Exercise-induced hypertension among healthy firefighters-a comparison between two different definitions
Adi Leiba1, Dorothee M Baur, Stefanos N Kales
1The Cambridge Health Alliance, Harvard Medical School, Employee Health and Industrial Medicine, Cambridge, MA 02139, USA.
Journal of the American Society of Hypertension : JASH
|December 19, 2012
Summary
Defining exercise-induced hypertension is crucial. A definition accounting for workload better identifies less fit individuals at higher risk, suggesting a maladaptive response in firefighters.
Area of Science:
- Cardiology
- Exercise Physiology
- Occupational Health
Background:
- Conflicting results exist on the link between hypertensive response to exercise and cardiovascular issues.
- Cardiorespiratory fitness is a key factor in cardiovascular health.
- Firefighters represent a population with unique occupational physical demands.
Purpose of the Study:
- To compare two definitions of exaggerated hypertensive response to exercise.
- To assess the association between these definitions and cardiorespiratory fitness in firefighters.
- To determine which definition better reflects cardiovascular risk.
Main Methods:
- Examined blood pressure response during maximal exercise treadmill tests in 720 male firefighters.
- Measured cardiorespiratory fitness using peak metabolic equivalent tasks (METs).
- Defined abnormal hypertensive response using a simple systolic blood pressure cutoff (≥ 200 mm Hg) and a workload-corrected definition.
Main Results:
- A simple 200 mm Hg cutoff protected less fit individuals (METs ≤ 12) from an exaggerated response (OR 0.45).
- The workload-corrected definition indicated less fit firefighters had nearly double the risk (OR 1.8).
- Blood pressure change corrected for maximal workload correlated better with cardiorespiratory fitness.
Conclusions:
- The definition of exercise-induced hypertension significantly impacts risk assessment in relation to fitness.
- A workload-corrected definition appears more sensitive in identifying potentially maladaptive responses.
- Further prospective studies are needed to establish the optimal definition for predicting cardiovascular risk.
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