Medline ® Abstract for Reference 31

OBJECTIVE: To investigate the relationship between blood pressure at 4 min after exercise using a Master's two-step and the risk for hypertension.

DESIGN: Prospective cohort study.

SETTING: Work site in Osaka, Japan.

PARTICIPANTS: A total of 6557 Japanese men, aged 35-63 years with systolic blood pressure (SBP)<140 mmHg and diastolic blood pressure (DBP)<90 mmHg, and no history of hypertension or diabetes at baseline.

MAIN OUTCOME MEASURES: Blood pressure was measured by standard techniques, using 160/95 mmHg for diagnosis of hypertension. Normotension was defined as no history of hypertension, and SBP<130 mmHg and DBP<85 mmHg. High normal blood pressure was defined as no history of hypertension and SBP>or= 130 and<140 mmHg or DBP>or= 85 and<90 mmHg.

RESULTS: During the 63 696 person-years follow-up period, we confirmed 660 cases of hypertension. SBP and DBP after exercise were associated with an increased risk for developing hypertension. The multiple-adjusted relative risk for SBP and DBP after exercise were 1.55 per 10 mmHg (confidence interval, 1.42-1.69) and 1.55 per 10 mmHg (confidence interval, 1.42-1.69), respectively. These associations were independent of resting SBP and DBP. Even after stratifying subjects according to blood pressure at rest, SBP or DBP at 4 min after exercise was associated with an increased risk for hypertension in subjects with normotension or high normal blood pressure at rest.

CONCLUSIONS: The blood pressure response after exercise with a two-step was associated with an increased risk for hypertension, independently of resting blood pressures.