Blood pressure response after two-step exercise as a powerful predictor of hypertension: the Osaka Health Survey

OBJECTIVE: To investigate the relationship between blood pressure at 4 min after exercise using a Master's two-step and the risk for hypertension. DESIGN: Prospective cohort study. SETTING: Work site in Osaka, Japan. PARTICIPANTS: A total of 6557 Japanese men, aged 35-63 years with systolic blood pressure (SBP) < 140 mmHg and diastolic blood pressure (DBP) < 90 mmHg, and no history of hypertension or diabetes at baseline. MAIN OUTCOME MEASURES: Blood pressure was measured by standard techniques, using 160/95 mmHg for diagnosis of hypertension. Normotension was defined as no history of hypertension, and SBP < 130 mmHg and DBP < 85 mmHg. High normal blood pressure was defined as no history of hypertension and SBP >or= 130 and < 140 mmHg or DBP >or= 85 and < 90 mmHg. RESULTS: During the 63 696 person-years follow-up period, we confirmed 660 cases of hypertension. SBP and DBP after exercise were associated with an increased risk for developing hypertension. The multiple-adjusted relative risk for SBP and DBP after exercise were 1.55 per 10 mmHg (confidence interval, 1.42-1.69) and 1.55 per 10 mmHg (confidence interval, 1.42-1.69), respectively. These associations were independent of resting SBP and DBP. Even after stratifying subjects according to blood pressure at rest, SBP or DBP at 4 min after exercise was associated with an increased risk for hypertension in subjects with normotension or high normal blood pressure at rest. CONCLUSIONS: The blood pressure response after exercise with a two-step was associated with an increased risk for hypertension, independently of resting blood pressures.