Recovery systolic blood pressure response after treadmill exercise procedures. Evidence against its usefulness in detecting coronary artery disease.

We compared the response of the systolic blood pressure (SBP) recovery ratio (obtained by dividing the SBP recovery values by the peak exercise values) during a treadmill exercise test in patients with chest pain and an angiographically normal coronary tree (n = 18) (C group), one or more greater than or equal to 70% stenosed major coronary vessel and normal resting ejection fraction (n = 26) (CAD group) or depressed left ventricular function (ejection fraction less than 40%) (n = 15) (CAD DYS group). The mean values of SBP recovery ratios were, in the three groups: 0.93 +/- 0.07, 0.97 +/- 0.07, 0.95 +/- 0.09, respectively, at the 1st min and 0.83 +/- 0.08, 0.88 +/- 0.09, 0.86 +/- 0.08, at the 3rd min. There are no significant differences in the CAD or CAD DYS group versus the C group, because of large overlapping of points in the plot. The post-exercise SBP response during treadmill procedures cannot provide the opportunity for differentiation of CAD patients with or without left ventricular dysfunction at rest from subjects with chest pain and normal coronary tree, while upright bicycle exercise, as we previously observed, can.