Article Text

Download PDFPDF
Cardiovascular physiology
Augmented blood pressure response to exercise is associated with improved long-term survival in older people
  1. P Hedberg1,2,
  2. J Öhrvik3,
  3. I Lönnberg4,
  4. G Nilsson2
  1. 1
    Department of Clinical Physiology, Central Hospital, Västerås, Sweden
  2. 2
    Center for Clinical Research, Uppsala University, Central Hospital, Västerås, Sweden
  3. 3
    Cardiology Research Unit, Karolinska Institutet, Stockholm, Sweden
  4. 4
    Department of Cardiology, Central Hospital, Västerås, Sweden
  1. Dr P Hedberg, Department of Clinical Physiology, Central Hospital, SE-721 89 Västerås, Sweden; par.o.hedberg{at}


Objective: Studies on the prognostic importance of the systolic blood pressure (SBP) response during exercise report ambiguous results. Most research focuses on younger and middle-aged selected patient groups and rarely includes women. We investigated the prognostic value of SBP response during exercise testing in 75-year-olds.

Design: Prospective observational cohort study.

Setting: A community-based random sample of 75-year-old men and women (n = 382).

Main outcome measures: The prognostic value of SBP change from rest to peak exercise during a symptom-limited cycle test was evaluated for the endpoints all-cause mortality and cardiovascular mortality during long-term follow-up.

Results: After a median follow-up of 10.6 years, 140 (37%) of the participants had died, 64 (17%) from cardiovascular causes. The all-cause mortalities for exercise SBP changes of ⩽30 mm Hg, 31–55 mm Hg and >55 mm Hg were 5.1, 4.2 and 2.6 per 100 person-years, respectively (logrank 9.6; p = 0.008). For every 10 mm Hg increase in SBP during exercise the relative hazard for all-cause mortality was reduced by 13% (p = 0.030) and for cardiovascular mortality by 26% (p = 0.004) after adjustment for sex, smoking, waist circumference, total/HDL cholesterol ratio, prevalent ischaemic heart disease, hypertension, diabetes, cardiovascular medication, pre-exercise SBP, exercise capacity, resting left ventricular ejection fraction and left ventricular mass index.

Conclusions: Our findings suggest that an augmented SBP response during exercise is associated with an improved long-term survival among community-living 75-year-old individuals.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding: The Västmanland Research Fund against Cardiovascular Disease.

  • Competing interests: None.

  • Ethics approval: Ethics approval was provided by the Ethics Committee of Uppsala University, Sweden.

  • Patient consent: Obtained.