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Exaggerated blood pressure response to early stages of exercise stress testing and presence of hypertension


Schultz, MG and Picone, DS and Nikolic, SB and Williams, AD and Sharman, JE, Exaggerated blood pressure response to early stages of exercise stress testing and presence of hypertension, Journal of Science and Medicine in Sport, 19, (12) pp. 1039-1042. ISSN 1440-2440 (2016) [Refereed Article]

Copyright Statement

Copyright 2016 Sports Medicine Australia

DOI: doi:10.1016/j.jsams.2016.04.004


OBJECTIVES: Exaggerated exercise blood pressure (EEBP) recorded during exercise testing at moderate-intensity is independently associated with cardiovascular mortality. It is hypothesized that EEBP may be indicative of underlying hypertension unnoticed by standard clinic (resting) BP measures (thus explaining increased mortality risk), but this has never been confirmed by association with hypertension defined using ambulatory BP monitoring, which was the aim of this study.

DESIGN: Cross-sectional study.

METHODS: 100 consecutive patients free from coronary artery disease (aged 569 years, 72% male) underwent clinically indicated exercise stress testing. Exercise BP was recorded at each stage of the Bruce protocol. Presence of hypertension was defined as 24-hour systolic BP ≥130mmHg or daytime systolic BP ≥135mmHg.

RESULTS: Exercise systolic BP at stage 1 and 2 of the test was significantly associated with the presence of hypertension (P <0.05), with the strongest association observed between stage 1 exercise systolic BP and 24-h systolic BP >130mmHg (AUC=0.752, 95% CI's 0.649-0.846, P <0.001). 79% of participants achieving systolic BP ≥150mmHg at stage 1 of the test were classified as having hypertension, with systolic BP >150mmHg predicting hypertension independently of age, sex and in-clinic hypertension status (OR=4.83, 95% CI's 1.62-14.39, P =0.005).

CONCLUSIONS: Irrespective of resting BP, systolic BP ≥150mmHg during early stages of the Bruce exercise stress test is associated with presence of hypertension. EEBP should be a warning signal to health/exercise professionals on the presence of hypertension and the need to provide follow up care to reduce cardiovascular risk.

Item Details

Item Type:Refereed Article
Keywords:Ambulatory, Cardiopulmonary, Cardiovascular risk, Systolic, Treadmill
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Schultz, MG (Dr Martin Schultz)
UTAS Author:Picone, DS (Dr Dean Picone)
UTAS Author:Nikolic, SB (Mrs Sonja Nikolic)
UTAS Author:Williams, AD (Associate Professor Andrew Williams)
UTAS Author:Sharman, JE (Professor James Sharman)
ID Code:114122
Year Published:2016
Web of Science® Times Cited:19
Deposited By:Menzies Institute for Medical Research
Deposited On:2017-02-07
Last Modified:2017-11-01

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