Association Between Exercise Systolic Blood Pressure and Risk of Stroke in Men With and Without Cardiovascular Disease.

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiopulmonary Rehabilitation and Prevention Pub Date : 2024-09-01 Epub Date: 2024-09-03 DOI:10.1097/HCR.0000000000000889

Sae Young Jae, Jun Gyo Gwon, Sudhir Kurl, Setor K Kunutsor, Jari A Laukkanen

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引用次数: 0

Abstract

Purpose: We tested the hypothesis that an exaggerated exercise systolic blood pressure (ESBP) would be associated with the risk of stroke in men with and without a history of cardiovascular disease (CVD).

Methods: An ESBP was defined as a maximal systolic blood pressure (SBP) ≥ 210 mmHg during graded exercise testing on a stationary bike until volitional fatigue in 2410 men aged 42 to 61 yr at baseline.

Results: Over a median 27-yr follow-up, 419 incident stroke events occurred. In a multivariable adjusted model, men with an ESBP had a significantly increased risk of stroke in the entire cohort (HR = 1.41: 95% CI, 1.15-1.74). This association was still significant following further adjustment for resting SBP (HR = 1.25: 95% CI, 1.01-1.56). In subgroup analysis, ESBP was modestly associated with an increased risk of stroke in men with a history of CVD (HR = 1.37: 95% CI, 0.98-1.93), with no strong evidence of an association in men without a history of CVD (HR = 1.20: 95% CI, 0.90-1.60).

Conclusions: These findings suggest that the heightened risk of stroke related to ESBP response in a general population-based sample of men may be primarily driven by a history of CVD. The results underscore the importance of considering exercise blood pressure response when interpreting stress tests, particularly in individuals with pre-existing CVD.

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患有和未患有心血管疾病的男性运动收缩压与中风风险之间的关系

目的：我们测试了一个假设，即在有或没有心血管疾病（CVD）病史的男性中，夸张的运动收缩压（ESBP）与中风风险有关：方法：2410 名基线年龄在 42 到 61 岁之间的男性在固定自行车上进行分级运动测试直至自愿疲劳时，ESBP 被定义为最大收缩压 (SBP) ≥ 210 mmHg：中位随访 27 年，共发生 419 例中风事件。在多变量调整模型中，在整个队列中，患有 ESBP 的男性中风风险显著增加（HR = 1.41：95% CI，1.15-1.74）。在进一步调整静息 SBP 后，这种相关性仍然显著（HR = 1.25：95% CI，1.01-1.56）。在亚组分析中，ESBP 与有心血管疾病史的男性中风风险增加关系不大（HR = 1.37：95% CI，0.98-1.93），而与无心血管疾病史的男性中风风险增加关系不大（HR = 1.20：95% CI，0.90-1.60）：这些研究结果表明，在基于普通人群的男性样本中，与 ESBP 反应相关的中风风险升高可能主要是由心血管病史引起的。这些结果强调了在解释压力测试时考虑运动血压反应的重要性，尤其是对已有心血管疾病史的人群。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cardiopulmonary Rehabilitation and Prevention 医学-心血管系统

CiteScore

5.40

自引率

34.20%

发文量

164

审稿时长

6-12 weeks

期刊介绍： JCRP was the first, and remains the only, professional journal dedicated to improving multidisciplinary clinical practice and expanding research evidence specific to both cardiovascular and pulmonary rehabilitation. This includes exercise testing and prescription, behavioral medicine, and cardiopulmonary risk factor management. In 2007, JCRP expanded its scope to include primary prevention of cardiovascular and pulmonary diseases. JCRP publishes scientific and clinical peer-reviewed Original Investigations, Reviews, and Brief or Case Reports focused on the causes, prevention, and treatment of individuals with cardiovascular or pulmonary diseases in both a print and online-only format. Editorial features include Editorials, Invited Commentaries, Literature Updates, and Clinically-relevant Topical Updates. JCRP is the official Journal of the American Association of Cardiovascular and Pulmonary Rehabilitation and the Canadian Association of Cardiac Rehabilitation.