The Predictive Value of Hypertensive Reaction at Stress Testing

The aim of the study was to find out whether hypertensive reaction induced by exer­cise test, as well as the patient’s body weight and heart rate can predict the development of hyper­tension. In order to test this hypothesis we stud­ied two groups of subjects who underwent their first submaximal stress test using a bicycle in the years 1984–1987. One group (HT group) con­sisted of 13 subjects with hypertensive reaction to exercise testing, while another group (K group) comprised 14 controls in whom stress testing triggered no hypertensive reaction. Hypertensive reaction was defined as an increase in systolic blood pressure over 200 mm Hg, and/or an increase in diastolic blood pressure by 15 mm Hg, if thus exceeding 90 mm Hg, occuring during a graded submaximal exercise test. Stress test­ing using the same protocol was repeated in both groups in 1994. Nine subjects in HT group and two controls were found to have developed hyper­tension. Hypertensive subjects had higher body weight than normotensive individuals and showed a significant increase in heart rate, while in normotensive subjects heart rate was seen to have declined over the past eight years. We assume that a simultaneous increase in blood pressure and heart rate may be due to a com­mon underlying mechanism, i.e. increased sym­pathetic tone. The results of this study support the hypothesis that hypertensive reaction trig­gered by exercise testing and the patient’s body weight have a prognostic value in hyperten­sion. Our results, however, failed to prove that heart rate at rest can predict the development of arterial hypertension.