The significance of hypertensive response to exercise as a predictor of hypertension and cardiovascular disease

Several studies have shown that exaggerated blood pressure (BP) response to exercise can predict the development of hypertension and target organ dama ge, but others did not. The aim of this study was to evaluate the relations hip between exaggerated BP response to exercise (ExBPR) and the development of hypertension or cardiovascular disease. We reviewed the charts of male subjects who, during the years 1991-1994, had a routine check up that inclu ded an exercise stress-test. For each subject, the following parameters wer e noted: age; body mass index (BMI); history of diabetes; cigarette smoking ; family history of ischaemic heart disease and lipid profile. BP and heart rate at rest and during exercise were recorded as well, ExBPR was defined whenever peak exercise systolic BP or diastolic BP was over 200 mm Hg or 10 0 mm Hg respectively. We identified 73 males who exhibited ExBPR and matche d them with a control group of 117 subjects with similar age who had a norm al BP response, The mean age of the studied group was 42.6 years and the av erage follow-up was 5.7 years, Baseline characteristics were similar in bot h groups. During the follow-up we observed hypertension among 22% in those with ExBPR in contrast to 2.6% in the control group (P < 0.0001). In additi on, more subjects of the ExBPR group required cardiovascular medications th an of those in the control group (19.2% vs 4.3%, P = 0.0008), Thus, it seem s that ExBPR predicts the development of hypertension and cardiovascular di seases. We therefore suggest that subjects with ExBPR should be followed mo re closely and be instructed for lifestyle modifications which may delay th e development of such diseases.