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    Exercise-induced Hypertension: Benign or Predictive?

    As a general internist (formerly a nephrologist), I always try to treat hypertension to target or below. I also address other risk factors, such as elevated lipids, as often as possible. But I recently discovered that I do not pay close enough attention to blood pressure readings taken before or after stress testing (or other monitored exercise). Let’s look at another important risk factor for hypertension that may not get enough attention.

    1. Which of the following statements regarding the predictive value of hypertension occurring during exercise on a bicycle (6 minutes) or Bruce protocol stress testing is/are true? (More than one may be correct)

    A. Adjusted for other cardiac risk factors, a systolic pressure between 200-275 mm Hg is associated with a 1.39 greater risk of cardiovascular (CV) mortality over a 35-year follow-up than a systolic pressure of 100-160 mm Hg.

    B. Systolic but not diastolic hypertension with stress testing predicts future hypertension.

    C. A delayed decline of systolic blood pressure during recovery from exercise predicts severe coronary artery disease. 

    Please click here for answer and next question.

    Gregory W. Rutecki, MD
    Dr Rutecki is with the Cleveland Clinic National Consultation Service.

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