Faculty Collaboration Database

Patients with hypertensive responses to exercise or dobutamine stress testing differ in resting hypertensive phenotype. J Am Soc Hypertens 2018 Feb;12(2):108-116

Date

12/26/2017

Pubmed ID

29275921

Pubmed Central ID

PMC5807193

DOI

10.1016/j.jash.2017.12.004

Scopus ID

2-s2.0-85038812967 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

Little is known of the importance of echocardiographic measures of resting systemic vascular resistance (SVR), cardiac output, and diastolic function in the development of a hypertensive response during dobutamine stress echocardiography. We performed a retrospective review of 325 subjects who underwent stress echocardiography and a resting echocardiogram on the same day. Logistical regressions were performed to determine associations between hypertensive response to each type of stress test and clinical and hemodynamic measurements obtained by transthoracic echocardiography. Patients with a hypertensive response to dobutamine or exercise stress modalities had Stage 1 hypertension. Those with a hypertensive response to dobutamine had a significantly elevated SVR and a lower cardiac output compared to those with a hypertensive response to exercise or a nonhypertensive response to dobutamine. An SVR ≥2000 dynes × sec/cm⁵ showed excellent discrimination between patients who did and did not have a hypertensive response to dobutamine (c = 0.80). A hypertensive response to both stress modalities showed an association with measures of diastolic dysfunction. The hemodynamic and echocardiographic phenotypes of individuals with a hypertensive response to exercise differ from those with a hypertensive response to dobutamine. Further work is necessary to understand and guide antihypertensive therapy when a hypertensive response to stress testing is discovered and to inform choice of stress modality when resting hypertension is present.

Author List

Kieu A, Shaikh A, Kaeppler M, Miles RJ, Widlansky ME

Author

Michael E. Widlansky MD Associate Director, Professor in the Medicine department at Medical College of Wisconsin

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

Adult
Aged
Cardiac Output
Dobutamine
Echocardiography, Stress
Exercise Test
Female
Humans
Hypertension
Male
Middle Aged
Rest
Retrospective Studies
Vascular Resistance