HDCN Article Review/Hyperlink

Tanaka H, Bassett DR JR, Turner MJ

Exaggerated blood pressure response to maximal exercise in endurance-trained individuals

Am J Hypertens (Dec) 9:1099-1103 1996

In patients who are not trained athletes, an exaggerated BP increase during exercise may predict future hypertension. However, such studies have not included trained athletes, nor compared BP responses to exercise in trained vs. untrained individuals. Previous studies have looked at the effects of endurance training on maximum BP response to exercise, and some have found an increase, whereas others have found no changes.

Tanaka et al compared BP responses to exercise on a cycle ergometer in 31 well trained endurance athletes vs. 26 controls. Mean age was about 25 years, and the great majority of each group were men. Systolic pressure at maximal exercise averaged 225 mm Hg in the trained group vs. 204 in the untrained group, although the latter group did not reach the same level of work. At the same level of work, differences were much more modest, about 10 mm Hg systolic. However, the point is made that trained individuals have a lower, not a higher incidence of cardiovascular risk, and therefore the maxim that exercise-induced hypertension connotes higher cardiovascular risk has at least one exception.

Comment: This is an interesting study, and shows that data from correlational studies needs to be applied with the target patient in mind. Cardiac output was not measured, and, if one assumes similar rates of CO at similar workloads, one is led to the conclusion of a higher vascular resistance in the trained individuals. Tanaka et al hypothesize that perhaps the trained individuals don't produce as many vasodilator metabolites at the same workload as untrained individuals. (John T. Daugirdas, M.D., University of Illinois at Chicago)