Exercise stress testing in blood pressure evaluation

The purpose of this study was: (1) to confirm exercise stress testing as a standard in the diagnosis of hypertension, (2) to clarify which measurements during exercise testing are most reliable, and (3) to refine the definition of normal blood pressure response during ergometric exercise testing. Blood pressure response during maximal ergometric exercise testing was observed in 183 persons with no history of hypertension, 176 persons with borderline blood pressure readings, and 60 established hypertensives. Men and women had significantly different blood pressure response to exercise (P less than 0.05). Comparison of blood pressures at 100-watts workload, at peak exercise, and 5-minutes postexercise provided significant information for distinguishing between normal, borderline, and established hypertensive persons (P less than 0.025-0.001). Comparing the slopes of pulse rate versus blood pressure linear regression curves was not helpful. Regression equations generated for predicting correct blood pressure classification improved classification accuracy (compared with random classification) by 44.9 percent in men and by 66.8 percent in women. The results showed that ergometric stress testing in blood pressure evaluation is a safe and reliable procedure for aiding in a more accurate diagnosis of hypertension.