Predictor Of Future Blood Pressure Research Articles

Exaggerated exercise blood pressure response in middle-aged men as a predictor of future blood pressure: a 10-year follow-up

ABSTRACTObjective: The prognostic value of an exaggerated exercise systolic blood pressure response (EESBPR) remains controversial. This study was designed to assess whether an EESBPR is associated with the predictor of future blood pressure. Methods: From an initial population of 1,534 male-subjects with normal BP or no medication who underwent ergometric exercise, 733 subjects (mean age: 41 years old) at baseline to follow-up BP after an average of 10 years were selected. A 12-min exercise tolerance test with three phases of estimated load from predictive maximum oxygen intake was performed at baseline, and exercise BP was measured. Results: Exercise BP response was classified by three group: Low group (G) (exercise SBP < 180 mmHg), Middle G (exercise BP:180–199 mmHg), High G (exercise BP:200 mmHg ≦). BP after 10 years in Low G was 123 ± 12/79 ± 7 mmHg, in Middle G:127 ± 13/81 ± 8 mmHg, in High G :134 ± 15/84 ± 10 mmHg. Compared with in Low G, BP after 10 years in High G significantly increased (p < 0.05). Multiple regression analysis was carried out to clarify the relationship of exercise SBP at baseline to BP after 10 years. In multivariate-adjusted models, the relationship of SBP at follow-up was stronger to exercise SBP (β = 0.271, P < 0.001) than to resting SBP (β = 0.148, P < 0.001). Maximum oxygen intake (β = −0.193, P = 0.003) and resting SBP correlated with SBP after 10 years. Conclusions: In middle-aged men, exercise SBP would be a stronger predictor of future SBP, DBP rather than BP at rest. In optimal of classification of BP (SBP < 120 mmHg), exercise BP response was clearly associated with BP after 10 years.

Exercise blood pressure in young adults as a predictor of future blood pressure: a 12-year follow-up of medical school graduates.

It has not been fully clarified whether exercise blood pressure (BP) in young adult men and women is useful to predict future BP, especially in Asian people. A long-term prospective study was conducted in graduates of a medical school in Japan; 138 men and 76 women whose mean age was 19.8 and 19.2, respectively, at baseline. A 5-min exercise tolerance test was performed at baseline, and BP immediately after exercise was measured. BP at 50% intensity exercise was also calculated. Multiple regression analysis was carried out to clarify the relationship of exercise BP at baseline to follow-up BP after an average of 12 years. In multivariate-adjusted models, the relationship of systolic blood pressure (SBP) at follow-up was stronger to SBP immediately after exercise (F=7.7, P=0.006) than to resting SBP (F=3.7, P=0.055) in men. The models in men showed that SBP immediately after exercise was a stronger predictor of follow-up SBP than SBP at 50% intensity exercise, and the results were similar for diastolic blood pressure (DBP) in men. For SBP in women, resting SBP was the strongest predictor of follow-up SBP (F=14.3, P<0.001), and exercise SBP was not significant predictor. For DBP in women, any DBP at rest or after exercise was not significantly related to DBP at follow-up. In young adult men, SBP and DBP immediately after exercise would be a stronger predictor of future SBP and DBP rather than BP at rest. However, in young adult women, resting SBP rather than exercise SBP would be better to predict future SBP.

7-Year Stability of Blood Pressure in the Canadian Population

Background. The purpose of the study was to examine the 7-year stability of systolic (SBP) and diastolic (DBP) blood pressures in the Canadian population.Methods. The sample included 1,503 participants 7–69 years of age from the 1981 Canada Fitness Survey who were remeasured in Campbell's Survey of 1988. Both SBP and DBP were adjusted for the effects of body mass index (BMI) using regression procedures.Results. Interage correlations from baseline to follow-up ranged from −0.17 to 0.61 for SBP and from −0.22 to 0.51 for DBP. With few exceptions, correlations were positive and significant, and were highest and most consistent in adulthood. Further, between 27 and 39% of participants in the upper or lower quintiles in 1981 remained there in 1988. There were few differences in adiposity between those who remained in the upper or lower quintiles and those who did not. One exception was that males who remained in the upper quintile of SBP had greater values for BMI, sum of skinfolds, and waist circumference at baseline. Among adults, the best predictor of future blood pressure was baseline blood pressure, which accounted for between 12 and 34% of the variance in follow-up blood pressure, followed by age, follow-up BMI, and, in females, baseline physical activity levels.Conclusions. Blood pressure demonstrated low to moderate stability over 7 years in Canada, and baseline level of adiposity was related to the stability of SBP in males.

Heart rate as a predictor of future blood pressure in schoolchildren

Heart rate (HR) has been shown to predict future blood pressures (BP) in studies in adults. We explored the relation of HR to future BP levels in a cohort of 344 black and 456 white schoolchildren ages 5 to 19 years, to examine the hypothesis that HR predicts subsequent BP even very early in life. After making baseline measurements, BP was assessed longitudinally 1 to 24 additional times (mean = 8.25) after the baseline period, at intervals of approximately 6 months. We found that HR was significantly related to future diastolic BP in the black boys ( P = .016) after adjusting for baseline diastolic BP, age, and body mass index, but not in the black girls or in the white children. Because HR is reflective of sympathetic nervous system (SNS) activity that in turn can be related to the renin-angiotensin system (RAS), we also explored the relation of HR to the RAS by studying relationships to variants in the angiotensinogen gene and the angiotensin I-converting enzyme (ACE) gene. We found a significantly positive relationship of HR to the presence of the deletion allele of the ACE gene ( P = .0015), but, again, only in the black boys. Because blacks in general appear to retain additional sodium when compared with whites, the SNS, as reflected in the HR, may influence BP more when individuals have increased sodium retention. In summary, baseline HR predicted future diastolic BP in the black boys but not in the black girls or in the white children.

Tracking of blood pressure in children and youth.

Part of a preventive pediatric strategy against cardiovascular diseases is the early identification of hypertension in childhood. There is a clearly established relationship between blood pressure measured during childhood and at later periods for the same individual. This relationship was investigated in studies of blood pressure tracking in children over the past two decades. This report reviews longitudinal studies that analysed tracking of blood pressure between the ages of 4 and 20 years. The results confirm the existence of tracking, but the statistical relationship seems too weak to justify preventive pediatric strategies based on blood pressure in childhood. However, during adolescence, tracking of blood pressure is affected by the processes of growth and maturation. Methodological problems may have also resulted in underestimation of the amount of tracking. An increase in the number of blood pressure measurements and the use of vertex-corrected blood pressure values would probably improve tracking. It is important to analyse the improvement in tracking coefficients when these new methods are used in order to determine the maximal extent to which blood pressure in childhood can predict future levels. Recently, several studies that were able to relate blood pressure values from childhood to adulthood suggested that tracking seems to persist over this long period. Together with comparable results from future analyses of studies considered in this review, more detailed information will become available about the predictability of blood pressure in children. Although blood pressure is the best single predictor of future blood pressure, results of this review indicate that its predictability is not sufficiently strong for preventive strategies in childhood. Therefore, the development of blood pressure predictors based on more than one parameter is recommended. © 1994 Wiley-Liss, Inc.

Predictors of Stable Hypertension in Young Borderline Subjects: A Five-Year Follow-Up Study

Forty-four young subjects with borderline hypertension underwent a 5-year follow-up. At the first examination their intralymphocytic Na+ (Nai) was measured before and after 1 month of a low-salt diet. Blood pressure and heart rate were recorded at rest (baseline), during mental arithmetic, and after the test (recovery). After 5 years, no subject with normal Nai developed hypertension, and, furthermore, subjects with normal Nai had no increase in blood pressure values. Thirty-one percent of subjects with high Nai developed hypertension. Subjects developing hypertension were characterized by a high pressor response to mental stress and by an increase in recovery diastolic blood pressure in comparison with baseline diastolic blood pressure. Sixty percent of the subjects whose recovery diastolic blood pressure was at least 6% higher than baseline developed hypertension. Eighty percent of subjects whose Nai was not reduced after the diet became hypertensive. Nai and diastolic blood pressure were unrelated at the first examination; however, a significant correlation was found between Nai recorded at first examination and diastolic blood pressure recorded after 5 years. It is concluded that Nai is a good predictor of future blood pressure in borderline subjects and that subjects with normal Nai have a very low risk of developing high blood pressure.

Follow-up of normotensive men with exaggerated blood pressure response to exercise

The early detection of hypertension is of foremost concern. It may be that individuals who are normotensive at rest but who show an exaggerated blood pressure (BP) response to exercise are at greater risk of developing hypertension in the future. From exercise tests, a group (ER) of healthy young males who were normotensive at rest ( BP ≤ 140 90 ) but showed an exaggerated BP response to exercise (systolic BP ≥ 200 mm Hg and/or diastolic BP ↑ 10 mm Hg to >90 mm Hg) were selected. A control group (NR) with exercise BP values less than these were matched for age, weight/height 2, skinfold thickness, resting BP ≤ 140 90 , resting heart rate, aerobic fitness level, physical activity, smoking history, and family history of hypertension. After a follow-up period of 5.8 years (range 3 to 14 years) eight of the subjects from the ER group were found to be hypertensive, whereas none of the NR group were hypertensive. Stepwise multivariate regression showed the exercise blood pressure to be the best predictor of future blood pressure of the parameters reviewed in this study. Exaggerated BP response to exercise may serve as an additional risk marker for hypertension.