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Blood pressure response after two-step exercise as a powerful predictor of hypertension: the Osaka Health Survey

Objective To investigate the relationship between blood pressure at 4 min after exercise using a Master's two-step and the risk for hypertension. Design Prospective cohort study. Setting Work site in Osaka, Japan. Participants A total of 6557 Japanese men, aged 35–63 years with systolic blood pressure (SBP) < 140 mmHg and diastolic blood pressure (DBP) < 90 mmHg, and no history of hypertension or diabetes at baseline. Main outcome measures Blood pressure was measured by standard techniques, using 160/95 mmHg for diagnosis of hypertension. Normotension was defined as no history of hypertension, and SBP < 130 mmHg and DBP < 85 mmHg. High normal blood pressure was defined as no history of hypertension and SBP ⩾ 130 and < 140 mmHg or DBP ⩾ 85 and < 90 mmHg. Results During the 63 696 person-years follow-up period, we confirmed 660 cases of hypertension. SBP and DBP after exercise were associated with an increased risk for developing hypertension. The multiple-adjusted relative risk for SBP and DBP after exercise were 1.55 per 10 mmHg (confidence interval, 1.42–1.69) and 1.55 per 10 mmHg (confidence interval, 1.42–1.69), respectively. These associations were independent of resting SBP and DBP. Even after stratifying subjects according to blood pressure at rest, SBP or DBP at 4 min after exercise was associated with an increased risk for hypertension in subjects with normotension or high normal blood pressure at rest. Conclusions The blood pressure response after exercise with a two-step was associated with an increased risk for hypertension, independently of resting blood pressures.