Exercise-Induced Hypertension. Correlation Between Exercise-Induced Hypertension, Blood Lipid Levels, Arteriosclerosis and Blood Pressure Variability

Objective and Method This thesis is designed to determine and explore the association between exercise-induced hypertension (EIH), blood lipid levels, arteriosclerosis, and blood pressure variation (BPV) in normotensive versus hypertensive individuals. The assessment of how patterns of blood pressure variability relate to the development and progression of arteriosclerosis is further discussed in this study. This research also aims to propose EIH as an early predictor of future hypertension and cardiovascular dysfunction. The selected study subjects are patients who underwent a treadmill exercise load test in the cardiac electrophysiology centre of the First Affiliated Hospital of Jinzhou Medical University from January 2025 to December 2025. A rise in blood pressure by ≥ 190 mm Hg in women and ≥ 210 mm Hg in men during the exercise was used as the diagnostic criteria for EIH. In line with the history of hypertension and the criteria for EIH, the patients were divided into four groups: normal blood pressure group without EIH (Group A), normal blood pressure group with EIH (Group B), hypertension group without EIH (Group C), and hypertension group with EIH (Group D). The four groups were compared in regard to gender, age, body mass index (BMI), the highest systolic and diastolic blood pressure, blood triglyceride (TG) levels, atherosclerosis index (AI), carotid-femoral pulse wave velocity (cfPWV), ankle-brachial index (ABI), 24-hour systolic and diastolic blood pressure coefficient of variation (CV), morning peak blood pressure, nocturnal blood pressure drop rate, and morning blood pressure surge; the maximum systolic and diastolic blood pressure during the exercise was correlated with the above indexes. The differences in BMI, maximum systolic and diastolic blood pressure during exercise, TG, AI, cfPWV, ABI, 24-hour SBP CV, nocturnal systolic blood pressure drop rate, and morning peak blood pressure were statistically significant ( P < 0.05) except for gender, age, and 24-hour diastolic BP CV (P > 0.05) when comparing the four groups. The maximum SBP during exercise was positively correlated with BMI, AI, TG, cfPWV, ABI, and morning peak blood pressure (P < 0.05), negatively correlated with 24-hour SBP CV and nocturnal SBP drop rate (P < 0.05), and had no correlation with gender, age, and 24-hour DBP CV (P > 0.05). The maximum DBP during exercise was positively correlated with BMI, AI, TG, cfPWV, and morning peak BP (P < 0.05), negatively correlated with 24-hour SBPCV, 24-hour DBP CV, and nocturnal SBP drop rate (P < 0.05), and had no correlation with gender, age, and ABI (P > 0.05). Conclusion Treadmill exercise load tests can detect EIH, which can occur in normotensive patients as frequently as in hypertensive patients. An abnormally elevated blood pressure during exercise is positively correlated with blood lipid levels and the degree of arteriosclerosis, and negatively correlated with BPV. The 24-hour ambulatory blood pressure monitoring has reference value for EIH inboth normotensive and hypertensive patients, while both AI and cfPWV have even greater reference value. A lower 24-hour BPV does not necessarily indicate better blood pressure levels, as it may reflect a higher baseline pressure, blunted physiological function (such as reduced nocturnal dipping), and an impaired vascular system, leading to a poor cardiovascular prognosis. In addition, the SBP response to exercise load tests is more sensitive than the DBP response.