Zafrir B, Aker A, Asaf Y, et al. - Regarding long-term risk for cardiovascular events and the likelihood for developing hypertension, an incremental prognostic information can be obtained through blood pressure (BP) measurements during rest, exercise and recovery phases of exercise stress testing (EST).

• In this retrospective analysis, treadmill ESTs (years 2005–2019) performed by the Bruce protocol in patients aged 35–75 years without a history of cardiovascular disease (n = 14 792; 48% women) were analyzed.

• An increase in the adjusted hazard ratio for MACE (major adverse cardiovascular event) was observed in relation to highest vs lowest SBP quartile at rest, submaximal-exercise, peak-exercise and recovery: 1.53, 1.33, 1.30, 1.35, respectively.

• A J-shaped pattern of the link between SBP at submaximal exercise and recovery with MACE was evident.

• In those without hypertension, excessive SBP response to peak exercise (≥190 mmHg in women and ≥210 mmHg in men) was identified to be an independent predictor of hypertension [hazard ratio]: 1.87, as were SBPs during submaximal exercise and recovery.