Diagnostic accuracy of different exercise blood pressure metrics in identifying hypertension on 24-h ambulatory blood pressure monitoring in athletes

Abstract

Exercise blood pressure (BP) metrics have been promoted as a means of identifying latent or mild hypertension in athletes. We evaluated the diagnostic accuracy of four exercise BP metrics to diagnose hypertension, defined by 24-h ambulatory BP monitoring (ABPM) as mean ≥130/80 mmHg, daytime ≥135/85 mmHg and/or nighttime ≥120/70 mmHg. Fifty-four endurance-trained athletes (48 [IQR 24–58] years, 67% male) underwent exercise testing with serial BP measurements and 24-h ABPM. Exaggerated exercise BP (EEBP) was defined as exceeding a threshold for any of the four metrics: 1) maximal systolic BP (SBPmax) using published cut-offs; SBPmax ≥ 220 mmHg and ≥200 mmHg in males and females, respectively, ..