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Peak exercise SBP a...
Peak exercise SBP and future risk of cardiovascular disease and mortality
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- Hedman, Kristofer, Docent, 1984- (författare)
- Linköpings universitet,Medicinska fakulteten,Avdelningen för diagnostik och specialistmedicin,Region Östergötland, Fysiologiska kliniken US
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- Lindow, Thomas (författare)
- Department of Clinical Physiology, Växjö Central Hospital, Clinical Sciences, Clinical Physiology, Lund University, Department of Research and Development, Region Kronoberg, Sweden; Kolling Institute, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia
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- Cauwenberghs, Nicholas (författare)
- Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
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- Carlén, Anna, 1985- (författare)
- Linköpings universitet,Medicinska fakulteten,Avdelningen för diagnostik och specialistmedicin,Region Östergötland, Fysiologiska kliniken US
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- Elmberg, Viktor (författare)
- Department of Clinical Physiology, Blekinge Hospital, Karlskrona, Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund, Sweden
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- Brudin, Lars (författare)
- Department of Clinical Physiology, Kalmar County Hospital, Kalmar
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- Ekström, Magnus (författare)
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund, Sweden
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(creator_code:org_t)
- 2021-09-01
- 2022
- Engelska.
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Ingår i: Journal of Hypertension. - : Lippincott Williams & Wilkins. - 0263-6352 .- 1473-5598. ; 40:2, s. 300-309
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https://journals.lww...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Objectives: This study aimed to evaluate the risk of all-cause mortality and incident cardiovascular disease associated with peak systolic blood pressure (PeakSBP) at clinical exercise testing.Methods: Data from 10 096 clinical exercise tests (54% men, age 18-85 years) was cross-linked with outcome data from national registries. PeakSBP was compared with recently published reference percentiles as well as expressed as percentage predicted PeakSBP using reference equations.Natural cubic spline modelling and Cox regression were used to analyse data stratified by sex and baseline cardiovascular risk profile.Results: Median [IQR] follow-up times were 7.9 [5.7] years (all-cause mortality) and 5.6 [5.9] years (incident cardiovascular disease), respectively. The adjusted risk of all-cause mortality [hazard ratio, 95% confidence interval (95% CI)] for individuals with PeakSBP below the 10th percentile was 2.00 (1.59-2.52) in men and 2.60 (1.97-3.44) in women, compared with individuals within the 10th--90th percentile. The corresponding risk for incident cardiovascular disease was 1.55 (1.28-1.89, men) and 1.34 (1.05-1.71, women). For males in the upper 90th percentile, compared with individuals within the 10th--90th percentile, the adjusted risks of all-cause death and incident cardiovascular disease were 0.35 (0.22-0.54) and 0.72 (0.57-0.92), respectively, while not statistically significant in women. Spline modelling revealed a continuous increase in risk with PeakSBP values less than 100% of predicted in both sexes, with no increase in risk more than 100% of predicted.Conclusion: Low, but not high, PeakSBP was associated with an increased risk of mortality and future cardiovascular disease. Using reference standards for PeakSBP could facilitate clinical risk stratification across patients of varying sex, age and exercise capacity.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- blood pressure; epidemiology; exercise testing
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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