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Exercise Blood Pressure Responses Predict CVD

High diastolic blood pressure during low-intensity exercise and recovery linked to increased risk

MONDAY, June 9 (HealthDay News) -- In middle-aged adults, elevated diastolic blood pressure -- but not elevated systolic blood pressure -- during low-intensity exercise and recovery is associated with an increased long-term risk of incident cardiovascular disease, researchers report in the June issue of the American Journal of Cardiology.

Gregory D. Lewis, M.D., of Massachusetts General Hospital and Harvard Medical School in Boston, and colleagues assessed blood pressure in 3,045 Framingham Study subjects (mean age 43) during stage 2 of the Bruce protocol and during recovery.

After a mean follow-up of 19 years, the researchers found that 240 patients experienced a first cardiovascular event and that 181 patients experienced a first coronary heart disease event. After adjusting for blood pressure at rest and conventional risk factors, they found that subjects in the top quintile for exercise diastolic blood pressure had an increased risk of incident cardiovascular disease (hazard ratio, 1.41) compared to subjects in the lower four quintiles. In recovery responses after exercise, they also found that subjects in the top quintile for diastolic blood pressure had an increased risk (HR, 1.53).

"We analyzed blood pressure during an early stage of incremental exercise (stage 2) instead of peak exercise or fixed moderate exercise, which was the focus of other studies," the authors state. "Examining the response to low-level exercise standardized the exercise exposure and reduced confounding by heterogeneity in fitness level and motivation. The prognostic value of low-level treadmill exercise may be of particular value in patients unable to sustain exercise at or beyond stage 2."

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