We have located links that may give you full text access.
Journal Article
Observational Study
Prognostic value of the increase in systolic blood pressure with exercise in patients with hypertension and known or suspected coronary artery disease.
Medicina Clínica 2017 January 21
BACKGROUND AND OBJECTIVE: The association of an exaggerated systolic blood pressure increase with exercise (EBPIE) with cardiovascular events remains controversial. Our aim was to determine the possible association of an EBPIE with survival and risk of serious cardiac events in patients with hypertension and known or suspected coronary artery disease (CAD).
PATIENTS AND METHODS: This is a retrospective observational study based on a sample of 5226 patients with a history of arterial hypertension and known or suspected CAD referred for exercise echocardiography. The EBPIE was defined as an increase in systolic blood pressure with exercise greater than or equal to the 95th percentile of this population (80mmHg). The end points were all-cause mortality, cardiac death and myocardial infarction (MI).
RESULTS: During a mean follow-up of 4.7 years, there were 978 deaths (including 371 cardiac) and 798 MI. Annual rates of all-cause mortality, cardiac mortality and MI were 2.73, 0.83 and 2.63% in patients with EBPIE and 4.4, 1.58 and 3.98% in those without EBPIE (P<.001, P=.012, and P=.014, respectively). After multivariate analysis, an EBPIE remained independently associated with a lower risk of all-cause mortality (HR: 0.70, 95% CI: 0.52-0.95; P=.023) and MI (HR: 0.69, 95% CI: 0.50-0.95; P=.022) but was not significantly associated with cardiac mortality (HR: 0.72, 95% CI: 0.43-1.20; P=.2).
CONCLUSIONS: EBPIE was associated with an increased likelihood of survival and lower rate of MI in hypertensive patients with known or suspected CAD.
PATIENTS AND METHODS: This is a retrospective observational study based on a sample of 5226 patients with a history of arterial hypertension and known or suspected CAD referred for exercise echocardiography. The EBPIE was defined as an increase in systolic blood pressure with exercise greater than or equal to the 95th percentile of this population (80mmHg). The end points were all-cause mortality, cardiac death and myocardial infarction (MI).
RESULTS: During a mean follow-up of 4.7 years, there were 978 deaths (including 371 cardiac) and 798 MI. Annual rates of all-cause mortality, cardiac mortality and MI were 2.73, 0.83 and 2.63% in patients with EBPIE and 4.4, 1.58 and 3.98% in those without EBPIE (P<.001, P=.012, and P=.014, respectively). After multivariate analysis, an EBPIE remained independently associated with a lower risk of all-cause mortality (HR: 0.70, 95% CI: 0.52-0.95; P=.023) and MI (HR: 0.69, 95% CI: 0.50-0.95; P=.022) but was not significantly associated with cardiac mortality (HR: 0.72, 95% CI: 0.43-1.20; P=.2).
CONCLUSIONS: EBPIE was associated with an increased likelihood of survival and lower rate of MI in hypertensive patients with known or suspected CAD.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app