CLUSTERING OF CORONARY RISK-FACTORS WITH INCREASING BLOOD-PRESSURE ATREST AND DURING EXERCISE

Background The metabolic cardiovascular syndrome is the label given to the clustering of unfavourable levels of a number of coronary risk fa ctors in subjects with high resting blood pressures. We found recently that exercise blood pressure had a strong independent prognostic valu e. Objective To search for possible similar associations between exerc ise blood pressure levels and coronary risk factors by studying conven tional and recently acknowledged coronary risk factors. Methods The st udy population comprised 1999 healthy men aged 40-59 years. Age-adjust ed coronary risk factor levels and their relation to resting and exerc ise blood pressures were studied. Resting blood pressure was measured after subjects had rested supine for 5 min. The exercise blood pressur e used was the systolic blood pressure measured with the subject sitti ng on a bicycle ergometer at the end of a work load of 600 kpm/min (10 0 W) for 6 min. Results Besides corroborating the relation between the metabolic syndrome and resting blood pressure levels, we observed sim ilar or even stronger associations between levels of various coronary risk factors and exercise blood pressure. We found rather strong, dire ct associations between exercise blood pressure and total cholesterol level, fasting triglyceride level and body mass index whereas inverse relations were found for glucose tolerance, physical fitness, pulmonar y functioning and the ability to increase heart rate during exercise. Virtually all these associations had a level of statistical significan ce of P < 0.001. Conclusions High exercise blood pressure levels are s trongly associated with unfavourable levels of a number of important c oronary risk factors. A similar metabolic syndrome to that observed in subjects with high resting blood pressures therefore appears to be pr esent in subjects with high exercise blood pressure responses. These a ssociations may considerably amplify the independent risk of high bloo d pressure responses to moderate exercise. (C) 1998 Rapid Science Ltd.