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Antihypertensives do not prevent exaggerated BP rise during exercise

5 days ago

Blood pressure (BP)-lowering medications do not appear to be protective against excessive BP increases during peak exercise testing or metaboreflex testing despite BP control at baseline, a study reports.

Researchers examined the BP response to incremental exercise testing and metaboreflex activation in 16 patients with treated–controlled hypertension, 16 with treated–uncontrolled hypertension, 11 with untreated hypertension (n=11) and 16 controls with normal BP. All groups were matched by age and body mass index.

Aerobic fitness did not differ among the four groups (p=0.97). At peak exercise on a cycle ergometer, absolute systolic (S)BP rose from baseline across all groups, although the increase was smaller in the normotensive control vs controlled, uncontrolled and untreated hypertension groups (SBP change, 47 vs 71, 81 and 79 mm Hg, respectively; p=0.0001).

Likewise, metaboreflex sensitivity was comparable in controlled, uncontrolled and untreated hypertension groups but significantly augmented compared to the normotensive control group (SBP change from baseline, 21, 28 and 25 vs 12 mm Hg, respectively; p<0.0001).

Hypertensive individuals on BP-lowering medications exhibited an amplified pressor response to exercise despite having controlled BP at rest. Researchers noted that this was partly caused by enhanced metaboreflex sensitivity.

The present data may have important implications as an exaggerated increase in BP during exercise poses a heightened risk of adverse cardiovascular events in treated and untreated hypertensives vs normotensives, researchers said.

The metaboreflex, which plays a key role in the exaggerated rise in SBP during exercise, represents a potential target for dynamic BP management, they added.

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