20 June 2020

Lasting spikes in blood pressure while exercising could be an unhealthy sign

A major ongoing US heart study looked at the link between blood pressure levels, as well as the time needed for high blood pressure to recede back to normal in nearly 2 000 people.

Middle-aged men and women who develop high blood pressure while performing even moderate exercise may be at higher risk for heart disease, a new study suggests.

"The way our blood pressure changes during and after exercise provides important information on whether we will develop disease in the future," researcher Vanessa Xanthakis, assistant professor of medicine at Boston University School of Medicine, said in a university news release.

In the study, Xanthakis and her colleagues looked at the link between blood pressure levels, as well as the time needed for high blood pressure to recede back to normal, for nearly 2 000 people enrolled in a major ongoing US heart health study.

Participants averaged 58 years of age, about a quarter were obese, and about a third had hypertension at the beginning of the study.

Follow a healthy lifestyle

All of the participants were tested for changes in blood pressure while running at a "submaximal" level on a treadmill for three minutes at a stretch.

Their blood pressure readings were taken in the middle of the exercise bout, and then the rate at which blood pressure returned to normal ("recovered") was recorded as they laid on their backs after the exercise.

Higher blood pressure during exercise was linked with a higher risk of developing hypertension over the 12 years of the study, the team found. As well, delays in blood pressure recovery after exercise were also associated with a higher risk of both heart disease and death during the study period, the researchers found.

Xanthakis believes that people should know their blood pressure numbers, speak to their doctor about changes in blood pressure during and after exercise, and follow a healthy lifestyle – including regular physical activity – to lower risk of heart disease later in life.

Dr Guy Mintz directs cardiovascular health at Northwell Health's Sandra Atlas Bass Heart Hospital in Manhasset, New York. Reading over the new findings, he pointed out that in a typical cardiac stress test, "blood pressure is also monitored and reported as normal or as a hypertensive response to exercise – and that's it. But now we see that an abnormal blood pressure response to exercise should be a wake-up call to the clinician."

Sustained elevated pressure

This means that in a typical stress test, "useful data is left on the table that doctors can use to risk-stratify their middle-aged cardiovascular patient," Mintz believes. "If we can identify this group of middle-aged patients early, we can intensify their cardiovascular risk reduction at a younger age."

Another heart specialist agreed.

"As the arteries harden, they cannot relax after exercise during the recovery phase," explained Dr Satjit Bhusri, a cardiologist at Lenox Hill Hospital in New York City. "This sustained elevated pressure during recovery is itself another independent marker of cardiovascular health," he said, and "the quicker the return to normal, the healthier the cardiovascular system."

The report was published online on 20 May in the Journal of the American Heart Association.

Image credit: iStock


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Hypertension expert

Dr Jacomien de Villiers qualified as a specialist physician at the University of Pretoria in 1995. She worked at various clinics at the Department of Internal Medicine, Steve Biko Hospital, these include General Internal Medicine, Hypertension, Diabetes and Cardiology. She has run a private practice since 2001, as well as a consultant post at the Endocrine Clinic of Steve Biko Hospital.

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