Exercise blood pressure: Clinical relevance and correct measurement
Open accessAbstract
Blood pressure (BP) is a mandatory safety measure during graded intensity clinical exercise stress testing. While it is generally accepted that exercise hypotension is a poor prognostic sign linked to severe cardiac dysfunction, recent meta-analysis data also implicate excessive rises in submaximal exercise BP with adverse cardiovascular events and mortality, irrespective of resting BP. Although more data is needed to derive submaximal normative BP thresholds, the association of a hypertensive response to exercise with increased cardiovascular risk may be due to underlying hypertension that has gone unnoticed by conventional resting BP screening methods. Delayed BP decline during recovery is also associated with adverse clinical outcomes. Thus, above and beyond being used as a routine safety measure during stress testing, exercise (and recovery) BP may be useful for identifying high-risk individuals and also as an aid to optimise care through appropriate follow-up after exercise stress testing. Accordingly, careful attention should be paid to correct measurement of exercise stress test BP (before, during and after exercise) using a standardised approach with trained operators and validated BP monitoring equipment (manual or automated). Recommendations for exercise BP measurement based on consolidated international guidelines and expert consensus are presented in this review.
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Measurement of submaximal exercise blood pressure is comparatively easy and removes the influence of external artifact (noise and movement) that may occur during exercise at maximal workloads.
“Measurement of submaximal exercise BP is comparatively easy and also removes the influence of external artifact (noise and movement) that may occur during exercise at maximal workloads (4).”
From Cardiorespiratory Fitness, Workload, and the Blood Pressure Response to Exercise Testing (2022) · cites this paper as [4]
Measurement of BP during moderate-intensity exercise is comparatively easy because it removes the influence of external artefacts (noise and movement) that can occur during higher intensity exercise.
“Importantly, measurement of BP during moderate-intensity exercise is also comparatively easy because it removes the influence of external artefacts (noise and movement) that can occur during higher intensity exercise [24].”
From The Identification and Management of High Blood Pressure Using Exercise Blood Pressure: Current Evidence and Practical Guidance (2022) · cites this paper as [24]
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- Authors
- Sharman, J. E., & LaGerche, A.
- Affiliations
- University of Tasmania (AU)
- Corresponding author
- Sharman, J E
- ORCID
- Sharman, J E
- Venue
- Journal of Human Hypertension
- Published
- 2014-10-02
- Volume
- 29
- Issue
- 6
- Pages
- 351-358
- ISSN
- 0950-9240 (ISSN-L)
- 1476-5527
- OpenAlex
- W2075705822
- Cited by
- 142
- References
- 77
- Citations by year
- 2026: 9 · 2025: 11 · 2024: 13 · 2023: 8 · 2022: 33 · 2021: 17 · 2020: 13 · 2019: 10 · 2018: 5 · 2017: 5 · 2016: 9 · 2015: 6 · 2013: 1
- FWCI
- 1.07
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Locations
- Journal of Human Hypertension (publishedVersion)
- PubMed (publishedVersion)
- eCite Digital Repository (University of Tasmania) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- blood pressure response to exercise, exercise stress testing, hypertension, cardiovascular risk, blood pressure measurement, cardiovascular mortality
- MeSH terms
- Blood Pressure, Blood Pressure Determination, Humans, Exercise
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