Document Detail


Exercise-induced hypertension, cardiovascular events, and mortality in patients undergoing exercise stress testing: a systematic review and meta-analysis.
MedLine Citation:
PMID:  23382486     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND The prognostic relevance of a hypertensive response to exercise (HRE) is ill-defined in individuals undergoing exercise stress testing. The study described here was intended to provide a systematic review and meta-analysis of published literature to determine the value of exercise-related blood pressure (BP) (independent of office BP) for predicting cardiovascular (CV) events and mortality. METHODS Online databases were searched for published longitudinal studies reporting exercise-related BP and CV events and mortality rates. RESULTS We identified for review 12 longitudinal studies with a total of 46,314 individuals without significant coronary artery disease, with total CV event and mortality rates recorded over a mean follow-up of 15.2±4.0 years. After adjustment for age, office BP, and CV risk factors, an HRE at moderate exercise intensity carried a 36% greater rate of CV events and mortality (95% CI, 1.02-1.83, P = 0.039) than that of subjects without an HRE. Additionally, each 10mm Hg increase in systolic BP during exercise at moderate intensity was accompanied by a 4% increase in CV events and mortality, independent of office BP, age, or CV risk factors (95% CI, 1.01-1.07, P = 0.02). Systolic BP at maximal workload was not significantly associated with the outcome of an increased rate of CV, whether analyzed as a categorical (HR=1.49, 95% CI, 0.90-2.46, P = 0.12) or a continuous (HR=1.01, 95% CI, 0.98-1.04, P = 0.53) variable. CONCLUSIONS An HRE at moderate exercise intensity during exercise stress testing is an independent risk factor for CV events and mortality. This highlights the need to determine underlying pathophysiological mechanisms of exercise-induced hypertension.
Authors:
Martin G Schultz; Petr Otahal; Verity J Cleland; Leigh Blizzard; Thomas H Marwick; James E Sharman
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Publication Detail:
Type:  Journal Article     Date:  2012-12-27
Journal Detail:
Title:  American journal of hypertension     Volume:  26     ISSN:  1941-7225     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  357-66     Citation Subset:  IM    
Affiliation:
Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia;
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