Document Detail


Exercise-induced hypertension among healthy firefighters-a comparison between two different definitions.
MedLine Citation:
PMID:  23246464     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Different studies have yielded conflicting results regarding the association of hypertensive response to exercise and cardiovascular morbidity. We compared two different definitions of exaggerated hypertensive response to exercise and their association with cardio-respiratory fitness in a population of healthy firefighters. We examined blood pressure response to exercise in 720 normotensive male career firefighters. Fitness was measured as peak metabolic equivalent tasks (METs) achieved during maximal exercise treadmill tests. Abnormal hypertensive response was defined either as systolic blood pressure ≥ 200 mm Hg; or alternatively, as responses falling in the upper tertile of blood pressure change from rest to exertion, divided by the maximal workload achieved. Using the simple definition of a 200 mm Hg cutoff at peak exercise less fit individuals (METs ≤ 12) were protected from an exaggerated hypertensive response (OR 0.45, 95%CI 0.30-0.67). However, using the definition of exercise-induced hypertension that corrects for maximal workload, less fit firefighters had almost twice the risk (OR 1.8, 95%CI 1.3-2.47). Blood pressure change corrected for maximal workload is better correlated with cardiorespiratory fitness. Systolic blood pressure elevation during peak exercise likely represents an adaptive response, whereas elevation out of proportion to the maximal workload may indicate insufficient vasodilation and a maladaptive response. Prospective studies are needed to best define exaggerated blood pressure response to exercise.
Authors:
Adi Leiba; Dorothee M Baur; Stefanos N Kales
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2012-12-14
Journal Detail:
Title:  Journal of the American Society of Hypertension : JASH     Volume:  7     ISSN:  1878-7436     ISO Abbreviation:  J Am Soc Hypertens     Publication Date:    2013 Jan-Feb
Date Detail:
Created Date:  2013-01-16     Completed Date:  2013-07-09     Revised Date:  2013-09-23    
Medline Journal Info:
Nlm Unique ID:  101312518     Medline TA:  J Am Soc Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  40-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.
Affiliation:
The Cambridge Health Alliance, Harvard Medical School, Employee Health and Industrial Medicine, Cambridge, MA 02139, USA.
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MeSH Terms
Descriptor/Qualifier:
Adaptation, Physiological / physiology*
Adult
Blood Pressure / physiology
Exercise / physiology*
Exercise Test / standards*
Firefighters*
Humans
Hypertension / epidemiology,  etiology*,  physiopathology*
Logistic Models
Male
Middle Aged
Models, Biological
Physical Fitness / physiology
Reference Values
Risk Factors
Vasodilation / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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