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Blood Pressure Response to Exercise and Cardiovascular Disease

  • Blood Pressure Monitoring and Management (J Cockcroft, Section Editor)
  • Published:
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Abstract

Purpose of Review

This review aimed to provide a clinical update on exercise blood pressure (BP) and its relationship to cardiovascular disease (CVD), outlining key determinants of abnormal exercise BP responses. We also highlight current evidence gaps that need addressing in order to optimise the relevance of exercise BP as clinical CVD risk factor.

Recent Findings

Abnormal exercise BP manifests as either exercise hypotension (low BP response) or as exaggerated exercise BP (high BP response). Exercise hypotension is an established sign of existing and likely severe CVD, but exaggerated exercise BP also carries elevated CVD risk due to its association with sub-clinical hypertension. Although exaggerated exercise BP is related to heightened CVD risk at any exercise intensity, recent data suggest that the BP response to submaximal intensity exercise holds greater prognostic and clinical significance than BP achieved at peak/maximal intensity exercise. Cardiorespiratory fitness is a strong modifier of the exercise BP response, and should be taken into consideration when assessing the association with CVD.

Summary

Both exercise hypotension and exaggerated exercise BP serve as markers that should prompt evaluation for potential underlying CVD. However, the clinical utility of these markers is currently inhibited by the lack of consensus informing the definitions and thresholds for abnormalities in exercise BP.

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Acknowledgments

MGS is supported by a National Health and Medical Research Council (NHMRC) Australian Early Career Fellowship (reference 1104731).

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Authors and Affiliations

  1. Menzies Institute for Medical Research, University of Tasmania, Hobart, 7000, Australia

    Martin G. Schultz & James E. Sharman

  2. Baker Heart and Diabetes Institute, Melbourne, Australia

    Andre La Gerche

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  1. Martin G. Schultz
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Correspondence to Martin G. Schultz.

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This article is part of the Topical Collection on Blood Pressure Monitoring and Management

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Schultz, M.G., La Gerche, A. & Sharman, J.E. Blood Pressure Response to Exercise and Cardiovascular Disease. Curr Hypertens Rep 19, 89 (2017). https://doi.org/10.1007/s11906-017-0787-1

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