Exercise testing in juvenile borderline hypertension

Exercise testing has emerged as an important method for improved evaluation of the cardiovascular system. However, juvenile patients presenting resting borderline hypertension have not been extensively studied. Therefore, this study evaluated the response to exercise in this group of patients. Nine hundred men aged 16 to 29 years performed a multistage near-maximal exercise test. The control group consisted of 338 age- and weight-matched, asymptomatic, healthy, normotensive individuals. Mean physical working capacity (+/- SD) was 129 +/- 28 W (82 +/- 18% of the normal according to our standardization) in the hypertension group, and 153 +/- 29 W (102 +/- 18%) in the control group (P less than 0.001). Mean systolic blood pressures at termination of exercise were 181 +/- 25 and 164 +/- 25 mm Hg in the hypertensive and the control groups, respectively; the mean diastolic values at termination of exercise were 49 +/- 32 and 32 +/- 29 mm Hg, respectively. The magnitude of the changes in blood pressure from rest to near-maximal values was smaller in the borderline-hypertensive individuals demonstrate a clear hypertensive pattern of reaction to physical activity, thus emphasizing the importance of exercise testing as part of the routine workup of such patients. The relationship between borderline hypertension and the risk of myocardial events has been established, and early hygienic or even pharmacological measures are necessary.