PEAK BLOOD PRESSURE RESPONSE TO EXERCISE IS ASSOCIATED WITH FUTURE HYPERTENSION

Early detection of hypertension has been shown to reduce morbidity and mortality in individuals afflicted with this disease. Longitudinal studies suggest that peak systolic blood pressure during maximal stress tests has the potential to predict new-onset hypertension (NOH). PURPOSE To determine if the peak blood pressure response to exercise in middle-adulthood is related to the subsequent development of NOH, independent of traditionally recognized cardiovascular disease risk factors. METHODS Data for peak systolic (PSBP) and diastolic (PDBP) blood pressure were collected in 50 men and 55 women (mean age, 37.8 ± 6.8; range, 25 to 50 years) from a subset of Fels Longitudinal Study participants. Pulse pressure (PP) was calculated as the difference between PSBP and PDBP. Incidence of NOH was determined at a follow-up visit 20 ± .5 years later. NOH was defined as measured SBP ± 140 mm Hg, measured DBP ± 90 mm Hg, report of physician diagnosed hypertension, or reported initiation of antihypertensive medication therapy. Separate regression analyses were used for each sex to determine if NOH was related to PSBP, PDBP, and PP independent of baseline age and BMI. PSBP and PDBP were further adjusted for PP at peak exercise. RESULTS After adjustment for age and BMI, men who were classified with NOH had a significantly higher PDBP and PP than those who remained normotensive (p ≤ 0.05). There were no significant effects for PSBP in men when adjusting for only age and BMI. When PP was examined as a covariate, men with NOH had higher PSBP then normotensive men, and significant effects for PDBP remained (p ≤ 0.05). There were no significant relationships between NOH and PSBP, PDBP, or PP in women even after adjustment for PP. CONCLUSION In men, exaggerated PDBP and PP response to exercise was predictive of NOH, suggesting that these measures may prove useful for pre-clinical identification of those at risk for future hypertension. Women may have other factors that affect NOH unaccounted for in this study. Supported by NIH Grant R01 HD12252