{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T04:07:56Z","timestamp":1792555676730,"version":"4.5.0"},"reference-count":52,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Hypertension"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>A hypertensive response to exercise unmasks hypertension and is associated with future cardiovascular events. Yet, there is heterogeneity in blood pressure response patterns to exercise by age and sex, and some high-risk trajectories may go undetected if only focusing on peak blood pressure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We analyzed blood pressure data from 13\u2009945 patients who underwent a Bruce protocol exercise tolerance test between 2016 and 2020, including the rate of change across stages. We used latent class analysis to identify distinct blood pressure trajectories and assessed their association with individual and composite outcomes of myocardial infarction, stroke, heart failure, revascularization, and death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Women had lower mean systolic and diastolic blood pressure at rest (128 mm\u2009Hg versus 132 mm\u2009Hg; 78 mm\u2009Hg versus 80 mm\u2009Hg) and through stages 1 to 3 of the Bruce protocol (stage 1: 140 mm\u2009Hg versus 144 mm\u2009Hg; 78 mm\u2009Hg versus 80 mm\u2009Hg; stage 2: 153 mm\u2009Hg versus 157 mm\u2009Hg; 79 mm\u2009Hg versus 81 mm\u2009Hg; stage 3: 159 mm\u2009Hg versus 167 mm\u2009Hg; 80 mm\u2009Hg versus 82 mm\u2009Hg). Systolic blood pressure increased more slowly in women. Three distinct systolic blood pressure trajectories emerged, with steeper trajectories associated with older populations and men. Systolic Classes II and III, characterized as an elevated baseline and a gradual rise (Class II) and a steep rise (Class III) with exercise, were associated with cardiovascular outcomes. Yet, only 1.4% and 34% of patients in Class II and III, respectively, met traditional criteria for hypertensive response to exercise, suggesting missed opportunities for prevention and treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Blood pressure response to exercise varies by sex; models incorporating trajectories of blood pressure could more fully capture individuals at higher risk for future cardiovascular events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/hypertensionaha.124.23717","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T09:00:14Z","timestamp":1756285214000},"page":"1663-1674","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Evaluating Blood Pressure Response Patterns to Exercise Stress Testing"],"prefix":"10.1161","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5160-5080","authenticated-orcid":true,"given":"Aishwarya","family":"Nene","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of California San Francisco School of Medicine (A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, MA (D.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4707-339X","authenticated-orcid":true,"given":"Olayinka","family":"Agboola","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Cardiovascular Medicine, Inova Fairfax Hospital, Falls Church, VA (O.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3671-3622","authenticated-orcid":true,"given":"Jeph","family":"Herrin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT (J.H., A.F., E.J.M., Y.L., J.L.M., E.S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oyere K.","family":"Onuma","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Corrigan Minehan Heart Center, Mass General Brigham, Boston, MA (O.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2561-4282","authenticated-orcid":true,"given":"Attila","family":"Feher","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT (J.H., A.F., E.J.M., Y.L., J.L.M., E.S.S.)."},{"name":"Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT (A.F., E.J.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2156-5962","authenticated-orcid":true,"given":"Edward J.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT (J.H., A.F., E.J.M., Y.L., J.L.M., E.S.S.)."},{"name":"Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT (A.F., E.J.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5264-2169","authenticated-orcid":true,"given":"Yuan","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT (J.H., A.F., E.J.M., Y.L., J.L.M., E.S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1820-2933","authenticated-orcid":true,"given":"Judith L.","family":"Meadows","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT (J.H., A.F., E.J.M., Y.L., J.L.M., E.S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1557-7713","authenticated-orcid":true,"given":"Erica S.","family":"Spatz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT (J.H., A.F., E.J.M., Y.L., J.L.M., E.S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","unstructured":"Centers for Disease Control and Prevention. 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