Correction of the hypertensive response in the treadmill testing by the work performance improves the prediction of hypertension by ambulatory blood pressure monitoring and incidence of cardiac abnormalities by echocardiography: Results of an eight year follow-up study

Zanettini, João Otávio; Zanettini, Jacira Pisani; Zanettini, Marco Tulio; Fuchs, Flávio Danni

doi:10.1016/j.ijcard.2008.11.208

Cited by 12 publications

(5 citation statements)

References 23 publications

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“…55 In a cohort study of elderly men from Scandinavia, subjects with masked hypertension had increased plasma glucose, body mass index and echocardiographically determined LV relative wall thickness compared with normotensive subjects (office BP < 140/90 mmHg and daytime BP < 135/85 mmHg). 56 These findings were confirmed in a recent study that analysed the association between intima-media thickness and masked nocturnal hypertension defined by self-measured BP < 135/85 mmHg associated with a night-time ambulatory BP ≥ 120/ 75 mmHg. The control group included subjects with self-measured home BP level < 135/85 mmHg and ambulatory nocturnal BP levels < 120/75 mmHg.…”

Section: Association Between Masked Hypertension and Target Organ Damagesupporting

confidence: 61%

Current approach to masked hypertension: From diagnosis to clinical management

James

2017

Clin Exp Pharma Physio

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The term 'masked hypertension phenomenon' was first described by the late Professor Thomas Pickering and is commonly defined as having a normal clinic blood pressure (BP) but an elevated 'out of office' reading. In the main, these elevated readings have been provided through ambulatory BP monitoring (ABPM), but sometimes home BP monitoring is used. It is now largely accepted that ABPM gives a better classification of risk than clinic BP. Thus, the elevated ABPM levels should relate to higher cardiovascular risk, and it follows that these people may be regarded as being genuinely hypertensive and at higher cardiovascular risk. The problem for clinical practice is how to identify and manage these individuals. The phenomenon should be suspected in individuals who have had an elevated clinic BP at some time, in young individuals with normal or normal-high clinic BP who have early left ventricular hypertrophy, in individuals with a family history of hypertension in both parents, patients with multiple risks for cardiovascular disease and perhaps diabetic patients. Masked hypertension appears to be more prevalent in individuals of male gender, with younger age, higher heart rate, obesity or high cholesterol levels and in smokers. Those with masked hypertension are at higher risk of events such as stroke and have a higher prevalence of target organ damage, for example, nephropathy. In conclusion, most of the debate around this topic relates to its reliable identification. Given the higher ambulatory mean blood pressure values there is an increased cardiovascular risk making this diagnosis important.

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Section: Association Between Masked Hypertension and Target Organ Damagesupporting

confidence: 61%

Current approach to masked hypertension: From diagnosis to clinical management

James

2017

Clin Exp Pharma Physio

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“…Only minority of the studies used METs for the correction of blood pressure response to exercise and all except one were performed on treadmill [5,6,12,13]. We found no studies on cycle ergometers taking into account the weight of the patients for the correction of work intensity (in contrast on treadmill which is inherently a weight bearing exercise).…”

Section: Discussionmentioning

confidence: 91%

The determinants of blood pressure response to exercise

Tuka¹,

Rosa²,

Dědinová³

et al. 2015

Cor Vasa

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“…As the workload reached during the final stage of the PWC 150 differed from one individual to another, we used the method described previously by Zanettini et al 24 to quantify the increase in BP adjusted for each individual's working capacity. Hence, we computed the difference between the SBP and DBP from rest to exercise divided by the intensity reached at the end of the last stage of the PWC 150 ( Figure S1, available in the online Data Supplement at http://hyper.ahajournals.org).…”

Section: Exercise Hemodynamic Measurementmentioning

confidence: 99%

Insulin Resistance, Low Cardiorespiratory Fitness, and Increased Exercise Blood Pressure

Huot

Arsenault²,

Gaudreault³

et al. 2011

Hypertension

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Abstract-Individuals with insulin resistance and low cardiorespiratory fitness are frequently found to have an increased waist circumference and high exercise blood pressure. We tested the hypothesis that the relationships among insulin resistance, low cardiorespiratory fitness, and increased exercise blood pressure may be mediated by an elevated waist circumference. This study included 317 apparently healthy men and women (mean age: 34.8Ϯ12.8 years; mean body mass index: 26.1Ϯ5.2 kg/m 2 ). Exercise blood pressure values were measured using a submaximal ergometer test evaluating physical working capacity. Plasma insulin and glucose levels were measured during a 3-hour oral glucose tolerance test. Multivariate regression analyses showed that waist circumference accounted for 32.8% (PϽ0.0001) and 45.1% (PϽ0.0001) of the variance in exercise systolic blood pressure in men and women, respectively. Participants were classified into tertiles according to either insulin response, measured during the oral glucose tolerance test, or fitness levels and then further subdivided into 2 subgroups using sex-specific waist circumference thresholds. Individuals with an increased waist circumference (Ն94 cm and Ն80 cm for men and women, respectively) had higher exercise systolic blood pressure compared with individuals with low waist circumference, irrespective of their level of insulin resistance (10.6 versus 6.8, 12.2 versus 7.7, and 13.2 versus 8.7 mm Hg/metabolic equivalent, respectively, for the low, intermediate, and high tertiles; PϽ0.05) or fitness levels (13.1 versus 8.2, 12.0 versus 7.9, and 10.6 versus 7.1 mm Hg/metabolic equivalent, respectively, for the low, intermediate, and high tertiles; PϽ0.05). Individuals with a higher waist circumference have elevated exercise systolic blood pressure, regardless of their insulin sensitivity or level of cardiorespiratory fitness.

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Correction of the hypertensive response in the treadmill testing by the work performance improves the prediction of hypertension by ambulatory blood pressure monitoring and incidence of cardiac abnormalities by echocardiography: Results of an eight year follow-up study

Cited by 12 publications

References 23 publications

Current approach to masked hypertension: From diagnosis to clinical management

Current approach to masked hypertension: From diagnosis to clinical management

The determinants of blood pressure response to exercise

Insulin Resistance, Low Cardiorespiratory Fitness, and Increased Exercise Blood Pressure

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