Peak Exercise Blood Pressure Stratified by Age and Gender in Apparently Healthy Subjects

https://doi.org/10.4065/71.5.445Get rights and content

Objective

To determine the peak blood pressure responses during symptom-limited exercise in a large sample of apparently healthy subjects, including both men and women over a wide range of ages.

Design

We retrospectively studied the blood pressure response during maximal treadmill exercise testing with use of the Bruce protocol in apparently healthy subjects.

Material and Methods

Peak exercise blood pressures in 7,863 male and 2,406 female apparently healthy subjects who underwent a screening treadmill exercise test with the Bruce protocol between 1988 and 1992 were analyzed by age and gender.

Results

In this large referral population of apparently healthy subjects, peak exercise systolic and diastolic blood pressures and delta systolic blood pressure (rest to peak exercise) were higher in men than in women and were positively associated with age. In men, the 90th percentile of systolic blood pressure increased from 210 mm Hg for the age decade 20 to 29 years to 234 mm Hg for ages 70 to 79 years; the corresponding increase among women was from 180 mm Hg to 220 mm Hg. Delta diastolic blood pressure also increased with advancing age. The difference in peak and delta systolic blood pressures between men and women seemed to decrease after age 40 to 49 years. Exercise hypotension, defined as peak exercise systolic pressure less than rest systolic pressure, occurred in 0.23&x0025; of men and 1.45&x0025; of women and was not significantly related to age.

Conclusion

Overall, peak exercise systolic and diastolic, as well as delta systolic, blood pressures were higher in men than in women and increased with advancing age. The reported data will enable clinicians to interpret more accurately the significance of peak exercise blood pressure response in a subject of a specific age and gender and will allow investigators to define exercise hypertension in statistical terms stratified by age and gender.

Section snippets

Background

Blood pressure is routinely measured during exercise testing, although its clinical significance in apparently healthy persons with normal electrocardiographic (ECG) responses is not fully appreciated. Investigators have suggested that an excessive blood pressure response to exercise (exercise hypertension) may predict future resting hypertension1, 2, 3 and may indicate left ventricular hypertrophy.4,5 It may also be associated with future cardiovascular disease or events.6

In contrast to heart

Subjects And Methods

Study Group.— Subject who underwent exercise treadmill testing between 1988 and 1992 were identified retrospectively from the Cardiovascular Health Clinic database at Mayo Clinic Rochester. Eligibility criteria for inclusion in the study were as follows: (1) exercise test performed according to the Bruce protocol (for patients who underwent multiple exercise tests, the initial exercise test was used); (2) no prior history of hypertension or any other cardiovascular or pulmonary disease; (3) not

Results

In the Cardiovascular Health Clinic database, a total of 7,863 men and 2,406 women fulfilled the entry criteria for the study. Because of the racial distribution of the general patient population at Mayo Clinic Rochester, more than 95&x0025; of subjects were Caucasian. Among the subjects, 241 men and 148 women were 20 to 29 years old, 1,204 men and 407 women were 30 to 39 years old, 2,421 men and 639 women were 40 to 49 years old, 2,479 men and 666 women were 50 to 59 years old, 1,319 men and

Discussion

In the current report, we describe the blood pressure response to symptom-limited maximal exercise with use of the Bruce treadmill protocol, categorized by gender and age in a large referral population of apparently healthy men and women. We present the 5th, 10th, 90th, and 95th percentiles of peak exercise blood pressure response, categorized by age and gender for reference in clinical practice and for future investigation of exercise hypertension.

As previous investigators have consistently

Conclusion

In this report, we described the peak blood pressure response to maximal exercise with use of the Bruce treadmill protocol for each gender and age decade in a large study population. Peak blood pressure during a maximal stress test is significantly related to age and gender. The current data should enable clinicians to provide a better interpretation of the significance of an exercise blood pressure response in an individual subject and also allow investigators to define exercise hypertension

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    *

    Current address: Junetedo University, Tokyo, Japan.

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