Key result
Hypertension linked to ~7-fold higher rate of abnormal exercise-induced blood pressure.
Why the study?
Regular physical exercise is a key component of non-pharmacological hypertension management, but exercise carries potential physiological stress risks. Whether all hypertensive patients are suitable for guideline-recommended moderate-to-vigorous intensity aerobic exercise required exploration.
Does symptom-limited bicycle cardiopulmonary exercise testing provoke abnormal exercise-induced high blood pressure more frequently in patients with hypertension compared to controls?
Cross-Sectional (n=47)
Does symptom-limited bicycle cardiopulmonary exercise testing provoke abnormal exercise-induced high blood pressure more frequently in patients with hypertension compared to controls?
Nearly one-third of hypertensive patients exhibit abnormal blood pressure elevation during exercise, suggesting that cardiopulmonary exercise testing should be considered before prescribing moderate-to-high intensity exercise regimens.
Abnormal exercise BP response may identify hypertension phenotypes; leaves open prognostic value and need for longitudinal validation before clinical use.
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.
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Bao et al. (2026) conducted a cross-sectional in Hypertension (n=47). Hypertension undergoing cardiopulmonary exercise test (CPET) vs. Normotensive controls was evaluated on Abnormal exercise-induced high blood pressure (SBP >210 mmHg in men or >190 mmHg in women) (p=<0.001). Hypertension patients undergoing CPET had a higher rate of abnormal exercise-induced high blood pressure compared with controls (32% vs 4.5%, P<0.001).
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