PEAK EXERCISE BLOOD-PRESSURE STRATIFIED BY AGE AND GENDER IN APPARENTLY HEALTHY-SUBJECTS

Objective: To determine the peak blood pressure responses during sympt om-limited exercise in a large sample of apparently healthy subjects, including both men and women over a wide range of ages. Design: We ret rospectively studied the blood pressure response during maximal treadm ill exercise testing with use of the Bruce protocol in apparently heal thy subjects. Material and Methods: Peak exercise blood pressures in 7 ,863 male and 2,406 female apparently healthy subjects who underwent a screening treadmill exercise test with the Bruce protocol between 198 8 and 1992 were analyzed by age and gender. Results: In this large ref erral population of apparently healthy subjects, peak exercise systoli c and diastolic blood pressures and delta systolic blood pressure (res t to peak exercise) were higher in men than in women and were positive ly associated with age. In men, the 90th percentile of systolic blood pressure increased from 210 mm Hg for the age decade 20 to 29 years to 234 mm Hg for ages 70 to 79 years; the corresponding increase among w omen was from 180 mm Hg to 220 mm Hg. Delta diastolic blood pressure a lso increased with advancing age. The difference in peak and delta sys tolic blood pressures between men and women seemed to decrease after a ge 40 to 49 years. Exercise hypotension, defined as peak exercise syst olic pressure less than rest systolic pressure, occurred in 0.23% of m en and 1.45% of women and was not significantly related to age. Conclu sion: Overall, peak exercise systolic and diastolic, as well as delta systolic, blood pressures were higher in men than in women and increas ed with advancing age. The reported data will enable clinicians to int erpret more accurately the significance of peak exercise blood pressur e response in a subject of a specific age and gender and will allow in vestigators to define exercise hypertension in statistical terms strat ified by age and gender.