[Prognostic significance of blood pressure during ergometry]

Evaluation of high blood pressure would be greatly facilitated by a standardized test procedure that could enable comparable and reproducible blood pressure determinations to be made. It would also be useful to have a standardized method for monitoring sympathetic activity, so that the occurrence and magnitude of inordinate stress responses could be assessed more accurately. One way to meet these requirements is through standardized ergometric testing at workloads of 50 to 100 watts using increments of 10 watts/min. or 25 watts/2 min. (cuff blood pressure measurements). Between the ages of 20 and 50 years the criteria for a hypertensive response during exercise are blood pressure values of more than 200/100 mmHg (mean + 1 SD of the normotensives) at a workload of 100 watts. In the recovery phase, blood pressure is considered as being hypertensive if a value of 140/90 mmHg ist exceeded in the fifth minute. There are several studies showing that the blood pressure response to ergometry predicts future hypertension in patients with normal resting blood pressure. Patients suffering from mild hypertension showed significantly higher blood pressures at 100 watts and after exercise than age-matched normotensives but significantly lower values than hypertensives with stable hypertension. Ergometric studies also assume a prognostic importance, with respect to prevention of acute and chronic complications of hypertension. Therefore we must require that antihypertensive drugs not only normalize the resting blood pressure, but also lower the blood pressure adequately in stressful situations.