Reproducibility of exaggerated blood pressure response to exercise in healthy patients

Background An exaggerated blood pressure response (ExBPR) to exercise has b een shown to be predictive of future hypertension and left ventricular hype rtrophy. The aim of this study was to test the reproducibility over time of ExBPR and to better characterize patients who consistently respond in this manner. Methods During periodical health examination, patients underwent routine tr eadmill exercise resting. ExBPR was said to be present if systolic blood pr essure and/or diastolic blood pressure at peak exercise exceeded 200 mm Hg and 100 mm Hg, respectively. Over the past 25 years, 117 healthy patients w ith ExBPR performed 2 to 7 consecutive treadmill exercise tests. According to subsequent ExBPR, these patients were divided into a concordant group-th ose who had at least two-thirds repetitions of the ExBPR-and a discordant g roup-those who had less than two-thirds repetitions, For comparison, we ide ntified patients who did not have ExBPR (control group). Results Of the 117 patients who had ExBPR, only 18 (15.4%) were in the conc ordant group in subsequent tests. No clinical features were found to charac terize patients in the concordant group. In the two study groups, the varia bility of blood pressure measurements during stress was significantly great er than in the control group. Also, systolic blood pressure measurements at rest and after 3 minutes of recovery were significantly lower in the contr ol group. Conclusions ExBPR to exercise is rarely reproducible, and there are no clin ical findings characterizing those who consistently respond in this manner. Thus the prognostic importance of blood pressure response to exercise shou ld be reconsidered.