Assessing cutoff values for increased exercise blood pressure to predict incident hypertension in a general population. Issue 7 (July 2015)

• Record Type: Journal Article
• Authors: Lorbeer, Roberto; Ittermann, Till; Völzke, Henry; Gläser, Sven; Ewert, Ralf; Felix, Stephan B.; Dörr, Marcus
• Is Part Of: Journal of hypertension. Volume 33:Issue 7(2015:Jul.)
• Publication Date: 2015-07
• Subjects: cutoff values -- general population -- incident hypertension -- increased exercise blood pressure; Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/HJH.0000000000000568
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Cutoff values for increased exercise blood pressure (BP) are not established in hypertension guidelines. The aim of the study was to assess optimal cutoff values for increased exercise BP to predict incident hypertension. Methods: Data of 661 normotensive participants (386 women) aged 25–77 years from the Study of Health in Pomerania (SHIP-1) with a 5-year follow-up were used. Exercise BP was measured at a submaximal level of 100 W and at maximum level of a symptom-limited cycle ergometry test. Cutoff values for increased exercise BP were defined at the maximum sum of sensitivity and specificity for the prediction of incident hypertension. The area under the receiver-operating characteristic curve (AUC) and net reclassification index (NRI) were calculated to investigate whether increased exercise BP adds predictive value for incident hypertension beyond established cardiovascular risk factors. Results: In men, values of 160 mmHg (100 W level; AUC = 0.7837; NRI = 0.534, P < 0.001) and 210 mmHg (maximum level; AUC = 0.7677; NRI = 0.340, P = 0.003) were detected as optimal cutoff values for the definition of increased exercise SBP. A value of 190 mmHg (AUC = 0.8347; NRI = 0.519, P < 0.001) showed relevance for the definition of increased exercise SBP in women at the maximum level. Conclusion: According to our analyses, 190 and 210 mmHg are clinically relevant cutoff values for increased exercise SBP at the maximum exercise level of cycle ergometry test for women and men, respectively. In addition, for men, our analyses provided a cutoff value of 160 mmHg for increased exercise SBP at the 100 W level. Abstract : Supplemental Digital Content is available in the text