Blood pressure response to exercise as a predictor of hypertension.

Published studies of the blood pressure response to exercise were reviewed to assess the probability of future hypertension in a subject with a "hypertensive" response to exercise. The reviewed data indicate that the sensitivity of a hypertensive response to exercise for future hypertension varied between 16% and 60%, and the specificity between 53% and 95%. The prevalence of hypertension on follow-up among normotensive subjects with a hypertensive response to exercise testing was 2.06 to 3.39 times higher than that among subjects with a normotensive response. Therefore, blood pressure response to exercise does have a predictive value for future hypertension. However, this predictive value is limited, since 38.1% to 89.3% of those with a hypertensive response to exercise did not have hypertension on follow-up, and a normotensive response only marginally reduced the risk of future hypertension. The use of exercise testing as a predictor of hypertension is still in need of experimental development and confirmation.