Abstract
Exercise-induced hypertension (EIH) is defined as elevated blood pressure (BP) > 190mm Hg for females and > 210 mmHg for males during exercise. EIH is prevalent among athletes and healthy individuals with no cardiovascular (CV) risk factors. While previous data corroborates exercise in reducing hypertension and cardiovascular risk, the development of EIH and its attendant cardiovascular risk necessitates a review of the pathophysiological mechanisms resulting in EIH. To date, these mechanisms causing EIH are not fully understood, nor are there any established guidelines on the management of EIH. In this article, we discuss in detail the pathophysiological mechanisms, the prognostic value, clinical implications, possible treatment, and future directions in managing EIH.
Highlights
BackgroundHypertension has become the most prevalent cardiovascular risk factor among the U.S population and worldwide [1]
Exercise-induced hypertension (EIH) is one factor that could be linked to the development of hypertension in young athletes and healthy individuals later in their lives [6]
One of the first and largest meta-analysis studies that investigated the prognostic value of exercise blood pressure (BP) in 46,314 individuals reported that high exercise BP during or after moderate exercise increased the risk of cardiocerebrovascular outcome
Summary
Hypertension has become the most prevalent cardiovascular risk factor among the U.S population and worldwide [1]. With the increasing concern that high blood pressure during exercise should be a warning signal to healthy young adults and athletes on developing hypertension and cardiac injury, early intervention is important to reduce the risk of end-organ damage [8]. Kim et al and Abdulla et al both reported that atrial fibrillation is 2.5 times more common in athletes who perform a high-intensity exercise such as marathon running and five times more common in athletes than the general population [35,36] Whether these structural heart changes result from physiologic adaptation to exercise or hypertension is uncertain [37]. Previous studies reported that this physiologic response to exercise was not associated with an increased risk of cardiovascular adverse events (e.g., arrhythmias) seen in hypertension-related LVH [38,39]. A reduction in the duration and the intensity of exercise may be warranted to prevent cardiovascular adverse events [35]
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