The aim of the present study was to examine whether exercise blood pressure can be used to predict the development of hypertension in normotensive middle-aged adults.
We investigated 7,082 normotensive subjects who were annually screened in a tertiary medical center and completed maximal treadmill exercise tests at each visit. After the initial 3 years, subjects were divided into approximate quartiles according to their average exercise systolic and diastolic blood pressure responses (≤158; 158-170; 170-183; ≥183 mmHg for systolic blood pressure and ≤73; 73-77; 77-82; ≥82 mmHg for diastolic blood pressure).
Mean age of the study population was 48 ± 9 years and 73% were men. Average baseline resting blood pressure was 120/77±12/7 mmHg. During a follow-up of 5±3 years, 971 (13.7%) subjects developed hypertension. The cumulative probability of new onset hypertension at 5 years was significantly increased with increasing quartiles of exercise systolic blood pressure (5%, 9%, 17%, and 35%, respectively; p<0.001), with a similar association shown for diastolic blood pressure. After adjustment for baseline resting blood pressure and clinical parameters, each 5 mmHg increments in exercise systolic and diastolic blood pressures were independently associated with respective 11% (p<0.001) and 30% (p<0.001) increased likelihood for the development of hypertension
In normotensive middle age individuals, blood pressure response to exercise is associated with future development of hypertension.
