Systolic blood pressure response to exercise stress test and risk of stroke

Background and Purpose-Systolic blood pressure (SBP) during exercise has be en found to predict a future diagnosis of hypertension, coronary heart dise ase, and cardiovascular disease death. No studies have been conducted to sh ow a relationship between SBP during exercise test and stroke. The aim of t he present study was to study the associations between SBP rise, percent ma ximum SBP at 2 minutes after exercise, and the risk of stroke in a populati on-ba ed sample of men with no prior coronary heart disease. Methods-SBP was measured every 2 minutes during and after the exercise test . The subjects were a population-based sample of 1026 men without clinical coronary heart disease, antihypertensive medication, or prior stroke at bas eline. During an average follow-up of 10.4 years, there were 46 cases of st roke (38 ischemic strokes). Results-Men with SBP rise >19.7 mm Hg per minute of exercise duration had a 2.3-fold increased risk of any stroke and a 2.3-fold increased risk of isc hemic stroke compared with men whose SBP rise was <16.1 nim Hg/min. Similar ly, percent maximum SBP at 2 minutes after exercise (SBP at 2 minutes' reco very divided by maximum SBP) was associated (highest tertile) with a 4.6-fo ld increased risk of any stroke and a 5.2-fold increased risk of ischemic s troke. Conclusions-SBP rise during exercise and percent maximum SBP at 2 minutes a fter exercise were directly and independently associated with the risk of a ll stroke and ischemic stroke. Exercise SBP testing may be recommended as a n additional tool in the prediction of future stroke.