Abstract：
BACKGROUND/OBJECTIVES:There is some evidence to suggest that exercise systolic blood pressure (SBP) may be associated with future risk of stroke in subjects without a history of coronary artery disease (CAD). However, the value of an exaggerated exercise SBP response (EESBPR) for predicting stroke in patients referred for stress testing for clinical reasons has not been investigated. METHODS:We evaluated a community-based sample of 10,047 patients with known or suspected CAD who underwent treadmill exercise echocardiography. An EESBPR was defined as a peak exercise SBP of >220mmHg. The ratio of the increase in SBP during exercise to exercise workload (ΔSBPeEW) was also estimated. The endpoints were stroke of any type, ischemic stroke and hemorrhagic stroke. Median follow-up was 3.5years. RESULTS:Annualized rates of stroke of any type, ischemic stroke and hemorrhagic stroke were 0.6% (95% CI 0.53-0.67), 0.49% (95% CI 0.42-0.56) and 0.12% (95% CI 0.09-0.15) in patients without EESBPR vs. 0.69% (95% CI 0.37-1), 0.49% (95% CI 0.23-0.76) and 0.19% (95% CI 0.02-0.35) in those with EESBPR (p=0.68, 0.90 and 0.39, respectively). Similarly, there was no significant univariate association between ΔSBPeEW and the occurrence of any endpoint. In multivariate analysis, hypertension, male sex, age, diabetes mellitus and resting SBP remained predictors of stroke of any type. EESBPR and ΔSBPeEW were not predictors of any of the endpoints evaluated. CONCLUSION:We did not observe any significant association between exercise SBP and the future occurrence of stroke in patients with known or suspected CAD referred for exercise echocardiography.
journal_name
Eur J Intern Medjournal_title
European journal of internal medicineauthors
Bouzas-Mosquera Mdel C,Bouzas-Mosquera A,Peteiro J,Broullón FJ,Alvarez-García N,Castro-Beiras Adoi
10.1016/j.ejim.2014.05.013subject
Has Abstractpub_date
2014-07-01 00:00:00pages
533-7issue
6eissn
0953-6205issn
1879-0828pii
S0953-6205(14)00149-6journal_volume
25pub_type
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