Abstract 11053: Is the Abnormal Rise in Both Systolic and Diastolic Blood Pressure Post-Mild Exercise Protocol Associated With More Cardiovascular Structural and Functional Abnormalities Than Isolated Systolic or Diastolic Rise Alone?

Abstract

Background: An isolated abnormal rise in systolic or diastolic BP post-mild exercise protocol (PMEP) is a major CVD risk factor. Purpose: To assess whether a combined abnormal rise in systolic and diastolic BP PMEP is associated with more cardiovascular structural and functional abnormalities (CVSFA) than an abnormal rise in either isolated systolic or diastolic BP PMEP. Methods: We screened 2,924 asymptomatic subjects, ages 20-79, for CVD risk using the Early Cardiovascular Disease Risk Scoring System, also known as the Rasmussen Risk Score, which was published previously. This consists of 10 tests: 7 vascular and 3 cardiac. The vascular tests are large (C1) and small (C2) artery stiffness, BP at rest, and after PMEP, CIMT, abdominal aorta ultrasound, and retinal photography. The 3 cardiac tests are Pro-BNP, ECG, and LV ultrasound. Out of the total subjects, 1106 (38%) were on no medications. These were divided into four BP subcategories according to the current ACC/AHA guidelines, shown in the table. Results: As shown in the table, combined systolic and diastolic BP rise PMEP is more common than either one alone. Systolic and diastolic BP rise PMEP is associated with more CVSFA, particularly in those with Stage 1 and 2 hypertensions compared to those who are normotensive. The CVSFA in combined systolic and diastolic BP PMEP is not statistically significant when compared to isolated abnormal rise in systolic or diastolic BP. Conclusions: Abnormal rise in BP PMEP is associated with significant CVSFA, regardless of whether isolated or combined. Hence, we recommend exercise stress testing protocol for risk stratification and optimal treatment in hypertensive patients.