Exercise blood pressure and the risk for future hypertension among normotensive middle-aged adults

Background-the aim of the present study was to examine whether exercise blood pressure can be used to predict the development of hypertension in normotensive middle-aged adults. methods and results-we investigated 7082 normotensive subjects who were annually screened in a tertiary medical center and completed maximal treadmill exercise tests at each visit. after the initial 3 years,subjects were divided into approximate quartiles according to their average exercise systolic and diastolic blood pressure responses (≤158; 158 to 170; 170 to 183; =183 mm hg for systolic blood pressure and ≤73; 73 to 77; 77 to 82; ≥82 mm hg for diastolic blood pressure). mean age of the study population was 48±9 years and 73% were men. average baseline resting blood pressure was 120/7712/7 mm hg. during a follow-up of 5±3 years,1036 (14.6%) subjects developed hypertension. the cumulative probability of new-onset hypertension at 5 years was significantly increased with increasing quartiles of exercise systolic blood pressure (5%,9%,17%,and 35%,respectively; p<0.001),with a similar association shown for diastolic blood pressure. after adjustment for baseline resting blood pressure and clinical parameters,each 5-mm hg increments in exercise either systolic or diastolic blood pressures were independently associated with respective 11% (p<0.001) and 30% (p<0.001) increased risk for the development of hypertension. conclusions-in normotensive middle-aged individuals,blood pressure response to exercise is associated with future development of hypertension. © 2015 the authors.