Exercise systolic blood pressure variability is associated with increased risk for new-onset hypertension among normotensive adults.
Both resting blood pressure (BP) variability and exercise BP previously showed association with incident hypertension. The aim of the present study was to examine whether visit-to-visit variability in exercise systolic blood pressure (SBP) can predict the risk for new-onset hypertension among normotensive adults. We investigated 6546 normotensive men and women who were annually screened in a tertiary medical center and completed treadmill exercise tests at each visit. Based on the initial three baseline annual visits, long-term intervisit variability of exercise SBP among the three tests was measured using standard deviation (SD) and coefficient of variation for each participant. The rate of newly diagnosed hypertension was measured in different variability levels during 6 ± 3 years of follow-up. Multivariate analysis adjusted for various clinical factors, including resting BP, showed that each 5 mm Hg rise in the SD of exercise SBP resulted in a significant 5% increase in the risk for the development of future hypertension (P = .015). Subjects in the upper exercise SBP SD variability tertile had a 28% (P = .007) increased risk for hypertension during follow-up, as compared with those in the lowest tertile. Similar results were achieved for the assessment of coefficient of variation of exercise SBP. In conclusion, visit-to-visit variability in exercise SBP can predict the development of future hypertension among normotensive individuals.
Leviev Heart Center, The Chaim Sheba Medical Center, Ramat Gan, Israel. Electronic address: assaf.berger@gmail.com.
Assaf
A
Berger
Department of Internal Medicine D, The Chaim Sheba Medical Center, Ramat Gan, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Ehud
E
Grossman
Leviev Heart Center, The Chaim Sheba Medical Center, Ramat Gan, Israel.
Moshe
M
Katz
Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel; Department of Internal Medicine C, The Chaim Sheba Medical Center, Ramat Gan, Israel.
Shaye
S
Kivity
Leviev Heart Center, The Chaim Sheba Medical Center, Ramat Gan, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Robert
R
Klempfner
Institute for Medical Screening, The Chaim Sheba Medical Center, Ramat Gan, Israel.
Shlomo
S
Segev
Leviev Heart Center, The Chaim Sheba Medical Center, Ramat Gan, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Ilan
I
Goldenberg
Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel; Department of Internal Medicine C, The Chaim Sheba Medical Center, Ramat Gan, Israel.
Yehezkel
Y
Sidi
Leviev Heart Center, The Chaim Sheba Medical Center, Ramat Gan, Israel; Pinchas Borenstein Talpiot Medical Leadership Program, The Chaim Sheba Medical Center, Ramat Gan, Israel.
Elad
E
Maor
D000328:Adult; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods*; D000075222:Essential Hypertension / Q000175:diagnosis*; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
Exercise; hypertension; systolic blood pressure; variability