Masked hypertension and submaximal exercise blood pressure among adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC)

Zhengzheng Huang  James E. Sharman  Ricardo Fonseca  Chloe Park  Nish Chaturvedi  George Davey Smith  Laura D. Howe  Deborah A. Lawlor  Alun D. Hughes  Martin G. Schultz

Scand J Med Sci Sports. 2019. doi: 10.1111/sms.13525. [Epub ahead of print]. 

https://onlinelibrary.wiley.com/doi/abs/10.1111/sms.13525

Zhengzheng Huang

1) Summarize your work in one sentence.

We examined if the BP response to a simple exercise step-test could identify or rule out the presence of masked hypertension in a group of apparently healthy adolescents.

2) Summarize your findings in one sentence.

The principal results of this study suggested that systolic BP following the short exercise step‐test could effectively rule-out the presence of masked hypertension, without the need to complete out-of-office (home or ambulatory) BP monitoring.

3) Which were the more important methods you used in this work? If it is not a traditional method, you can briefly explain the concept of that methodology.

The novel methodology of this study was that we used exercise BP to determine the presence/absence of masked hypertension. BP is optimally assessed using a combination of in-clinic and out-of-clinic measurements (including home and/or ambulatory BP). However, out-of-clinic methods are not always available or practical. However, a potentially simple alternative is to use the BP response to a light-to-moderate intensity exercise challenge. Indeed, ‘exercise BP’ measured at a light‐to‐moderate intensity reflects a cardiovascular load commensurate with activities of daily living and likely more closely reflects true BP than do traditional in‐clinic measures performed at rest. Thus, using exercise BP could negate the need for out-of-clinic monitoring to screen for masked hypertension in the first instance.

4) What did you learn from this paper, what was your take-home message?

Exercise BP may be useful tool in addition to clinic BP for screening out underlying high BP and related cardiovascular risk in adolescents, without the need to undertake out-of-clinic BP monitoring.