Hypertension, Vol 20, 333-339, Copyright © 1992 by American Heart Association
J Filipovsky, P Ducimetiere and ME Safar
Systolic blood pressure and heart rate measured at rest and during a
standardized exercise test were analyzed in the cohort of middle-aged male
employees followed-up an average of 17 years in the Paris Prospective Study
I. The population sample selected for the analysis included 4,907 men who
completed at least 5 minutes of bicycle ergometry, who had no heart disease
at entry, and whose resting blood pressure was less than or equal to
180/105 mm Hg. Exercise-induced increase in systolic blood pressure was
positively correlated with resting systolic blood pressure (r = 0.104, p
less than 0.0001), whereas the correlation of exercise-induced heart rate
increase with resting heart rate was negative (r = -0.169, p less than
0.001). Using Cox regression analysis with the inclusion of resting
systolic blood pressure and heart rate; exercise-induced elevations of
systolic blood pressure and heart rate; and controlling for age, smoking,
total cholesterol, body mass index, electrical left ventricular
hypertrophy, and sports activities, cardiovascular mortality was found to
be associated with the systolic blood pressure increase (p less than 0.05),
whereas no association with resting systolic blood pressure was found.
Total mortality was predicted by resting systolic blood pressure and its
elevation (p less than 0.01 for both) and by resting heart rate (p less
than 0.0001). The heart rate increase did not contribute to death
prediction. In conclusion, the magnitude of the exercise-induced increase
of systolic blood pressure, but not of heart rate, may represent a risk
factor for death from cardiovascular as well as noncardiovascular causes,
independently of resting blood pressure and heart rate.
ARTICLES
Prognostic significance of exercise blood pressure and heart rate in middle-aged men
INSERM U258, Paris, France.
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