Ergometry in the Assessment of Arterial Hypertension

Abstract

The blood pressure behavior during and after ergometric exercise was investigated in 552 males in order to clarify if this standardized procedure is suitable for differentiating between normotensive subjects and hypertensive patients. Patients suffering from mild hypertension showed significantly (p < 0.001) higher blood pressures (213 ± 22/116 ± 11 mm Hg) at 100 W and after loading than age-matched normotensives (188 ± 14/92 ± 9 mm Hg) but significantly (p < 0.001) lower values than hypertensives with stable hypertension (225 ± 22/126 ± 11 mm Hg). Moreover, the systolic pressure response to ergometric work was significantly (p < 0.05 – p < 0.01) influenced by age. Using the normal upper limits for blood pressure during and after ergometry the ergometric procedure revealed that 50% of the patients with borderline hypertension at rest could be classified as hypertensives. Their blood pressure response at 100 W (216 ± 21/113 ± 8 mm Hg) did not significantly differ from the patients with mild hypertension. In contrast, in the 50% who reacted negatively to ergometric testing, the systolic blood pressure response at 100 W (204 ± 18 mm Hg) was significantly (p < 0.01) lower than that of those who demonstrated a positive reaction, revealing exactly the same diastolic blood pressure value of 92 mm Hg as the normotensives. The present study strongly suggests that the assessment of blood pressure during ergometric testing is quite useful in distinguishing between normotensive and hypertensive patients and in making estimates of blood pressure response to daily stress more accurate.

Blood Pressure Response to Heart Rate During Exercise Test and Risk of Future Hypertension

“…In contrast, DBP remains unchanged or shows only a slight increase as a consequence of metabolic vasodilatation of the peripheral vessels. 17 However, some researchers 11,17,18 have observed a significant rise in DBP even in normotensive subjects, suggesting an increased resting peripheral vascular resistance 11,19 and impaired capacity for exercise-induced vasodilation. 20,21 This hemodynamic pattern can be explained by a hyperreactivity of the sympathetic nerves and an increased vascular response to adrenergic stimulation or by a thickening of the arteriolar wall that alters its ability to respond to vasoconstrictor stimuli.…”

“…22 Conversely, statistically significant differences appear in indirect DBP readings measured especially during maximal exercise 16,22,23 because maximal ergometric work requires isometric muscle contractions, which produce a marked increase in total peripheral resistance. 11,17,18 However, it has been demonstrated that direct and indirect measurements of DBP satisfactorily correlate below the workload of mild or moderate exercise. 17,18,22,23 Furthermore, several studies have shown that endurance-trained persons are more likely to exhibit significantly higher SBP increases during maximal exercise than untrained persons, despite their reduced risk for developing hypertension.…”

“…11,17,18 However, it has been demonstrated that direct and indirect measurements of DBP satisfactorily correlate below the workload of mild or moderate exercise. 17,18,22,23 Furthermore, several studies have shown that endurance-trained persons are more likely to exhibit significantly higher SBP increases during maximal exercise than untrained persons, despite their reduced risk for developing hypertension. 24,25 These findings lead to the idea that an exaggerated BP response to exercise should be determined based on SBP and DBP together from data obtained during relatively low submaximal exercise workload.…”

Acute Cardiovascular Response to Pre-Prandial and Postprandial Exercise in Active Men

“…It is shown in the literature that diastolic BP response to exercise is mediated by the vasodilation capacity of peripheral vessels and the consequent reduction in peripheral vascular resistance 25 . Ordinarily, diastolic BP remain constant or show small increases during submaximal or maximal aerobic exercise 22,26 . In this study, diastolic BP increased significantly only after exercise in the postprandial condition.…”

Exercise Systolic Arterial Blood Pressure in Middle-Aged Women with Normal and Elevated Arterial Blood Pressure

“…In patients with coronary heart disease, maximal systolic blood pressure was shown to be significantly related to the severity of coronary artery disease (10). The blood pressure response to exercise has been used in the assessment of hypertension (7,14) or to detect persons at risk for future hypertension (4,2 1). Considerable variations in blood pressure have been reported (2).…”