Exercise hypertension in hypertensive patients is associated with enhanced ventricular contractility and excessive rate-pressure product response to stress, indicating a need for more careful clinical evaluation.
Does the evaluation of stress-induced hypertensive response provide important prognostic and diagnostic information in clinical practice?
Exercise-induced hypertension may indicate enhanced ventricular contractility and excessive rate-pressure product, serving as a potential warning signal for future resting hypertension and left ventricular hypertrophy.
Various diagnostic methods have been used to evaluate hypertensive patients under physical and pharmacological stress. Several studies have shown that exercise hypertension has an independent, adverse impact on outcome; however, other prognostic studies have shown that exercise hypertension is a favorable prognostic indicator and associated with good outcome. Exercise hypertension may be encountered as a warning signal of hypertension at rest and future hypertensive left ventricular hypertrophy. The results of diagnostic stress tests support that hypertensive response to exercise is frequently associated with high rate-pressure product in hypertensives. In addition to the observations on high rate-pressure product and enhanced ventricular contractility in patients with hypertension, evaluation of myocardial contractility by Doppler tissue imaging has shown hyperdynamic myocardial function under pharmacological stress. These recent quantitative data in hypertensives suggest that hyperdynamic myocardial function and high rate-pressure product response to stress may be related to exaggerated hypertension, which may have more importance than that it has been already given in clinical practice.
Küçukler et al. (Mon,) conducted a review in Exercise hypertension. Exercise hypertension in hypertensive patients is associated with enhanced ventricular contractility and excessive rate-pressure product response to stress, indicating a need for more careful clinical evaluation.