https://scholars.lib.ntu.edu.tw/handle/123456789/466157
標題: | Usefulness of Paradoxical Systolic Blood Pressure Increase After Exercise as a Predictor of Cardiovascular Mortality | 作者: | Huang, Chi-Lun TA-CHEN SU WEN-JONE CHEN LIAN-YU LIN Wang, Wen-Lin Feng, Mee-Huei Liau, Chiau-Suong Lee, Yuan-Teh MING-FONG CHEN |
公開日期: | 1-九月-2008 | 卷: | 102 | 期: | 5 | 起(迄)頁: | 518-523 | 來源出版物: | American Journal of Cardiology | 摘要: | Exercise treadmill testing (ETT) is a well-accepted examination for patients with suspected coronary artery disease (CAD), and exercise induced ST-segment deviation is commonly used for CAD detection. However, recent evidence shows that systolic blood pressure (SBP) changes during and after exercise were associated with CAD severity, risk of acute myocardial infarction and stroke, new-onset hypertension, and even cardiovascular mortality. We retrospectively assessed 3,054 patients referred for ETT in 1996. Blood pressure and heart rate were recorded at rest, during peak exercise, and 1 and 3 min after exercise. SBP at 3 min of recovery equal to or higher than that at 1-min of recovery was defined as paradoxical SBP increase. These patients were categorized into 4 groups according to ETT ST-segment change and postexercise SBP change. After 10 years of follow-up, 346 patients (11%) died, with 129 (4%) dying from cardiovascular disease (CVD). Among the 4 groups, patients with ischemic ST-segment change and paradoxical SBP increase were associated with a higher risk for mortality, with odds ratios of 1.86 (95% confidence interval 1.31 to 2.65) for all-cause mortality and 3.18 (95% confidence interval 1.94 to 5.20) for CVD mortality, respectively. Patients with isolated paradoxical SBP increase still had a higher risk of CVD mortality (odds ratio 1.80, 95% confidence interval 1.70 to 3.04), even after controlling other cardiovascular risk factors. In subgroup analysis of 346 mortality subjects, patients with ischemic ST-segment change and paradoxical SBP increase would be more likely to die from CVD. In conclusion, compared with ischemic ST-segment change, paradoxical SBP increase after exercise is an important and significant predictor of CVD mortality. ? 2008 Elsevier Inc. All rights reserved. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/466157 https://www.scopus.com/record/display.uri?eid=2-s2.0-51749108180&doi=10.1016%2fj.amjcard.2008.04.027&origin=inward&txGid=0389920b35e1ed0c6d8deae0a7dbc8de |
ISSN: | 0002-9149 | DOI: | 10.1016/j.amjcard.2008.04.027 | SDG/關鍵字: | adult; article; blood pressure measurement; cardiac patient; cardiovascular disease; confidence interval; female; follow up; heart rate; human; ischemic heart disease; major clinical study; male; medical record review; mortality; patient referral; priority journal; retrospective study; risk factor; systolic blood pressure; treadmill exercise; Blood Pressure; Cause of Death; Confidence Intervals; Electrocardiography; Exercise Test; Female; Follow-Up Studies; Humans; Hypertension; Male; Middle Aged; Myocardial Ischemia; Odds Ratio; Prognosis; Retrospective Studies; Risk Factors; Survival Rate; Taiwan |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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