| 1. |
- Schultz, Martin G., et al.
(author)
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The Identification and Management of High Blood Pressure Using Exercise Blood Pressure : Current Evidence and Practical Guidance
- 2022
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In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:5
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Journal article (peer-reviewed)abstract
- High blood pressure (BP) is a leading risk factor for cardiovascular disease (CVD). The identification of high BP is conventionally based on in-clinic (resting) BP measures, performed within primary health care settings. However, many cases of high BP go unrecognised or remain inadequately controlled. Thus, there is a need for complementary settings and methods for BP assessment to identify and control high BP more effectively. Exaggerated exercise BP is associated with increased CVD risk and may be a medium to improve identification and control of high BP because it is suggestive of high BP gone undetected on the basis of standard in-clinic BP measures at rest. This paper provides the evidence to support a pathway to aid identification and control of high BP in clinical exercise settings via the measurement of exercise BP. It is recommended that exercise professionals conducting exercise testing should measure BP at a fixed submaximal exercise workload at moderate intensity (e.g., similar to 70% age-predicted heart rate maximum, stage 1-2 of a standard Bruce treadmill protocol). If exercise systolic BP is raised (>= 170 mmHg), uncontrolled high BP should be assumed and should trigger correspondence with a primary care physician to encourage follow-up care to ascertain true BP control (i.e., home, or ambulatory BP) alongside a hypertension-guided exercise and lifestyle intervention to lower CVD risk related to high BP.
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| 2. |
- Climie, Rachel E.D., et al.
(author)
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Hypertension : pathophysiology and relevance to the cardiometabolic syndrome
- 2023
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In: Cardiovascular Endocrinology and Metabolism : Theory and Practice of Cardiometabolic Medicine - Theory and Practice of Cardiometabolic Medicine. - 9780323999915 - 9780323983181 ; , s. 83-96
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Book chapter (peer-reviewed)abstract
- High blood pressure, or hypertension, is the leading single risk factor for the global burden of disease. Hypertension often coexists with several anthropometric and metabolic abnormalities, including abdominal obesity, dyslipidemia, and glucose intolerance—in combination referred to as metabolic (or cardiometabolic) syndrome. Indeed, hypertension occurs in a large proportion of those with metabolic syndrome; however, the interconnected relationship between the components of metabolic syndrome makes it challenging to determine the underlying causes and consequences. Metabolic disease is associated with arterial changes which favor the development and maintenance of hypertension, including endothelial dysfunction, arteriolar remodeling, and large artery stiffening. Thus it is evident that the vasculature plays a key role in perpetuating the relationship between hypertension and metabolic syndrome. Given that childhood health has a substantial influence on cardiometabolic health later in life, efforts should be targeted at the prevention of risk factor onset early in the life course, to stem the growing burden of both hypertension and metabolic disease.
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