title: Is an exaggerated blood pressure response to exercise in hypertensive patients a benign phenomenon or a dangerous alarm?
abstract: BACKGROUND
  A hypertensive response to exercise is associated with high cardiovascular risk, whereas scarce data are available about its relation to surrogates of subclinical atherosclerosis. Endothelial dysfunction and intima-media thickness (IMT) have been demonstrated in atherosclerotic patients.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the relationships between a hypertensive response to exercise and IMT as well as endothelial function as surrogates of subclinical atherosclerosis.
  
  
  METHODS
  A total of 52 untreated males with stage I essential hypertension and a negative treadmill exercise test for exercise-induced myocardial ischemia were divided into two groups: group I which included 21 patients with a hypertensive response to exercise (peak exercise systolic blood pressure ≥210 mm Hg) and group II which included 31 individual with normal blood pressure response. Flow-mediated dilatation (FMD) and dilatation ratio (as markers of endothelial function) and measurements of carotid IMT were done for both groups.
  
  
  RESULTS
  Group I patients showed significant reduction in FMD (5.61 ± 5.25 vs 10.52 ± 4.78, p = 0.026) and dilatation ratio (50.28 ± 26.03 vs 94.8 ± 40.06, p < 0.001) compared to group II. Moreover, Group I patients also showed significant increase in IMT compared to group II (0.102 ± 0.033 vs 0.089 ± 0.03, p = 0.047).
  
  
  CONCLUSIONS
  Hypertensive response to exercise in patients with untreated stage I essential hypertension is associated with endothelial dysfunction and increased carotid IMT. It seems that this phenomenon is not a benign one but rather a dangerous alarm.
authors.affiliation: El Minya University, Egypt makder1999@yahoo.com.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Kader Abdel Wahab
mesh_terms: D000328:Adult; D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000503:physiopathology; D015444:Exercise; D005080:Exercise Test; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D018615:Ultrasonography, Doppler, Color; D014664:Vasodilation
keywords: Hypertensive; exercise; flow-mediated dilatation; intima-media thickness