EXERCISE BLOOD-PRESSURE RESPONSE AND 5-YEAR RISK OF ELEVATED BLOOD-PRESSURE IN A COHORT OF YOUNG-ADULTS - THE CARDIA STUDY

Systolic blood pressure response to exercise has been shown to predict development of hypertension in men, but this association has not been examined in population-based samples of men, or in women or non-whites. This relationship was explored in 3741 normotensive black and white young adults undergoing treadmill testing in the CARDIA study and examined 5 years later for development of hypertension. Exaggerated response to exercise (systolic pressure greater than or equal to 210 mm Hg in men and greater than or equal to 190 mm Hg in women) was detected in 687 subjects (18%) at baseline, and incident hypertension (blood pressure greater than or equal to 140/90 mm Hg or on medication) was detected in 184 subjects (4.9%) at followup. Persons with exaggerated response to exercise at baseline had 5 mm Hg higher systolic and 1 mm Hg higher diastolic pressures at follow-up (P < .005) and were 1.70 times more likely to have developed hypertension than were persons with normal response (P <.001). After adjustment for age, race, sex, clinic, resting systolic pressure, body mass index, heavy activity score, exercise duration, and preexercise systolic pressure, exaggerated response was associated with a 2.14 mm Hg increase in year 5 systolic pressure (P <.0001). These associations did not differ by race or sex. Although the increment in systolic pressure associated with exaggerated exercise response was small (1 to 3 mm Hg), this small increment sustained over time could lead to a substantially increased incidence of hypertension and hypertension-related target organ damage. Determination of factors associated with exaggerated response may provide further insights into the development of hypertension in young adults.