The relationship between occupational noise exposure and hypertension as well as other coronary risk factors is recently highlighted. The objective of this study was to investigate if exaggerated blood pressure response to exercise testing can be used as a predictive tool for cardiovascular risk stratification in relation to occupational noise exposure.Subjects and Methods: Normotensive male workers free from diabetes and cardiovascular disease, in one of the industrial facilities in Alexandria were included in the study. Personal noise exposure levels were measured for workers exposed to noise in compressors and maintenance workshops as mean time weighted average (TWA). Three groups were considered each one comprised 50 workers representing high noise exposed group (compressor operators with TWA 90±4 dBA), low noise
exposed group (maintenance workers with TWA 79±6 dBA) and non exposed group from administrative staff. After ethical consideration and obtaining a written consent,all participants were subjected to a questionnaire about personal and occupational data including perceived noise annoyance. Conventional coronary risk factors were measured. A standard symptom limited ergometer exercise test with Bruce protocol was performed and peak exercise hemodynamic variables were defined. Exaggerated blood pressure response at exercise was defined as peak SBP > 200 mmHg and/or peak
DBP > 95 mmHg.Results: The three groups were similar in socio-demographic data. Exaggerated BP response at exercise was significantly more prevalent among high noise exposed  group in comparison to other groups. The sensitivity and specificity of the suggested test in predicting high risk cases (those with ≥ 3 risk factors) were 77.5% and 84.6%
respectively. Logistic regression analysis of results of the predictive test showed significant relation to noise level, perceived noise annoyance, resting HR and LDLcholesterol (P< 0.05 for all). Conclusion and recommendations: Exaggerated BP response to exercise can be used as a predictive tool for early detection of high risk noise exposed workers in occupational health preventive programs. Noise exposure levels should be reduced to
safe health criteria.