Key result
Hypertensive response to exercise was associated with a higher rate of positive stress echocardiography tests compared to a normotensive response (40.6% vs 31.0%; p=0.0005).
Why the study?
Hypertensive response to exercise has prognostic value, but data regarding its influence on stress echocardiography results remain controversial.
Does a hypertensive response to exercise impact the positivity rate of stress echocardiography in patients with known or suspected ischemic heart disease?
Observational (n=3,434)
Does a hypertensive response to exercise impact the positivity rate of stress echocardiography in patients with known or suspected ischemic heart disease?
A hypertensive response to exercise during stress echocardiography is associated with a significantly higher rate of positive test results, suggesting the importance of optimizing blood pressure prior to testing.
Hypertensive exercise response was associated with more positive stress echoes; leaves open whether pre-test BP optimization improves test accuracy.
Background. Hypertensive response of blood pressure (BP) to exercise has substantial prognostic impact. Hypertensive response to exercise is shown to be a predictor for development of hypertension and stroke. The data concerning hypertensive response to exercise influence on stress echocardiography results are controversial. Objective. The aim of the study was to assess the frequency of hypertensive response of BP to exercise and its impact on the result of the stress echocardiography on treadmill in patients with known or suspected ischemic heart disease. Design and methods. We analyzed 3434 tests performed in out-patient department during 1 month period (21.01–21.02) of every year since 2007 to 2020. We studied the occurrence of hypertensive response to exercise during exercise stress echocardiography on treadmill and its relation to positive results of the test. Results. The prevalence of hypertensive response to exercise varied from 8,6 % to 41,5 % (average in 14-year period — 23,24%), however, the proportion of tests with hypertensive response to exercise significantly declined in the period from 2015 to 2020 years. Patients with hypertensive response to exercise showed significantly more frequent positive tests in comparison to patients with normotensive BP response: 40,6 % vs 31,0% (r = 12,2, р = 0,0005), though yearly analysis showed no correlation between the number of tests with hypertensive response to exercise and number of positive tests (r = 0,21; р = 0,47). Conclusions. Significant correlation between BP response and stress echocardiography results means that hypertensive response to exercise has an impact on the test results, therefore antihypertensive treatment optimization is essential before test.
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Карев et al. (2021) conducted an observational in Known or suspected ischemic heart disease (n=3,434). Hypertensive response to exercise vs. Normotensive BP response was evaluated on Positive stress echocardiography test (p=0.0005). Hypertensive response to exercise was associated with a higher rate of positive stress echocardiography tests compared to a normotensive response (40.6% vs 31.0%; p=0.0005).
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