Detecting abnormal exercise-induced high blood pressure in hypertension
L W Bao, hh Chen, D Y Li, Y J Song, Y Z ShenAbstract
Background
Regular physical exercise remains key component of non-pharmacological management for hypertension. However, as a form of physiological stress, exercise itself carries potential risks. It is worth exploring whether all hypertension patients are suitable for moderate-to-vigorous intensity aerobic exercise recommended by guidelines.
Method
A cross-sectional study was implemented in hypertension (HTN) and the controls, employing cardio pulmonary exercise test (CPET) to evaluate the blood pressure changes during exercise. During CPET, routine ventilation tests were performed, followed by symptom-limited bicycle exercise with continuous monitoring until termination criteria were met. Peak VO2, VE/VCO2, systolic blood pressure (SBP) at peak and recovery period and diastolic blood pressure (DBP) at peak and recovery period were recorded. Abnormal exercise-induced high blood pressure is defined as SBP above 210mmHg in man or 190mmHg in woman. Stata 15.0 was used for analyzing the differences of exercise-induced blood pressure values between two groups.
Results
There were 25 hypertensives and 22 controls enrolled in the study. The average age was 47.2+12.9 years old and 46.8% were males. There were no significant differences in Peak VO2 (23.2+5.82 vs 21.5+5.44, p=0.29) and VE/VCO2 (27.3 (25.7-28.7) vs 28.8 (26.5-29.6), p=0.48) between HTN group and the controls. Peak SBP (193 +21.9 vs 168 +25.1, p=0.003) and DBP (104 +13.2 vs 84.0+19.6, p=0.002) were significantly higher in HTN group versus the controls. Abnormal exercise-induced high blood pressure occurred in 32% HTN and 4.5% in the controls ((n=8 vs n=1, p<0.001).
Conclusion
Peak SBP and DBP were significantly higher in hypertensive patients, with nearly 32% showing abnormal exercise-induced blood pressure elevation. Therefore, moderate-to-high intensity exercise is not advisable for all hypertensions, and exercise test should be considered before prescribing a regular exercise regimen.