Faculty Collaboration Database

Can blood pressure responses to tests unmask future blood pressure trends and the need for antihypertensive medication? Ten years of follow-up. Clin Physiol Funct Imaging 2002 Mar;22(2):125-33

Date

05/15/2002

Pubmed ID

12005154

DOI

10.1046/j.1365-2281.2002.00407.x

Scopus ID

2-s2.0-0036252007 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

An exaggerated blood pressure (BP) response to test may unmask the subjects who have a high risk of developing hypertension. In this prospective 10 years of follow-up, we examined whether the predictive value of casual BP measurements on future BP level and need for antihypertensive medication could be improved by using BP responses to different physical tests. At baseline, BP was recorded by casual measurements and intra-arterial monitoring. During the intra-arterial BP recording, standardized postural and exercise tests were performed on 97 healthy, untreated men (34 normotensive, 29 borderline hypertensive, and 34 mild hypertensive). After 10 years of follow-up, 87 of them (90%) returned for casual and non-invasive 24-h BP measurements. At follow-up, 20 (23%) of the men had antihypertensive medication. The prediction of casual systolic blood pressure (SBP) was best improved by SBP at 10 min after the dynamic exercise test (adj. R2 = 0.448; adj. R2 = 0.356 for casual SBP alone). The prediction of casual diastolic blood pressure (DBP) was most improved by DBP at 10 min after the dynamic exercise test (adj. R2 = 0.282; adj. R = 0.259 for casual BP alone). SBP in the supine test best improved the prediction of 24-h SBP (adj. R2 = 0 448; adj. R2 = 0.275 for casual SBP alone). DBP in the standing test best improved the prediction of 24-h DBP (adj. R2 = 0.252; adj. R2 = 0.214 for casual DBP alone). Pre-exercise DBP and casual SBP were the best predictors of the need for antihypertensive medication (Cox-Snell R2 = 0.256; Cox-Snell R2 = 0.164 for casual SBP alone). In conclusion the prediction of future BP and need for antihypertensive medication can be improved by using BP measurements during postural and exercise tests. Future SBP is more predictable than DBP.

Author List

Jokiniitty J, Majahalme S, Kähönen M, Tuomisto MT, Turjanmaa V

Author

Silja Majahalme MD, PhD Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Antihypertensive Agents
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Exercise Test
Follow-Up Studies
Humans
Hypertension
Logistic Models
Male
Middle Aged
Posture
Predictive Value of Tests
Prospective Studies