Peak Blood Pressure Responses During Maximum Cardiopulmonary Exercise Testing: Reference Standards From FRIEND (Fitness Registry and the Importance of Exercise: A National Database).

Sabbahi A, Arena R, Kaminsky LA, Myers J, Phillips SA

Hypertension. 2018 Feb;71(2):229-236. doi: 10.1161/HYPERTENSIONAHA.117.10116.
Epub 2017 Dec 18.

The objective of this study is to expand on previous efforts in establishing
normative standards of exercising blood pressure (BP) at maximal physical
exertion derived from treadmill cardiopulmonary exercise testing in the United
States. Four experienced laboratories in the United States with established
quality control procedures contributed data from September 1, 1986, to February
1, 2015. A total of 2917 maximal (peak respiratory exchange ratio ≥1.00)
treadmill cardiopulmonary exercise testing responses from apparently healthy men
and women (aged 20-79 years) without cardiovascular disease were submitted to
FRIEND (Fitness Registry and the Importance of Exercise: A National Database).
Percentiles of maximal systolic and diastolic BP were determined for each decade.
Our results show a continued increase in peak systolic BP with age in both men
and women to the sixth decade, followed by a plateau between the sixth and
seventh decades. However, the trajectory of peak diastolic BP with age is
different between men and women. Men showed an increase in peak systolic BP until
the fifth decade, which plateaued by the seventh decade. In contrast, women
showed a continued increase in peak diastolic BP across each decade. Existing
reference data for exercising BP have not been updated for >20 years. Normative
peak exercising BP values from FRIEND can be used to provide a more current
representation of maximal BP during exercise testing in the US population.