Utility of blood pressure measured during an exercise as a risk factor for new-onset hypertension

Introduction: An exaggerated response of blood pressure (BP) relative to the increase in heart rate during exercise is a marker of risk for developing hypertension in the future. However, the exact methodology used in the exercise test to define an exaggerated response of BP remains controversial. The aim of this study was to compare two methods for defining exaggerated BP during exercise and their potential to predict high BP in the long term follow-up. Method: Data from 160 exercise tests performed 20 years ago was retrospectively analyzed including two subgroups: group A: BP measurement performed during the stages of the exercise (110 tests), group B: measurement of BP performed during the 1st minute of recovery (50 tests). Exaggerated BP was defined according to the percentile 90th of Miyai's criteria. Follow-up was obtained by telephone interview in all subjects completing a follow-up 20 years (1992-2012). Hypertension was defined by the diagnosis of their treating physician or by antihypertensive therapy. Results: Mean age was 28±11 years, 72% were male. According to Miyai's criteria, 31 (%) patients and 1 (%) in group A and B respectively, presented an exaggerated BP during exercise. After 20 years, 21 (18%) and 8 (16%) had hypertension respectively in each group. ROC curves for prediction of hypertension in the long-term according to the finding of an exaggerated BP during exercise in each group are shown. ![Figure][1] Conclusions: These results indicate that Miyai's criteria to define an exaggerated BP during exercise that could predict long term development of hypertension is useful, provided BP measurement is adequately measured at different stages of the exercise test. [1]: pending:yes