According to a study, the risk of stroke increases when the difference between resting and maximal activity systolic blood pressure (SBP) grows, regardless of BP at rest. This suggests that a high blood pressure response to exercise is an independent predictor of stroke.
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Out of the 2,014 men who took part in the Oslo Ischemia Study in the 1970s, this study looked at the baseline data of 1,392
men who remained healthy and completed bicycle exercise tests both at baseline
and 7 years afterwards. The difference between resting and maximal SBP at
baseline was used to split participants into quartiles.
The researchers calculated the risk of stroke using
Cox proportional hazard, controlling for resting blood pressure, age, smoking,
serum cholesterol, and physical fitness. They followed participants for 35
years, until they had their first ischemic or hemorrhagic stroke.
174 (89 percent) of the 195 strokes that occurred were
ischemic. Age, resting SBP, resting diastolic BP, and SBP at moderate and
maximal exertion all showed significant positive correlations with stroke risk
in univariate analysis.
In multivariate analysis, SBP quartile 4 (SBP >99
mm Hg) had a 2.6-fold greater risk of stroke (p0.0001) compared to SBP quartile
2 (SBP 73–85 mm Hg), which had the lowest risk of stroke. Furthermore, SBP
quartile 1 was linked to a 1.7-fold higher risk of stroke than quartile 2,
demonstrating a J-shaped relationship.
“Previous research has linked intermediate workload
exercise BP to coronary disease, whereas maximal exercise BP has been linked to
stroke,” the researchers explained.
Source: J Hypertens 2021;39:2022-2029