title: Exaggerated blood pressure response during exercise treadmill testing: functional and hemodynamic features, and risk factors.
abstract: The factors which contribute to an exaggerated blood pressure response (EBPR) during the exercise treadmill test (ETT) are not wholly understood. The association between the insertion/deletion polymorphisms of the angiotensin-converting enzyme (ACE) and M235T of the angiotensinogen with EBPR during ETT still remains unstudied. To identify and compare the risk factors for hypertension between normotensive subjects with EBPR and those who exhibit a normal curve of blood pressure (BP) during ETT. In a series of EBPR cases from a historical cohort of normotensive individuals, a univariate analysis was performed to estimate the association of the studied factors with BP behavior during ETT. Additionally, logistic multivariate regression was conducted to analyze the joint effects of the variables. P-values above 0.05 were considered statistically significant. From a total of 10,027 analyzed examinations, only 219 met the criteria employed to define EBPR, which resulted in a prevalence of 12.6%. For the systolic component of the BP, hyperreactive subjects displayed a mean age and body mass index (BMI) significantly higher than the others (P=0.002 and <0.001, respectively). No association was observed between the polymorphisms cited above and EBPR. An analysis of the joint effect of variables has indicated that only age (P< 0.001) and BMI (P=0.001) were specifically associated with systolic BP during exercise. Age and BMI were the only factors that independently influenced EBPR during ETT.
authors.affiliation: Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Recife, Brazil. sandrolima2002@gmail.com
authors.forename: Sandro G
authors.initials: SG
authors.lastname: de Lima
authors.forename: Maria de F P M
authors.initials: Mde F
authors.lastname: de Albuquerque
authors.forename: João R M
authors.initials: JR
authors.lastname: de Oliveira
authors.forename: Constância F J
authors.initials: CF
authors.lastname: Ayres
authors.forename: José E G
authors.initials: JE
authors.lastname: da Cunha
authors.forename: Danyllo F
authors.initials: DF
authors.lastname: de Oliveira
authors.forename: Roberta R
authors.initials: RR
authors.lastname: de Lemos
authors.forename: Manuela B R
authors.initials: MB
authors.lastname: de Souza
authors.forename: Odwaldo B
authors.initials: OB
authors.lastname: e Silva
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000808:Angiotensinogen / Q000235:genetics; D001794:Blood Pressure / Q000235:genetics / Q000502:physiology*; D015331:Cohort Studies; D005080:Exercise Test; D005260:Female; D056726:Genetic Association Studies; D006439:Hemodynamics / Q000235:genetics / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000235:genetics / Q000503:physiopathology; D054643:INDEL Mutation; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics; D011110:Polymorphism, Genetic; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000808:Angiotensinogen; C488034:ACE protein, human; D007703:Peptidyl-Dipeptidase A