(Hypertension. 1996;27:1059-1064.)
© 1996 American Heart Association, Inc.
Articles |
Anticipatory Blood Pressure Response to Exercise Predicts Future High Blood Pressure in Middle-aged Men
From the Human Population Laboratory, Western Consortium for Public Health (S.A.E., D.E.G.); the Human Population Laboratory, California Department of Health Services (G.A.K.), Berkeley, Calif; and the Research Institute of Public Health and Department of Community Health and General Practice, University of Kuopio (Finland) (J.T.S.).
Abstract Increases in blood pressure during the period of
emotional arousal attendant to impending exertion are well documented,
yet the etiologic significance of these elevations is unknown. Research
suggests that exaggerated cardiovascular responses to
psychological stress may be importantly related to hypertension. We
examined blood pressure reactivity in anticipation of an exercise
stress test in relation to future hypertension in the Kuopio
Ischemic Heart Disease Risk Factor Study, a
population-based study of middle-aged men from Eastern Finland.
Subjects were 508 unmedicated men with resting blood pressure less than
165/95 mm Hg who completed a bicycle ergometer stress test at baseline
and whose hypertensive status was assessed at 4 years of follow-up.
Systolic and diastolic reactivity were calculated
as the difference between blood pressure measured after seated rest on
the bicycle ergometer before initiation of exercise and mean seated
resting blood pressure measured 1 week earlier. Logistic regression
models adjusted for age and resting blood pressure revealed a graded
association between quartiles of reactivity and risk of subsequent
hypertension (
165/95 mm Hg), with men showing systolic
responses greater than or equal to 30 mm Hg or diastolic
responses greater than 15 mm Hg at nearly four times the risk of
becoming hypertensive (odds ratios, 3.80 [95% confidence interval,
1.90 to 7.63] and 3.65 [95% confidence interval, 1.86 to 7.17],
respectively) relative to the least-reactive groups
(systolic response, <10 mm Hg; diastolic
response, <5 mm Hg). Adjustments for traditional risk factors for
hypertension did not alter these associations. Results demonstrate the
clinical significance of the pressor response in anticipation of
exercise and support the hypothesis that cardiovascular
reactivity to psychological challenge plays a role in the etiology of
hypertension.
Key Words: cardiovascular system • hypertension • exercise • blood pressure • risk factors
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