Hypertensive response to exercise - to treat or not to treat?

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Hypertensive response to exercise (HRE) is often documented in individuals without known cardiovascular disease. However, its impact on patient prognosis and the necessity treatment are still not clear. Objective We aimed evaluate a hypertensive test (ET) clinical outcome. Methods This was single-center retrospective study patients with HRE stress testing (STE) performed between January 2012 December 2015. In our center, we define as systolic blood pressure (SBP) > 210mmHg men >190mmHg women, diastolic (DBP) 90mmHg or an increase baseline BP at least 60 mmHg 50 during exercise. Demographic, clinical, echocardiographic, electrocardiographic data were collected, results obtained using Chi-square Student-t tests; logistic regression. Results evaluated 500 who underwent STE, 457 which had vs 43 (mean age 57 ± 11 61 8 years, p = 0,01). Among two groups there no differences gender (76.5% 69.7%) race nor risk factors, namely hypertension, diabetes dyslipidaemia. their responses STE outcomes, mean follow-up 22 months. univariate multivariate analysis, presence Sokolow-Lion criteria left ventricular hypertrophy ECG associated exam (OR 5.26; CI95% 2.4-11.6; < 0.001). previously therapy calcium channel blockers seemed protect against prior ET 0.48, 0.24-0.97, 0.004) compared other antihypertensive drugs. Regarding increased developing heart failure (p 0.027) (versus HRE) follow up but failed predict adverse outcomes such acute coronary syndrome, atrial fibrillation stroke. Within ET, 78 did have established diagnosis HTA 49 12.16 75.6% men). these observed initiation after 27.6% patients, starting anti-hypertensives significant incidence stroke, AF, HF, hospitalization for events death. Conclusions observe any among studied regarding prognosis, except highest HRE. Initiation modify however sample underpowered, so, further studies required order clarify value