Hedman et al. must be congratulated for their excellent work setting up reference values for systolic blood pressure (SPB) at upright bicycle exercise tests. However, they missed comparing their data with the now second-largest study by Heck et al. This study is published in German only and, therefore, is fairly unknown in the non-German speaking medical world. Almost 40 years ago the group in Cologne investigated the SPB response in a stepwise increasing bicycle ergometry with 16,656 measurements in 2972 subjects. They based their model on physiology and assumed that a baseline SBP rises linearly with increasing work load (WL). Now we know that they were…