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Exercise Hypertension

Citation

Schultz, MG and Sharman, JE, Exercise Hypertension, Pulse, 1, (3-4) pp. 161-176. ISSN 2235-8676 (2013) [Refereed Article]

Copyright Statement

Copyright 2013 Karger AG, Basel

DOI: doi:10.1159/000360975

Abstract

Irrespective of apparent ‘normal’ resting blood pressure (BP), some individuals may experience an excessive elevation in BP with exercise (i.e. systolic BP ≥ 210 mm Hg in men or ≥ 190 mm Hg in women or diastolic BP ≥ 110 mm Hg in men or women), a condition termed exercise hypertension or a ‘hypertensive response to exercise’ (HRE). An HRE is a relatively common condition that is identified during standard exercise stress testing; however, due to a lack of information with respect to the clinical ramifications of an HRE, little value is usually placed on such a finding. In this review, we discuss both the clinical importance and underlying physiological contributors of exercise hypertension. Indeed, an HRE is associated with an increased propensity for target organ damage and also predicts the future development of hypertension, cardiovascular events and mortality, independent of resting BP. Moreover, recent work has highlighted that some of the elevated cardiovascular risks associated with an HRE may be related to high-normal resting BP (pre-hypertension) or ambulatory ‘masked’ hypertension and that an HRE may be an early warning signal of abnormal BP control that is otherwise undetected with clinic BP. Whilst an HRE may be amenable to treatment via pharmacological and lifestyle interventions, the exact physiological mechanism of an HRE remains elusive, but it is likely a manifestation of multiple factors including large artery stiffness, increased peripheral resistance, neural circulatory control and metabolic irregularity. Future research focus may be directed towards determining threshold values to denote the increased risk associated with an HRE and further resolution of the underlying physiological factors involved in the pathogenesis of an HRE.

Item Details

Item Type:Refereed Article
Keywords:Resting blood pressure, Exercise hypertension, Hypertensive response to exercise, Lifestyle interventions, Blood pressure control
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Schultz, MG (Dr Martin Schultz)
Author:Sharman, JE (Professor James Sharman)
ID Code:90722
Year Published:2013
Deposited By:Menzies Institute for Medical Research
Deposited On:2014-04-17
Last Modified:2016-10-19
Downloads:0

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