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Review
. 2011 Aug 16:9:22.
doi: 10.1186/1476-7120-9-22.

Stress induced hypertensive response: should it be evaluated more carefully?

Nagehan Kucukler  1 , Fatih Yalçin, Theodore P Abraham, Mario J Garcia
Affiliations
Review

Stress induced hypertensive response: should it be evaluated more carefully?

Nagehan Kucukler et al. Cardiovasc Ultrasound. .

Abstract

Various diagnostic methods have been used to evaluate hypertensive patients under physical and pharmacological stress. Several studies have shown that exercise hypertension has an independent, adverse impact on outcome; however, other prognostic studies have shown that exercise hypertension is a favorable prognostic indicator and associated with good outcome. Exercise hypertension may be encountered as a warning signal of hypertension at rest and future hypertensive left ventricular hypertrophy. The results of diagnostic stress tests support that hypertensive response to exercise is frequently associated with high rate-pressure product in hypertensives. In addition to the observations on high rate-pressure product and enhanced ventricular contractility in patients with hypertension, evaluation of myocardial contractility by Doppler tissue imaging has shown hyperdynamic myocardial function under pharmacological stress. These recent quantitative data in hypertensives suggest that hyperdynamic myocardial function and high rate-pressure product response to stress may be related to exaggerated hypertension, which may have more importance than that it has been already given in clinical practice.

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Figures

Figure 1
Figure 1
Exercise stress echocardiographic images. A: Measurements of left ventricular outflow tract velocities at rest and peak exercise, B: Basal septal tissue systolic velocities at rest and peak exercise, in a hypertensive 53-year-old woman with left ventricular hypertrophy [28].
Figure 2
Figure 2
Dobutamine stress echocardiographic images. Measurements of maximum basal septal tissue systolic velocities at rest and peak stress in a hypertensive patient with basal septal hypertrophy [30].
Figure 3
Figure 3
Enlarged left ventricular cavity after peak exercise. Exercise echocardiogram obtained from an apical four-chamber view of the heart in a 73-year-old woman with a hypertensive response to exercise. An end-systolic image taken immediately after peak exercise (right) shows an enlarged left ventricular (LV) cavity compared with image at rest (left). LA: left atrium; RA: right atrium; RV: right ventricle [39].
See this image and copyright information in PMC

References

    1. O'Brien E, Asmar R, Beilin L, Imai Y, Mallion JM, Mancia G, Mengden T, Myers M, Padfield P, Palatini P, Parati G, Pickering T, Redon J, Staessen J, Stergiou G, Verdecchia P. European Society of Hypertension Working Group on Blood Pressure Monitoring. European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement. J Hypertens. 2003;21:821–48. doi: 10.1097/00004872-200305000-00001. - DOI - PubMed
    1. Smirk FH. Observations on the mortality of 270 treated and 199 untreated retinal grade I and II hypertensive patients followed in all instances for five years. N Z Med J. 1964;3:413–43.
    1. Perloff D, Sokolow M, Cowan RM, Juster RP. Prognostic value of ambulatory blood pressure measurements: further analysis. J Hypertens. 1989;7:3–10. doi: 10.1097/00004872-198902001-00002. - DOI - PubMed
    1. Grosse P, Durandet P, Roudaut R, Broustet JP, Dallocchio M. Valeur pronostique de la tension artérielle d'effort chez I' hypertendu. Arch Mal Coeur. 1989;82:1339–42. - PubMed
    1. Lauer MS, Levy D, Anderson KM, Plehn JF. Is there a relationship between exercise systolic blood pressure response and left ventricular mass? The Framingham Heart Study. Ann Intern Med. 1992;116:203–10. - PubMed