Table I.
Patients’ Baseline Clinical Characteristics and Exercise Parameters
| Exercise BP Recoverya and HR Recoveryb Subgroups | ||||||
|---|---|---|---|---|---|---|
| All (N=830) | Normal BP rec Normal HR rec (n=465) | Delayed BP rec Normal HR rec (n=156) | Normal BP rec Delayed HR rec (n=137) | Delayed BP rec Delayed HR rec (n=72) | P Value | |
| Clinical Characteristics | ||||||
| Age, y | 53.8±11.4 | 52.7±11.4 | 54.1±11.6 | 55.4±11.0 | 57.5±10.8 | .002 |
| Male sex, No. (%) | 550 (66.3) | 302 (64.9) | 94 (60.3) | 105 (76.6) | 49 (68.1) | .022 |
| Family history of CAD, No. (%) | 188 (22.7) | 102 (21.9) | 34 (21.8) | 34 (24.8) | 18 (25.0) | .851 |
| BMI, kg/m2 | 27.0±3.5 | 26.8±3.5 | 27.1±3.5 | 27.2±3.3 | 27.6±3.9 | .231 |
| Smoking, No. (%) | 238 (28.7) | 133 (28.6) | 36 (23.1) | 46 (33.6) | 23 (31.9) | .224 |
| Arterial hypertension, No. (%) | 456 (54.9) | 238 (51.2) | 84 (53.8) | 85 (62.0) | 49 (68.1) | .015 |
| Dyslipidemia, No. (%) | 467 (56.3) | 262 (56.3) | 88 (56.4) | 84 (61.3) | 33 (45.8) | .203 |
| Diabetes mellitus, No. (%) | 56 (6.7) | 23 (4.9) | 11 (7.1) | 13 (9.5) | 9 (12.5) | .049 |
| Treatment: ACE inhibitors or ARBs, No. (%) | 265 (31.9) | 140 (30.1) | 46 (29.5) | 52 (38.0) | 27 (37.5) | .199 |
| Diuterics, No. (%) | 134 (16.1) | 57 (12.3) | 26 (16.7) | 32 (23.4) | 19 (26.4) | .001 |
| Calcium channel blockers, No. (%) | 133 (16.0) | 67 (14.4) | 25 (16.0) | 27 (19.7) | 14 (19.4) | .388 |
| β‐Blockers, No. (%) | 111 (13.4) | 61 (13.1) | 16 (10.3) | 22 (16.1) | 12 (16.7) | .401 |
| Statins, No. (%) | 199 (24.0) | 117 (25.2) | 28 (17.9) | 39 (28.5) | 15 (20.8) | .182 |
| Antiplatelet agents, No. (%) | 105 (12.7) | 52 (11.2) | 15 (9.6) | 26 (19.0) | 12 (16.7) | .042 |
| Exercise Parameters | ||||||
| Exercise duration, s | 540.5±150.1 | 563.4±145.5 | 528.0±152.6 | 510.1±147.3 | 478.3±151.1 | <.001 |
| METs | 10.7±2.7 | 11.1±2.6 | 10.6±2.7 | 10.2±2.6 | 9.7±2.6 | <.001 |
| Resting HR, bpm | 82.9±12.8 | 81.4±11.8 | 80.1±13.2 | 90.0±12.9 | 85.4±13.1 | <.001 |
| Peak exercise HR, bpm | 161.6±17.8 | 163.8±16.4 | 162.2±19.6 | 157.7±18.7 | 154.1±18.4 | <.001 |
| Achieved HR, % of predicted | 97.3±9.0 | 98.0±8.3 | 97.9±10.4 | 95.8±9.2 | 94.8±9.5 | .006 |
| Recovery HR, bpm | ||||||
| First minute | 130.4±18.4 | 128.4±17.1 | 125.7±19.0 | 139.0±18.6 | 136.8±18.5 | <.001 |
| Second minute | 109.2±16.9 | 107.7±15.8 | 104.2±17.1 | 117.2±17.5 | 114.6±16.3 | <.001 |
| Third minute | 101.0±15.1 | 99.5±13.8 | 96.6±15.1 | 109.3±16.0 | 104.7±15.0 | <.001 |
| Resting SBP, mm Hg | 118.5±15.7 | 117.7±15.0 | 116.8±15.1 | 120.8±17.5 | 122.9±17.0 | .008 |
| Peak exercise SBP, mm Hg | 172.5±23.0 | 176.2±22.4 | 161.3±22.0 | 176.7±22.7 | 164.5±20.5 | <.001 |
| Exaggerated BP response,c No. (%) | 237 (28.6) | 173 (37.2) | 22 (14.1) | 36 (26.3) | 6 (8.3) | <.001 |
| Recovery SBP, mm Hg | ||||||
| First minute | 166.2±23.9 | 165.6±23.2 | 166.8±25.0 | 164.3±25.5 | 171.8±22.0 | .154 |
| Second minute | 154.7±25.3 | 151.0±24.3 | 161.5±25.6 | 153.0±26.3 | 166.5±22.5 | <.001 |
| Third minute | 144.3±22.3 | 139.2±20.2 | 155.0±21.9 | 139.9±21.5 | 162.5±20.9 | <.001 |
| Resting RP product, bpm×mm Hg | 9844±2126 | 9592±1910 | 9354±2028 | 10,885±2315 | 10,547±2482 | <.001 |
| Peak exercise RP product, bpm×mm Hg | 27,880±4753 | 28,837±4486 | 26,224±4979 | 27,798±4452 | 25,442±4701 | <.001 |
| Recovery RP product, bpm×mm Hg | ||||||
| First minute | 21,637±4161 | 21,226±3866 | 21,052±4670 | 22,715±3979 | 23,507±4345 | <.001 |
| Second minute | 16,894±3769 | 16,278±3551 | 16,877±3971 | 17,838±3629 | 19,105±3827 | <.001 |
| Third minute | 14,581±3155 | 13,871±2876 | 15,009±3326 | 15,229±2996 | 17,010±3214 | <.001 |
| Angina‐like symptoms, No. (%) | 24 (2.9) | 11 (2.4) | 6 (3.8) | 4 (2.9) | 3 (4.2) | .385 |
| Ischemic ST‐segment response, No. (%) | 104 (12.5) | 56 (12.0) | 22 (14.1) | 17 (12.4) | 9 (12.5) | .356 |
| QRS scored | 0.7±3.4 | 1.3±3.3 | 0.2±3.7 | −0.1±3.3 | −0.8±3.6 | .001 |
Abbreviations: ACE, angiotensin‐converting enzyme; ARBs, angiotensin receptor blockers; BMI, body mass index; BP, blood pressure; bpm, beats per minute; CAD, coronary artery disease; HR, heart rate; METs, metabolic equivalents (3.5 mL O2/kg/min); rec, recovery; RP product, rate‐pressure product (HR×SBP); SBP, systolic blood pressure. aDelayed BP recovery: third minute of recovery SBP/peak exercise SBP ≥0.90. bDelayed HR recovery: peak exercise HR – first minute of recovery HR ≤23 bpm. cExaggerated BP response: peak exercise SBP – resting SBP ≥65 mm Hg. dQRS score: (resting [R−Q−S] aVF+resting [R−Q−S] V5)−(peak exercise [R−Q−S] aVF+peak exercise [R−Q−S] V5).