Abstract
A decrease in diastolic blood pressure (DBP) with exercise is considered normal, but the significance of an increase in DBP has not been validated. Our aim was to determine the relationship of DBP increasing on a stress test regarding comorbidities and mortality. Our database was reviewed from 1993 to 2010 using the first stress test of a patient. Non-Minnesota residence, baseline cardiovascular (CV) disease, rest DBP <60 or >100 mm Hg, and age <30 or ≥80 were exclusion criteria. DBP response was classified: normal if peak DBP-rest DBP < 0, borderline 0-9, and abnormal ≥10 mm Hg. Mortality was determined from Mayo Clinic records and Minnesota Death Index. Logistic regression was used to determine the relationship of DBP response to the presence of comorbidities. Cox regression was used to determine total and CV mortality risk by DBP response. All analyses were adjusted for age, sex, and resting DBP. Twenty thousand seven hundred sixty patients were included (51 ± 11 years, female n = 7,314). Rest/peak averaged DBP 82 ± 8/69 ± 15 mm Hg in normal vs. 79 ± 9/82 ± 9 mm Hg in borderline vs. 76 ± 9/92 ± 11 mm Hg in abnormal DBP response. There were 1,582 deaths (8%) with 557 (3%) CV deaths over 12 ± 5 years of follow-up. In patients ...Continue Reading
References
Jan 1, 1977·Circulation·R A WolthuisJ H Triebwasser
Sep 1, 1992·Hypertension·J FilipovskýM E Safar
Feb 1, 1992·Annals of Internal Medicine·M S LauerJ F Plehn
Apr 1, 1974·The American Journal of Cardiology·R A BruceD R Peterson
Mar 1, 1994·American Journal of Hypertension·T A ManolioA Oberman
May 1, 1996·Mayo Clinic Proceedings·H DaidaG T Gau
Oct 28, 1999·The New England Journal of Medicine·C R ColeM S Lauer
Aug 3, 2001·European Heart Journal·D MasudaS Sasayama
Mar 15, 2002·The New England Journal of Medicine·Jonathan MyersJ Edwin Atwood
Oct 3, 2002·Circulation·Raymond J GibbonsUNKNOWN American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Ex
Oct 24, 2002·Journal of the American College of Cardiology·Raymond J GibbonsUNKNOWN American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Committee to Update the 1997 Ex
Oct 8, 2005·American Heart Journal·Hiroyuki YamagishiJunichi Yoshikawa
Jun 14, 2006·Hypertension·Bruce AlpertRichard Williams
Oct 5, 2006·JAMA : the Journal of the American Medical Association·Domenico CorradoGaetano Thiene
Nov 8, 2006·Circulation·Paul Kligfield, Michael S Lauer
May 11, 2012·Circulation·George ThanassoulisRamachandran S Vasan
Feb 6, 2013·American Journal of Hypertension·Martin G SchultzJames E Sharman
Jul 3, 2013·Journal of Science and Medicine in Sport·Maya J LambiaseJames N Roemmich
Mar 26, 2014·Journal of the American Heart Association·Abhijeet DhobleStephen L Kopecky
Oct 1, 2014·Progress in Cardiovascular Diseases·Jonathan MyersPeter Kokkinos
Dec 3, 2014·Mayo Clinic Proceedings·Nóra SydóThomas G Allison
Apr 24, 2015·Journal of the American Heart Association·Assaf BergerElad Maor
Aug 10, 2017·European Journal of Preventive Cardiology·Christina ChrysohoouDimitris Tousoulis
Oct 20, 2017·Current Hypertension Reports·Martin G SchultzJames E Sharman
Citations
Apr 20, 2021·Hypertension·Yazan AssafThomas G Allison
Jun 7, 2021·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Florian EggerFelix Mahfoud
Nov 26, 2021·High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension·Alessandro BiffiMassimo Volpe