Patients with hypertensive responses to exercise or dobutamine stress testing differ in resting hypertensive phenotype
Kieu A, Shaikh A, Kaeppler M, Miles RJ, Widlansky ME. Patients with hypertensive responses to exercise or dobutamine stress testing differ in resting hypertensive phenotype. J Am Soc Hypertens. 2018;12(2):108-116.
Little is known of the importance of echocardiographic measures of resting systemic vascular resistance (SVR), cardiac output, and diastolic function in the development of a hypertensive response during dobutamine stress echocardiography. We performed a retrospective review of 325 subjects who underwent stress echocardiography and a resting echocardiogram on the same day. Logistical regressions were performed to determine associations between hypertensive response to each type of stress test and clinical and hemodynamic measurements obtained by transthoracic echocardiography. Patients with a hypertensive response to dobutamine or exercise stress modalities had Stage 1 hypertension. Those with a hypertensive response to dobutamine had a significantly elevated SVR and a lower cardiac output compared to those with a hypertensive response to exercise or a nonhypertensive response to dobutamine. An SVR ≥2000 dynes × sec/cm