What question did this study set out to answer?

Determine whether a 7-year longitudinal increase in exercise systolic blood pressure at a moderate workload predicts subsequent 28-year coronary heart disease incidence and mortality in healthy men.

March 26, 2013HypertensionOpen Access

Seven-Year Increase in Exercise Systolic Blood Pressure at Moderate Workload Predicts Long-Term Risk of Coronary Heart Disease and Mortality in Healthy Middle-Aged Men

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Why the study?

Does an increase in exercise systolic blood pressure over 7 years predict long-term risk of coronary heart disease and mortality in healthy middle-aged men?

Population

1392 apparently healthy middle-aged men

Comparison

Highest quartile of increase in exercise… vs Lowest quartile of exercise systolic blood…

Design

Cohort

Follow-up

28 years

Authors

PSPer Torger SkrettebergOslo University Hospital IGIrene GrundvoldOslo University Hospital SKSverre E. KjeldsenPreventive Cardiology

Discussion

Member takes

Implication

May aid CHD risk stratification via serial exercise SBP in men; leaves open whether targeting trajectories improves outcomes.

Key Points

Determine whether a 7-year longitudinal increase in exercise systolic blood pressure at a moderate workload predicts subsequent 28-year coronary heart disease incidence and mortality in healthy men.
Prospective study of 1,392 healthy men with peak systolic blood pressure measured during a 100 W bicycle exercise test in 1972-1975 and repeated in 1979-1982.
Participants were categorized into quartiles of 7-year exercise systolic blood pressure change and followed for 28 years for coronary heart disease and mortality endpoints.
Cox proportional hazards regression models adjusted for baseline cardiovascular risk factors (Model 1) and additionally for baseline and changes in physical fitness (Model 2).
Men in the highest quartile of exercise SBP increase (Q4) had a significantly greater risk of CHD compared to Q1 (Model 1: RR 1.55, 95% CI 1.17-2.03; Model 2: RR 1.40, 95% CI 1.06-1.85).
Coronary heart death risk was markedly elevated in Q4 versus Q1 across both multivariable adjustments (Model 1: RR 1.93, 95% CI 1.24-3.02; Model 2: RR 1.70, 95% CI 1.08-2.68).
Q4 had increased risk of cardiovascular and all-cause death in Model 1, though these associations did not maintain statistical significance after adjusting for fitness in Model 2.

Structured PICO

Does an increase in exercise systolic blood pressure over 7 years predict long-term risk of coronary heart disease and mortality in healthy middle-aged men?

Population

1392 apparently healthy middle-aged men

Intervention

Highest quartile (Q4) of increase in exercise systolic blood pressure at 100 W workload over 7 years

Comparator

Lowest quartile (Q1) of exercise systolic blood pressure change over 7 years

Outcome

Coronary heart disease (including angina pectoris, nonfatal myocardial infarction, and fatal CHD) and mortality over 28 yearshard clinical

An increase in exercise systolic blood pressure at moderate workload over 7 years independently predicts long-term risk of coronary heart disease and mortality in healthy men.

Cite This Study

Skretteberg et al. (2013) studied this question.

synapsesocial.com/papers/6a71389075498292b70ab18a https://doi.org/10.1161/hypertensionaha.111.00793

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Seven-Year Increase in Exercise Systolic Blood Pressure at Moderate Workload Predicts Long-Term Risk of Coronary Heart Disease and Mortality in Healthy Middle-Aged Men

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Seven-Year Increase in Exercise Systolic Blood Pressure at Moderate Workload Predicts Long-Term Risk of Coronary Heart Disease and Mortality in Healthy Middle-Aged Men

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Also Consider