title: Usefulness of blood pressure rise prior to exercise stress testing to predict the risk of future hypertension in normotensive Korean men.
abstract: The aim of this study was to test the hypothesis that blood pressure (BP) increase before exercise stress testing is associated with the incidence of hypertension in a prospective study of 3,805 normotensive men without hypertension at baseline. Changes in BP were defined as the difference between seated BP at rest and BP measured immediately before exercise stress testing. Hypertension was defined as systolic and diastolic BP ≥ 140/90 mm Hg or hypertension diagnosed by a physician at the second examination. During 18,923 patient-years of follow-up, 371 new cases of hypertension developed (incidence rate 19.6 per 1,000 patient-years). Men with systolic BP changes >0 mm Hg and diastolic BP changes >7 mm Hg had 1.70 times (95% confidence interval [CI] 1.37 to 2.12) and 2.23 times (95% CI 1.76 to 2.82) increased relative risk for incident hypertension compared with men whose systolic BP changes were <0 mm Hg and diastolic BP changes were <7 mm Hg after adjustment for confounders. Men in the highest quartile of mean BP change (>10 mm Hg) had a higher incidence of hypertension (relative risk 2.98, 95% CI 2.19 to 4.06) compared with those in the lowest quartile (<0 mm Hg), and each 1 mm Hg increment in mean BP was associated with a 6% (95% CI 1.05 to 1.09) higher incidence of hypertension after adjustment for risk factors. In conclusion, BP increase before exercise stress testing is associated with incident hypertension, independent of risk factors in normotensive men. The assessment of BP immediately before exercise testing may be a useful addition to the standard exercise stress testing procedures.
authors.affiliation: Department of Sport Science, University of Seoul, Seoul, South Korea. Electronic address: syjae@uos.ac.kr.
authors.forename: Sae Young
authors.initials: SY
authors.lastname: Jae
authors.affiliation: Department of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
authors.forename: Sudhir
authors.initials: S
authors.lastname: Kurl
authors.affiliation: Department of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
authors.forename: Jari A
authors.initials: JA
authors.lastname: Laukkanen
authors.affiliation: Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Yoon-Ho
authors.initials: YH
authors.lastname: Choi
authors.affiliation: Department of Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Won Hah
authors.initials: WH
authors.lastname: Park
authors.affiliation: Department of Kinesiology and Nutrition, University of Illinois, Chicago, Illinois.
authors.forename: Kanokwan
authors.initials: K
authors.lastname: Bunsawat
authors.affiliation: Department of Exercise Science, Syracuse University, Syracuse, New York.
authors.forename: Kevin S
authors.initials: KS
authors.lastname: Heffernan
authors.affiliation: Department of Kinesiology and Nutrition, University of Illinois, Chicago, Illinois.
authors.forename: Bo
authors.initials: B
authors.lastname: Fernhall
authors.affiliation: Cardiology Division, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Seok-Min
authors.initials: SM
authors.lastname: Kang
authors.affiliation: Division of Cardiology, Cheil General Hospital, Kwandong University College of Medicine, Seoul, South Korea.
authors.forename: Jeong Bae
authors.initials: JB
authors.lastname: Park
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012016:Reference Values; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors