Exercising in Stressful Environmental Conditions with Hypertension Versus Normal Blood Pressure

Hypertension (high blood pressure [BP]) is the most common, costly, and preventable cardiovascular disease risk factor in the world. Regular aerobic exercise is universally recommended as a lifestyle therapeutic intervention for the prevention, treatment, and control of high blood pressure. However, the stressor response to exercise in extreme but commonly experienced stressful environments may be exacerbated in individuals with hypertension, a situation not fully described in the literature. Therefore, we performed a systematic search examining the potential adverse health effects of exercising in hot, humid, cold, or air-polluted environments among adults with hypertension. Studies included adults with hypertension compared to normal BP and that with at least one physiological marker in response to heat, humidity, cold, windchill, or air pollution. The present systematic review revealed few studies that explored differences between individuals with hypertension and normal BP while exercising in commonly experienced stressful environmental conditions. Our preliminary evidence suggests that adults with hypertension may be more vulnerable to adverse cardiovascular stressor responses while exercising in the heat. Future studies are required to better characterize these maladaptive responses to extreme heat or humidity to better identify potential counter-measures for this vulnerable population.