title: Exercise blood pressure and the risk for future hypertension among normotensive middle-aged adults.
abstract: BACKGROUND
  The aim of the present study was to examine whether exercise blood pressure can be used to predict the development of hypertension in normotensive middle-aged adults.
  
  
  RESULTS
  We investigated 7082 normotensive subjects who were annually screened in a tertiary medical center and completed maximal treadmill exercise tests at each visit. After the initial 3 years, subjects were divided into approximate quartiles according to their average exercise systolic and diastolic blood pressure responses (≤158; 158 to 170; 170 to 183; ≥183 mm Hg for systolic blood pressure and ≤73; 73 to 77; 77 to 82; ≥82 mm Hg for diastolic blood pressure). Mean age of the study population was 48 ± 9 years and 73% were men. Average baseline resting blood pressure was 120/77 ± 12/7 mm Hg. During a follow-up of 5 ± 3 years, 1036 (14.6%) subjects developed hypertension. The cumulative probability of new-onset hypertension at 5 years was significantly increased with increasing quartiles of exercise systolic blood pressure (5%, 9%, 17%, and 35%, respectively; P<0.001), with a similar association shown for diastolic blood pressure. After adjustment for baseline resting blood pressure and clinical parameters, each 5-mm Hg increments in exercise either systolic or diastolic blood pressures were independently associated with respective 11% (P<0.001) and 30% (P<0.001) increased risk for the development of hypertension.
  
  
  CONCLUSIONS
  In normotensive middle-aged individuals, blood pressure response to exercise is associated with future development of hypertension.
authors.affiliation: Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel (A.B., M.K., R.K., I.G., E.M.).
authors.forename: Assaf
authors.initials: A
authors.lastname: Berger
authors.affiliation: Department of Internal Medicine D, Chaim Sheba Medical Center, Ramat Gan, Israel (E.G.) Sackler School of Medicine, Tel-Aviv University, Israel (E.G., S.K., R.K., I.G., Y.S.).
authors.forename: Ehud
authors.initials: E
authors.lastname: Grossman
authors.affiliation: Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel (A.B., M.K., R.K., I.G., E.M.).
authors.forename: Moshe
authors.initials: M
authors.lastname: Katz
authors.affiliation: Department of Internal Medicine C, Chaim Sheba Medical Center, Ramat Gan, Israel (S.K., Y.S.) Sackler School of Medicine, Tel-Aviv University, Israel (E.G., S.K., R.K., I.G., Y.S.).
authors.forename: Shaye
authors.initials: S
authors.lastname: Kivity
authors.affiliation: Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel (A.B., M.K., R.K., I.G., E.M.) Sackler School of Medicine, Tel-Aviv University, Israel (E.G., S.K., R.K., I.G., Y.S.).
authors.forename: Robert
authors.initials: R
authors.lastname: Klempfner
authors.affiliation: Institute for Medical Screening, Chaim Sheba Medical Center, Ramat Gan, Israel (S.S.).
authors.forename: Shlomo
authors.initials: S
authors.lastname: Segev
authors.affiliation: Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel (A.B., M.K., R.K., I.G., E.M.) Sackler School of Medicine, Tel-Aviv University, Israel (E.G., S.K., R.K., I.G., Y.S.).
authors.forename: Ilan
authors.initials: I
authors.lastname: Goldenberg
authors.affiliation: Department of Internal Medicine C, Chaim Sheba Medical Center, Ramat Gan, Israel (S.K., Y.S.) Sackler School of Medicine, Tel-Aviv University, Israel (E.G., S.K., R.K., I.G., Y.S.).
authors.forename: Yehezkel
authors.initials: Y
authors.lastname: Sidi
authors.affiliation: Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel (A.B., M.K., R.K., I.G., E.M.) Pinchas Borenstein Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Ramat Gan, Israel (E.M.).
authors.forename: Elad
authors.initials: E
authors.lastname: Maor
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors
keywords: diastolic blood pressure; exercise; hypertension; systolic blood pressure