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Exercise blood pressure predicts mortality from myocardial infarction
R Mundal1, S E Kjeldsen, L Sandvik
1Department of Internal Medicine, Central Hospital of Akershus, Norbyhagen, Norway.
Hypertension (Dallas, Tex. : 1979)
|March 1, 1996
Summary
Systolic blood pressure during exercise is a stronger predictor of myocardial infarction (MI) risk than resting blood pressure. Elevated exercise blood pressure in middle-aged men indicates a higher risk of MI morbidity and mortality.
Area of Science:
- Cardiology
- Preventive Medicine
- Exercise Physiology
Background:
- Casual blood pressure is a standard hypertension measure.
- Its predictive power for myocardial infarction (MI) may be limited.
- Exercise-induced blood pressure changes are less understood regarding cardiac risk.
Purpose of the Study:
- To determine if systolic blood pressure during exercise predicts MI morbidity and mortality.
- To compare the predictive value of exercise blood pressure versus casual blood pressure.
- To assess the prognostic information of exercise blood pressure in middle-aged men.
Main Methods:
- 1999 apparently healthy men (40-59 years) were studied (1972-1975).
- Systolic blood pressure was measured at rest and during bicycle ergometer exercise.
- Follow-up averaged 16 years, recording myocardial infarction events.
Main Results:
- Exercise systolic blood pressure strongly predicted MI morbidity and mortality.
- Men with casual BP < 140 mm Hg but exercise BP ≥ 200 mm Hg had higher MI risk (18.8% vs. 9.5%).
- Mortality from MI was significantly higher in those with elevated exercise BP (58% vs. 33%).
Conclusions:
- Exercise blood pressure is a superior predictor of MI morbidity and mortality compared to casual blood pressure.
- An early rise in systolic blood pressure during exercise provides additional prognostic information.
- Standardized exercise testing may help differentiate hypertension severity.