title: Submaximal Exercise Systolic Blood Pressure and Heart Rate at 20 Years of Follow-up: Correlates in the Framingham Heart Study.
abstract: Beyond their resting values, exercise responses in blood pressure (BP) and heart rate (HR) may add prognostic information for cardiovascular disease (CVD). In cross-sectional studies, exercise BP and HR responses correlate with CVD risk factors; however, it is unclear which factors influence longitudinal changes in exercise responses over time, which is important for our understanding of the development of CVD.
  
  
  
  We assessed BP and HR responses to low-level exercise tests (6-minute Bruce protocol) in 1231 Framingham Offspring participants (55% women) who underwent a routine treadmill test in 1979-1983 (baseline; mean age 39±8 years) that was repeated in 1998-2001 (follow-up; mean age 58±8 years). Adjusting for baseline exercise responses, we related the follow-up exercise responses to baseline CVD risk factors and to their changes between examinations. Compared with men, women had greater rise in exercise systolic (S)BP and HR at 20-year follow-up (both P<0.005). Baseline blood lipid levels, resting SBP and HR, and smoking status were associated with greater exercise SBP at follow-up (all P<0.05). Weight gain across examinations was associated with higher exercise SBP and HR at follow-up (both P<0.0001). Smoking cessation was associated with a 53% reduced risk of attaining the highest quartile of exercise SBP (≥180 mm Hg) at follow-up (P<0.05).
  
  
  
  An adverse CVD risk factor profile in young adults and its worsening over time were associated with higher SBP and HR responses to low-level exercise in midlife. Maintaining or adopting a healthy risk factor profile may favorably impact the exercise responses over time.
authors.affiliation: Sections of Preventative Medicine and Epidemiology, and Cardiology, Department of Medicine, Boston University School of Medicine, Boston, MA The Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA spartano@bu.edu.
authors.forename: Nicole L
authors.initials: NL
authors.lastname: Spartano
authors.affiliation: Framingham Heart Study, Framingham, MA Department of Mathematics and Statistics, Boston University, Boston, MA.
authors.forename: Asya
authors.initials: A
authors.lastname: Lyass
authors.affiliation: Framingham Heart Study, Framingham, MA Department of Mathematics and Statistics, Boston University, Boston, MA Department of Biostatistics, Boston University School of Public Health, Boston, MA.
authors.forename: Martin G
authors.initials: MG
authors.lastname: Larson
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Cambridge, MA Pulmonary and Critical Care Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA Broad Institute of MIT and Harvard, Cambridge, MA.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Lewis
authors.affiliation: Sections of Preventative Medicine and Epidemiology, and Cardiology, Department of Medicine, Boston University School of Medicine, Boston, MA Framingham Heart Study, Framingham, MA Department of Epidemiology, Boston University School of Public Health, Boston, MA.
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000503:physiopathology; D004812:Epidemiologic Methods; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D000070497:Healthy Lifestyle / Q000502:physiology; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012727:Sex Characteristics; D016540:Smoking Cessation; D015430:Weight Gain / Q000502:physiology
keywords: aging; blood pressure; epidemiology; exercise; heart rate; risk factors