmqvist
authors: L
authors: L
authors: Mortensen
authors: C
authors: C
authors: Kanckos
authors: C
authors: C
authors: Ljungman
authors: K
authors: K
authors: Mehlig
authors: K
authors: K
authors: Manhem
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D015331:Cohort Studies; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011336:Probability; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires