Hypertension, Vol 24, 56-62, Copyright © 1994 by American Heart Association
R Mundal, SE Kjeldsen, L Sandvik, G Erikssen, E Thaulow and J Erikssen
The outcome of 1999 apparently healthy men aged 40 to 59 years investigated
from 1972 through 1975 was ascertained after 16 years to determine whether
systolic blood pressure measured with subjects in the sitting position
during a bicycle ergometer exercise test adds prognostic information on
cardiovascular mortality beyond that of casual blood pressure measured
after 5 minutes of supine rest. During a total follow-up of 31,984 patient
years, 278 patients died, 150 from cardiovascular causes. Casual blood
pressure and pulse pressure as well as peak exercise systolic blood
pressure during 6 minutes on the starting workload of 600 kpm/min
(approximately 100 W, 5880 J/min) were all related to cardiovascular
mortality. The relative risk (RR) of dying from cardiovascular causes
associated with an increment of 48.5 mmHg (= 2 SD) in systolic blood
pressure at 600 kilopondmeter (kpm)/min was significant (RR = 1.5, 95%
confidence interval [CI] = 1.1-2.3, P = .040) even when adjusting for a
large number of variables measured in the present study, including age,
exercise capacity, smoking habits, and casual blood pressures. The
influence of blood pressure at 600 kpm/min was so strong that the
predictive value of resting casual blood pressures became nonsignificant
when these were analyzed as continuous variables also including exercise
blood pressure as a covariate. However, the maximal systolic blood pressure
during the exercise test was unrelated to cardiovascular
mortality.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Exercise blood pressure predicts cardiovascular mortality in middle- aged men
Department of Internal Medicine, Central Hospital of Akershus, Nordbyhagen, Norway.
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