S A McHam1, T H Marwick, F J Pashkow, M S Lauer. 1. George M. and Linda H. Kauffman Center for Heart Failure, Department of Cardiology, Cleveland Clinic Foundation, Ohio 44195, USA.
Abstract
OBJECTIVE: This study was performed to determine whether a delayed decline in systolic blood pressure (SBP) after graded exercise is an independent correlate of angiographic coronary disease. BACKGROUND: The predictive importance of the rate of SBP decline after exercise relative to blood pressure changes during exercise has not been well explored. METHODS: Among adults who underwent symptom-limited exercise treadmill testing and who underwent coronary angiography within 90 days, a delayed decline in SBP during recovery was defined as a ratio of SBPs at 3 min of recovery to SBP at 1 min of recovery >1.0. Severe angiographic coronary artery disease was defined as left main disease, three-vessel disease or two-vessel disease with involvement of the proximal left anterior descending artery. RESULTS: There were 493 subjects eligible for analyses (age 59 +/- 11 years, 78% male). Severe angiographic coronary disease was noted in 102 (21%). There were associations noted between a delayed decline in SBP during recovery and severe angiographic coronary disease (34% vs. 17%, odds ratio [OR] 2.59, confidence interval [CI] 1.58 to 4.25, p = 0.001). In multivariate logistic regression analyses adjusting for SBP changes during exercise and other potential confounders, a delayed decline in SBP during recovery remained predictive of severe angiographic coronary disease (adjusted OR 2.22, 95% CI 1.27 to 3.87, p = 0.005). CONCLUSIONS: A delayed decline in SBP during recovery is associated with a greater likelihood of severe angiographic coronary disease even after accounting for the change in SBP during exercise.
OBJECTIVE: This study was performed to determine whether a delayed decline in systolic blood pressure (SBP) after graded exercise is an independent correlate of angiographic coronary disease. BACKGROUND: The predictive importance of the rate of SBP decline after exercise relative to blood pressure changes during exercise has not been well explored. METHODS: Among adults who underwent symptom-limited exercise treadmill testing and who underwent coronary angiography within 90 days, a delayed decline in SBP during recovery was defined as a ratio of SBPs at 3 min of recovery to SBP at 1 min of recovery >1.0. Severe angiographic coronary artery disease was defined as left main disease, three-vessel disease or two-vessel disease with involvement of the proximal left anterior descending artery. RESULTS: There were 493 subjects eligible for analyses (age 59 +/- 11 years, 78% male). Severe angiographic coronary disease was noted in 102 (21%). There were associations noted between a delayed decline in SBP during recovery and severe angiographic coronary disease (34% vs. 17%, odds ratio [OR] 2.59, confidence interval [CI] 1.58 to 4.25, p = 0.001). In multivariate logistic regression analyses adjusting for SBP changes during exercise and other potential confounders, a delayed decline in SBP during recovery remained predictive of severe angiographic coronary disease (adjusted OR 2.22, 95% CI 1.27 to 3.87, p = 0.005). CONCLUSIONS: A delayed decline in SBP during recovery is associated with a greater likelihood of severe angiographic coronary disease even after accounting for the change in SBP during exercise.
Authors: Edgar Argulian; Jose Ricardo F Po; Seth Uretsky; Kiran K Kommaraju; Suketukumar Patel; Vikram Agarwal; Randy Cohen; Alan Rozanski Journal: J Nucl Cardiol Date: 2016-02-24 Impact factor: 5.952
Authors: Vasiliki V Georgiopoulou; Andreas P Kalogeropoulos; Ritam Chowdhury; José Nilo G Binongo; Kirsten Bibbins-Domingo; Nicolas Rodondi; Eleanor M Simonsick; Tamara Harris; Anne B Newman; Stephen B Kritchevsky; Javed Butler Journal: Am J Prev Med Date: 2016-11-14 Impact factor: 5.043
Authors: Gregory D Lewis; Philimon Gona; Martin G Larson; Jonathan F Plehn; Emelia J Benjamin; Christopher J O'Donnell; Daniel Levy; Ramachandran S Vasan; Thomas J Wang Journal: Am J Cardiol Date: 2008-03-28 Impact factor: 2.778