Exercise BP response in subjects with high-normal BP - Exaggerated blood pressure response to exercise and risk of future hypertension in subjects with high-normal blood pressure
Exercise BP response in subjects with high-normal BP - Exaggerated blood pressure response to exercise and risk of future hypertension in subjects with high-normal blood pressure
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DOI：
10.1016/s0735-1097(00)00903-7
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发表时间：
2000-11-01
影响因子：
24
通讯作者：
Takeda, S
中科院分区：
文献类型：
--
作者：
Miyai, N;Arita, M;Takeda, S
本研究旨在评估运动时血压反应过度（EBPR）在预测高血压从高正常状态发展中的临床实用性。背景动态和等长运动时血压反应过度与将来高血压风险增加有关，虽然这些反应的重要性，关于识别个人与高-血压正常的人容易发展为高血压是未知的。方法研究人群包括239名血压正常值高的男性样本结果Kaplan-Meier生存分析显示，血压对运动反应的上四分位数的受试者在随访时高血压的累积发病率显著高于对照组（P < 0.05），而血压对运动反应的上四分位数的受试者在随访时高血压的累积发病率显著高于对照组（P < 0.05）。高于中二分位数和下四分位数（log-rank检验，p <0.05）。采用考克斯比例风险生存模型进行的多因素分析显示，在调整了一些传统的高血压危险因素后，EBPR与高血压的发生风险显著且独立相关（RR = 2.31，95%可信区间= 1.45 ~ 6.25）。结论：EBPR是高血压患者新发高血压的一个重要危险因素。因此，运动测试可以提供有效的信息，可以帮助识别具有正常高血压的个体，其未来患高血压的风险更大。(C)2000年，美国心脏病学会。
OBJECTIVES This study was designed to assess the clinical usefulness of an exaggerated blood pressure (BP) response to exercise (EBPR) in predicting the development of hypertension from a high-normal state.BACKGROUND Exaggerated BP response during both dynamic and isometric exercises are associated with increased risk of future hypertension, while the significance of these responses concerning the identification of individuals with high-normal BP who are prone to develop hypertension is unknown.METHODS The study population comprised a sample of 239 men with high-normal BP (aged 42.3 +/- 5.9 years) who underwent a symptom-limited bicycle ergometer exercise testing at baseline and then were followed for 5.1 years.RESULTS The Kaplan-Meier survival analysis showed that the subjects in the upper quartile of BP response to exercise had a significantly higher cumulative incidence of hypertension on follow-up than those in the middle two and lower quartiles (log-rank test, p < 0,05). Multivariate analysis using the Cox proportional hazards survival model showed that the EBPR was significantly and independently associated with the risk of developing hypertension after adjustment for some traditional risk factors for hypertension (RR = 2,31, 95% confidence interval = 1.45 to 6.25).CONCLUSIONS These findings suggest that an EBPR is an important risk factor for new-onset hypertension from a high-normal stale and, thus, exercise testing can provide valid information that may help identify individuals with high-normal BP at a greater risk of future hypertension. (C) 2000 by the American College of Cardiology.