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Exercise Systolic Blood Pressure Response During Cycle Ergometry is Associated with Future Hypertension in Normotensive Individuals

Carlén, Anna ; Åkesson Lindow, Thomas LU ; Cauwenberghs, Nicholas ; Elmberg, Viktor LU orcid ; Brudin, Lars ; Ekström, Magnus LU orcid and Hedman, Kristofer (2024) In European Journal of Preventive Cardiology p.1-8
Abstract
Aims
We aimed to investigate the association between the exercise systolic blood pressure (SBP) response and future hypertension (HTN) in normotensive individuals referred for cycle ergometry, with special regard to reference exercise SBP values and exercise capacity.

Methods and results
In this longitudinal cohort study, data from 14 428 exercise tests were cross-linked with Swedish national registries on diagnoses and medications. We excluded individuals with a baseline diagnosis of cardiovascular disease or HTN. The peak exercise SBP (SBPpeak) was recorded and compared with the upper limit of normal (ULN) derived from SBPpeak reference equations incorporating age, sex, resting SBP, and exercise capacity. To evaluate the... (More)
Aims
We aimed to investigate the association between the exercise systolic blood pressure (SBP) response and future hypertension (HTN) in normotensive individuals referred for cycle ergometry, with special regard to reference exercise SBP values and exercise capacity.

Methods and results
In this longitudinal cohort study, data from 14 428 exercise tests were cross-linked with Swedish national registries on diagnoses and medications. We excluded individuals with a baseline diagnosis of cardiovascular disease or HTN. The peak exercise SBP (SBPpeak) was recorded and compared with the upper limit of normal (ULN) derived from SBPpeak reference equations incorporating age, sex, resting SBP, and exercise capacity. To evaluate the impact of exercise capacity, three SBP to work rate slopes (SBP/W-slopes) were calculated, relative to either supine or seated SBP at rest or to the first exercise SBP. Adjusted hazard ratios [HRadjusted (95% confidence interval, CI)] for incident HTN during follow-up, in relation to SBP response metrics, were calculated. We included 3895 normotensive individuals (49 ± 14 years, 45% females) with maximal cycle ergometer tests. During follow-up (median 7.5 years), 22% developed HTN. Higher SBPpeak and SBPpeak > ULN were associated with incident HTN [HRadjusted 1.19 (1.14–1.23) per 10 mmHg, and 1.95 (1.54–2.47), respectively]. All three SBP/W-slopes were positively associated with incident HTN, particularly the SBP/W-slope calculated as supine-to-peak SBP [HRadjusted 1.25 (1.19–1.31) per 1 mmHg/10 W].

Conclusion
Both SBPpeak > ULN based on reference values and high SBP/W-slopes were associated with incident HTN in normotensive individuals and should be considered in the evaluation of the cycle ergometry SBP response. (Less)
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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
European Journal of Preventive Cardiology
pages
1 - 8
publisher
Oxford University Press
external identifiers
  • pmid:38204381
ISSN
2047-4881
DOI
10.1093/eurjpc/zwae012
language
English
LU publication?
yes
id
6fab7d9b-b919-4aab-b81c-b0d167ae0505
date added to LUP
2024-04-16 22:47:46
date last changed
2024-04-17 08:43:37
@article{6fab7d9b-b919-4aab-b81c-b0d167ae0505,
  abstract     = {{Aims<br/>We aimed to investigate the association between the exercise systolic blood pressure (SBP) response and future hypertension (HTN) in normotensive individuals referred for cycle ergometry, with special regard to reference exercise SBP values and exercise capacity.<br/><br/>Methods and results<br/>In this longitudinal cohort study, data from 14 428 exercise tests were cross-linked with Swedish national registries on diagnoses and medications. We excluded individuals with a baseline diagnosis of cardiovascular disease or HTN. The peak exercise SBP (SBPpeak) was recorded and compared with the upper limit of normal (ULN) derived from SBPpeak reference equations incorporating age, sex, resting SBP, and exercise capacity. To evaluate the impact of exercise capacity, three SBP to work rate slopes (SBP/W-slopes) were calculated, relative to either supine or seated SBP at rest or to the first exercise SBP. Adjusted hazard ratios [HRadjusted (95% confidence interval, CI)] for incident HTN during follow-up, in relation to SBP response metrics, were calculated. We included 3895 normotensive individuals (49 ± 14 years, 45% females) with maximal cycle ergometer tests. During follow-up (median 7.5 years), 22% developed HTN. Higher SBPpeak and SBPpeak &gt; ULN were associated with incident HTN [HRadjusted 1.19 (1.14–1.23) per 10 mmHg, and 1.95 (1.54–2.47), respectively]. All three SBP/W-slopes were positively associated with incident HTN, particularly the SBP/W-slope calculated as supine-to-peak SBP [HRadjusted 1.25 (1.19–1.31) per 1 mmHg/10 W].<br/><br/>Conclusion<br/>Both SBPpeak &gt; ULN based on reference values and high SBP/W-slopes were associated with incident HTN in normotensive individuals and should be considered in the evaluation of the cycle ergometry SBP response.}},
  author       = {{Carlén, Anna and Åkesson Lindow, Thomas and Cauwenberghs, Nicholas and Elmberg, Viktor and Brudin, Lars and Ekström, Magnus and Hedman, Kristofer}},
  issn         = {{2047-4881}},
  language     = {{eng}},
  month        = {{01}},
  pages        = {{1--8}},
  publisher    = {{Oxford University Press}},
  series       = {{European Journal of Preventive Cardiology}},
  title        = {{Exercise Systolic Blood Pressure Response During Cycle Ergometry is Associated with Future Hypertension in Normotensive Individuals}},
  url          = {{http://dx.doi.org/10.1093/eurjpc/zwae012}},
  doi          = {{10.1093/eurjpc/zwae012}},
  year         = {{2024}},
}