Association Between Exercise Systolic Blood Pressure and Risk of Stroke in Men With and Without Cardiovascular Disease.

J Cardiopulm Rehabil Prev

Author Affiliations: Department of Sport Science, University of Seoul, Seoul, Republic of Korea (Dr Jae); Division of Vascular Surgery, Department of Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea (Dr Gwon); Department of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland (Drs Kurl and Laukkanen); Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK (Dr Kunutsor); Faculty of Sport and Health Science, University of Jyväskylä, Jyväskylä, Finland (Dr Laukkanen); and Central Finland Health Care District Hospital District, Jyväskylä, Finland (Dr Laukkanen).

Published: September 2024

AI Article Synopsis

  • The study aimed to determine if an exaggerated exercise systolic blood pressure (ESBP) is linked to a higher risk of stroke in men, regardless of cardiovascular disease (CVD) history.
  • During exercise tests, they defined ESBP as systolic blood pressure reaching or exceeding 210 mmHg in 2,410 men aged 42 to 61.
  • Over 27 years, results showed that men with ESBP had a significantly increased risk of stroke, especially those with a history of CVD, highlighting the relevance of exercise blood pressure responses in evaluating cardiovascular health.

Article Abstract

Purpose: We tested the hypothesis that an exaggerated exercise systolic blood pressure (ESBP) would be associated with the risk of stroke in men with and without a history of cardiovascular disease (CVD).

Methods: An ESBP was defined as a maximal systolic blood pressure (SBP) ≥ 210 mmHg during graded exercise testing on a stationary bike until volitional fatigue in 2410 men aged 42 to 61 yr at baseline.

Results: Over a median 27-yr follow-up, 419 incident stroke events occurred. In a multivariable adjusted model, men with an ESBP had a significantly increased risk of stroke in the entire cohort (HR = 1.41: 95% CI, 1.15-1.74). This association was still significant following further adjustment for resting SBP (HR = 1.25: 95% CI, 1.01-1.56). In subgroup analysis, ESBP was modestly associated with an increased risk of stroke in men with a history of CVD (HR = 1.37: 95% CI, 0.98-1.93), with no strong evidence of an association in men without a history of CVD (HR = 1.20: 95% CI, 0.90-1.60).

Conclusions: These findings suggest that the heightened risk of stroke related to ESBP response in a general population-based sample of men may be primarily driven by a history of CVD. The results underscore the importance of considering exercise blood pressure response when interpreting stress tests, particularly in individuals with pre-existing CVD.

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Source
http://dx.doi.org/10.1097/HCR.0000000000000889DOI Listing

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