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Decrease in systolic blood pressure during exercise testing: reproducibility, response to coronary bypass surgery and

D A Weiner, C H McCabe, S S Cutler

    The American Journal of Cardiology
    |May 1, 1982
    PubMed
    Summary
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    An exercise-induced drop in systolic blood pressure is a reproducible finding in cardiac patients. Coronary bypass surgery appears to reverse this abnormal exercise response.

    Area of Science:

    • Cardiology
    • Exercise Physiology

    Background:

    • An exercise-induced decrease in systolic blood pressure is an abnormal finding during treadmill testing.
    • This phenomenon's prevalence and prognostic significance require further investigation.

    Purpose of the Study:

    • To assess the reproducibility of exercise-induced systolic blood pressure decrease.
    • To determine the prognostic value of this finding.
    • To evaluate the effect of coronary bypass surgery on this response.

    Main Methods:

    • Retrospective analysis of 436 patients undergoing treadmill exercise testing and cardiac catheterization.
    • Identification of 47 patients with exercise-induced systolic blood pressure reduction.
    • Comparison of outcomes between medically treated and surgically treated groups (coronary bypass).

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    Main Results:

    • The exercise-induced systolic blood pressure decrease was observed in 11% of all patients, and 21% of those with severe coronary artery disease.
    • Patients with this finding were more likely male, had typical angina, and prior myocardial infarction.
    • The decrease was consistently present in the medically treated group but absent after coronary bypass surgery.
    • Coronary bypass surgery led to significant improvements in exercise capacity.

    Conclusions:

    • Exercise-induced systolic blood pressure decrease is a highly reproducible indicator.
    • Coronary bypass surgery can reverse this abnormal exercise response.
    • This finding may hold prognostic significance in patients with coronary artery disease.