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Exercise tests in labile hypertensive patients.

From a collectivity of 17,256 subjects below the age of 30 years, 80 subjects with labile hypertension (LH) were selected. The LH subjects were subjected to exercise test and the response of arterial blood pressure (BP) was followed up. The data obtained were compared with similar determinations carried out in a group of normotensive subjects. The mean value of systolic blood pressure (SBP) on exercise in the normal subjects was 171.0 +/- 2.9 mmHg and that of diastolic blood pressure (DBP) was 77.5 + 1.5 mmHg. The LH subjects presented, on exercise increases of both SBP and DBP in 35 cases (43.7%), increase of only SBP in 10 cases (12.5%) and "normal" type response in 35 cases (43.7%). In these subjects the mean value of SBP, on exercise, was 191.0 +/- 2.6 mmHg (p less than 0.001 as compared with the normal) and that of DBP was 90.0 +/- 1.9 mmHg (p less than 0.001 as compared with the normal). The above data proved that the LH subjects represented a group distinct from the normal subjects. The LH subjects presented a bimodal percent distribution of SBP and DBP on exercise, suggesting the existence of two subgroups one with "normal" type BP response the other with "hypertensive" type response. The BP response to exercise represents a simple test for the detection of abnormal BP increases. The authors consider as fully justified a longitudinal study of LH subjects. The exercise test might have a predictive value in detecting the early signs of essential hypertension.