Review Pulse 2013;1:161–176 Exercise Hypertension

Resting blood pressure · Exercise hypertension · Hypertensive response to exercise · Lifestyle interventions · Blood pressure control Irrespective of apparent ‘normal ’ resting blood pressure (BP), some individuals may experi-ence an excessive elevation in BP with exercise (i.e. systolic BP ≥ 210 mm Hg in men or ≥ 190 mm Hg in women or diastolic BP ≥ 110 mm Hg in men or women), a condition termed exercise hypertension or a ‘hypertensive response to exercise ’ (HRE). An HRE is a relatively common condition that is identified during standard exercise stress testing; however, due to a lack of information with respect to the clinical ramifications of an HRE, little value is usually placed on such a finding. In this review, we discuss both the clinical importance and underlying phys-iological contributors of exercise hypertension. Indeed, an HRE is associated with an increased propensity for target organ damage and also predicts the future development of hyperten-sion, cardiovascular events and mortality, independent of resting BP. Moreover, recent work has highlighted that some of the elevated cardiovascular risks associated with an HRE may be related to high-normal resting BP (pre-hypertension) or ambulatory ‘masked ’ hypertensio