Please write an article with "My pressure is..."(More than 200 words)
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The adverse effect of lack of exercise on the blood pressure is well known. A sedentary life frequently leads to chronic hypertension, and in turn, high blood pressure can lead to heart, brain, and kidney damage.
We will address the topic of chronic hypertension in a separate article. Today, we will discuss a phenomenon called “hypertensive response to exercise” which can occur in seemingly healthy subjects who have no history of hypertension but whose blood pressure during exercise seems to increase “too much.”
As a brief background, we should point out that the blood pressure varies all the time, even from one minute to the next. The reason being that the pressure inside the arteries reflects the intensity of movement of the blood throughout the body, and this movement changes all the time in response to the changing needs of the body and to multiple factors.
Many organ systems participate in the control of the blood pressure at various times, including the heart and blood vessels, the nervous system, the kidneys, and some hormonal glands. Regulation of the blood pressure is a very complicated matter.
To be sure, the blood pressure is expected to rise during exercise (in particular, it is the systolic blood pressure that goes up), and it returns to normal within a few minutes of rest.
In some people, however, the rise in blood pressure seems “excessive” or above the level of increase habitually seen. Cardiologists and exercise physiologists who encounter this effect during a treadmill or stationary bicycle stress test call this phenomenon a “hypertensive response to exercise” (we’ll abbreviate it HRE) or, alternatively, an “exaggerated blood pressure response to exercise.”
The phenomenon of HRE immediately raises several questions:
Can we define HRE precisely? Is there a specific number over which one can say for sure that the blood pressure during exercise is “too high”?
What is the significance of HRE in the short term? Is it dangerous?
What is the the significance of HRE in the long term. Is it a marker of future risk of hypertension?
Could it be that HRE occurs primarily during stress tests, but not when people are exercising for recreation?
1) Is there a cut-off number? Unfortunately, the answer to this question is “no.” There is no standard, satisfactory threshold number that allows us to confidently separate people who demonstrate HRE and people who do not. Since the blood pressure varies so widely depending on a number of factors, identifying specific cut-off numbers is elusive or misleading. Some researchers have used a systolic blood pressure cut-off value of 200, others 210, and still others 220 to define HRE. The inability to define a cut-off point makes the other questions difficult to answer also.
2) What are the short-term effects of HRE? For the most part, if everything else seems OK, the subject feels fine, and there are no abnormalities on testing, most experts agree that having HRE is not by itself a cause for concern during exercise, so athletes who demonstrate HRE (however defined) should not be alarmed on that basis.
For some people, however, the elevation in blood pressure with exercise is accompanied by other signs of problems. They may feel particularly short of breath, and the ECG may become abnormal. If images of the heart are taken during such cases, it is not uncommon to see that the heart is struggling and not squeezing as well as it should. This more worrisome response typically occurs in people who have more advanced underlying cardiovascular disease. Such cases may indicate that treatment for high blood pressure should be intensified.
3) What are the long-term effects of HRE? Unfortunately, because HRE is hard to define precisely, studies are not providing clear-cut answers to this question. Some scientists think that HRE could be an early sign of hypertension. In other words, the person is at a stage where the blood pressure is high during exercise only, but in a few years, it may be high at rest as well. This concern has not been confirmed in all studies looking at the long term effects of HRE.
Some studies have raised a concern about an increased risk of future cardiovascular complications, such as stroke, but this has not been supported by other investigations.
A recent study using a new and sophisticated ultrasound technique has suggested that the hearts of people with HRE may be under subtle strain during exercise. At this time, this finding must be considered preliminary and is not by itself a cause for concern.
4) Could it be that HRE occurs only because of the stress of the stress test? There is no good answer to that question because it is hard to measure exercise blood pressure accurately outside of a clinic environment, or at least, it has not been done on a large scale.
ᴏɴ ᴀ ʀᴇᴄᴇɴᴛ ᴍᴏɴᴅᴀʏ, ʜᴇʟᴇɴ ᴇʟᴢᴏ ɢᴏᴛ ᴀ ᴄᴀʟʟ ꜰʀᴏᴍ ʜᴇʀ ᴅᴏᴄᴛᴏʀ'ꜱ ᴏꜰꜰɪᴄᴇ. ᴀ ᴅᴇᴠɪᴄᴇ ɪᴍᴘʟᴀɴᴛᴇᴅ ɪɴ ʜᴇʀ ʜᴇᴀʀᴛ ᴡᴀꜱ ɴᴏᴛ ꜰᴜɴᴄᴛɪᴏɴɪɴɢ. ꜱʜᴇ ɴᴇᴇᴅᴇᴅ ᴛᴏ ɢᴏ ᴛᴏ ᴛʜᴇ ʜᴏꜱᴘɪᴛᴀʟ ᴀɴᴅ ʜᴀᴠᴇ ɪᴛ ʀᴇᴘʟᴀᴄᴇᴅ.
ꜱʜᴇ ᴡᴀꜱ ᴀɢʜᴀꜱᴛ -- ʜᴇʀ ʜᴇᴀʀᴛ ɪꜱ ᴅᴀᴍᴀɢᴇᴅ ᴀɴᴅ, ᴀᴛ ᴀɴʏ ᴛɪᴍᴇ, ᴄᴀɴ ꜱᴛᴀʀᴛ Qᴜɪᴠᴇʀɪɴɢ ɪɴꜱᴛᴇᴀᴅ ᴏꜰ ʙᴇᴀᴛɪɴɢ. ɪꜰ ᴛʜᴇ ᴅᴇᴠɪᴄᴇ, ᴀ ᴅᴇꜰɪʙʀɪʟʟᴀᴛᴏʀ, ᴡᴀꜱ ᴜɴᴀʙʟᴇ ᴛᴏ ꜱʜᴏᴄᴋ ʜᴇʀ ʜᴇᴀʀᴛ ʙᴀᴄᴋ ᴛᴏ ɴᴏʀᴍᴀʟ, ʜᴇʀ ʟɪꜰᴇ ᴡᴀꜱ ɪɴ ᴅᴀɴɢᴇʀ.
ɪɴ ᴛʜᴇ ᴏʟᴅ ᴅᴀʏꜱ, ᴍʀꜱ.ᴇʟᴢᴏ, 73, ᴡʜᴏ ʟɪᴠᴇꜱ ᴏᴜᴛꜱɪᴅᴇ ᴛᴜʟꜱᴀ, ᴏᴋʟᴀ., ᴄᴏᴜʟᴅ ʜᴀᴠᴇ ɢᴏɴᴇ ꜰᴏʀ ᴍᴏɴᴛʜꜱ ʙᴇꜰᴏʀᴇ ᴛʜᴇ ᴘʀᴏʙʟᴇᴍ ᴡᴀꜱ ᴅɪꜱᴄᴏᴠᴇʀᴇᴅ ᴀᴛ ᴀ ʀᴏᴜᴛɪɴᴇ ᴏꜰꜰɪᴄᴇ ᴠɪꜱɪᴛ.
ʙᴜᴛ ꜱʜᴇ ʜᴀꜱ ᴀ ɴᴇᴡ ᴅᴇꜰɪʙʀɪʟʟᴀᴛᴏʀ ᴛʜᴀᴛ ᴄᴏᴍᴍᴜɴɪᴄᴀᴛᴇꜱ ᴅɪʀᴇᴄᴛʟʏ ᴡɪᴛʜ ʜᴇʀ ᴅᴏᴄᴛᴏʀ, ꜱᴇɴᴅɪɴɢ ꜱɪɢɴᴀʟꜱ ᴀʙᴏᴜᴛ ɪᴛꜱ ꜰᴜɴᴄᴛɪᴏɴꜱ ᴀɴᴅ ꜱᴇᴛᴛɪɴɢ ᴏꜰꜰ ᴀʟᴀʀᴍꜱ ɪꜰ ᴛʜɪɴɢꜱ ɢᴏ ᴡʀᴏɴɢ.
ᴏɴ ᴛʜᴇ ʜᴏʀɪᴢᴏɴ ɪꜱ ᴀɴ ᴇᴠᴇɴ ꜱᴍᴀʀᴛᴇʀ ʜᴇᴀʀᴛ ᴅᴇᴠɪᴄᴇ, ᴏɴᴇ ᴛʜᴀᴛ ᴅᴇᴛᴇᴄᴛꜱ ᴅᴇᴛᴇʀɪᴏʀᴀᴛɪᴏɴ ɪɴ ᴠᴀʀɪᴏᴜꜱ ʜᴇᴀʀᴛ ꜰᴜɴᴄᴛɪᴏɴꜱ ᴀɴᴅ ᴛᴇʟʟꜱ ᴛʜᴇ ᴘᴀᴛɪᴇɴᴛ ʜᴏᴡ ᴛᴏ ᴀᴅᴊᴜꜱᴛ ᴍᴇᴅɪᴄᴀᴛɪᴏɴꜱ.
ᴛʜᴇʏ ᴀʀᴇ ᴘᴀʀᴛ ᴏꜰ ᴀ ɴᴇᴡ ᴡᴀᴠᴇ ᴏꜰ ꜱᴍᴀʀᴛ ɪᴍᴘʟᴀɴᴛᴀʙʟᴇ ᴅᴇᴠɪᴄᴇꜱ ᴛʜᴀᴛ ɪꜱ ᴛʀᴀɴꜱꜰᴏʀᴍɪɴɢ ᴛʜᴇ ᴄᴀʀᴇ ᴏꜰ ᴘᴇᴏᴘʟᴇ ᴡɪᴛʜ ʜᴇᴀʀᴛ ᴅɪꜱᴇᴀꜱᴇ ᴀɴᴅ ᴄʀᴇᴀᴛɪɴɢ ᴀ ʙᴏɴᴀɴᴢᴀ ꜰᴏʀ ʀᴇꜱᴇᴀʀᴄʜᴇʀꜱ. ᴛʜᴇ ʜᴏᴘᴇ ɪꜱ ᴛʜᴀᴛ ᴛʜᴇ ᴅᴇᴠɪᴄᴇꜱ, ɴᴏᴡ ʙᴇɪɴɢ ᴛᴇꜱᴛᴇᴅ ɪɴ ᴄʟɪɴɪᴄᴀʟ ᴛʀɪᴀʟꜱ, ᴡɪʟʟ ꜱᴀᴠᴇ ʟɪᴠᴇꜱ, ʀᴇᴅᴜᴄᴇ ᴍᴇᴅɪᴄᴀʟ ᴇxᴘᴇɴꜱᴇꜱ ᴀɴᴅ ɴᴜᴅɢᴇ ʜᴇᴀʀᴛ ᴘᴀᴛɪᴇɴᴛꜱ ᴛᴏᴡᴀʀᴅ ᴍᴀɴᴀɢɪɴɢ ᴛʜᴇɪʀ ꜱʏᴍᴘᴛᴏᴍꜱ ᴍᴜᴄʜ ᴛʜᴇ ᴡᴀʏ ᴘᴇᴏᴘʟᴇ ᴡɪᴛʜ ᴅɪᴀʙᴇᴛᴇꜱ ᴍᴀɴᴀɢᴇ ᴛʜᴇɪʀꜱ. ᴘᴀᴛɪᴇɴᴛꜱ, ᴡʜᴏ ᴏꜰᴛᴇɴ ᴀʀᴇ ꜰʀᴀɪʟ ᴏʀ ʟɪᴠᴇ ꜰᴀʀ ꜰʀᴏᴍ ᴛʜᴇɪʀ ᴅᴏᴄᴛᴏʀꜱ, ᴄᴀɴ ʙᴇ ꜱᴘᴀʀᴇᴅ ꜰʀᴇQᴜᴇɴᴛ ᴏꜰꜰɪᴄᴇ ᴠɪꜱɪᴛꜱ. ᴅᴏᴄᴛᴏʀꜱ ᴄᴀɴ ʟᴇᴀʀɴ ɪᴍᴍᴇᴅɪᴀᴛᴇʟʏ ɪꜰ ᴅᴇᴠɪᴄᴇꜱ ᴀʀᴇ ᴍᴀʟꜰᴜɴᴄᴛɪᴏɴɪɴɢ ᴏʀ ɪꜰ ᴘᴀᴛɪᴇɴᴛꜱ' ʜᴇᴀʀᴛꜱ ᴀʀᴇ ꜱᴛᴀʀᴛɪɴɢ ᴛᴏ ꜰᴀɪʟ. (ᴘᴏꜱᴛ ʏᴏᴜʀ Qꜱ ᴏɴ ʜᴇᴀʀᴛ ʜᴇᴀʟᴛʜ-ᴄᴀʀᴇ ʜᴇʀᴇ)
"ɪᴛ'ꜱ ʟɪᴋᴇ ʜᴀᴠɪɴɢ ᴀɴ ᴏꜰꜰɪᴄᴇ ᴠɪꜱɪᴛ ᴇᴠᴇʀʏ ᴅᴀʏ ᴀɴᴅ ᴀ ᴄᴏᴍᴘʟᴇᴛᴇ ᴘʜʏꜱɪᴄᴀʟ ᴇᴠᴇʀʏ ᴡᴇᴇᴋ," ꜱᴀɪᴅ ᴅʀ. ʟᴇꜱʟɪᴇ ꜱᴀxᴏɴ, ᴀ ᴄᴀʀᴅɪᴏʟᴏɢɪꜱᴛ ᴀᴛ ᴛʜᴇ ᴜɴɪᴠᴇʀꜱɪᴛʏ ᴏꜰ ꜱᴏᴜᴛʜᴇʀɴ ᴄᴀʟɪꜰᴏʀɴɪᴀ.
ᴛʜᴇ ʙɪɢ ʟᴇᴀᴘ ꜰᴏʀᴡᴀʀᴅ ᴄᴀᴍᴇ ᴀ ꜰᴇᴡ ʏᴇᴀʀꜱ ᴀɢᴏ ᴡʜᴇɴ ᴅᴇᴠɪᴄᴇ ᴄᴏᴍᴘᴀɴɪᴇꜱ ꜰɪɢᴜʀᴇᴅ ᴏᴜᴛ ʜᴏᴡ ᴛᴏ ᴍᴀᴋᴇ ᴛʀᴀɴꜱᴍɪᴛᴛᴇʀꜱ ᴛʜᴀᴛ ꜱᴇɴᴅ ᴅᴀᴛᴀ ᴏᴠᴇʀ ᴀ ʙʀᴏᴀᴅᴇʀ ʀᴀɴɢᴇ, 20 ᴏʀ 30 ꜰᴇᴇᴛ. ᴛʜᴀᴛ ᴍᴇᴀɴᴛ ᴛʜᴀᴛ, ᴡɪᴛʜ ʜᴇʀ ᴅᴇᴠɪᴄᴇ, ᴍʀꜱ. ᴇʟᴢᴏ ᴅɪᴅ ɴᴏᴛ ʜᴀᴠᴇ ᴛᴏ ᴡᴀɪᴛ ᴛɪʟʟ ʜᴇʀ ᴅᴏᴄᴛᴏʀ ᴄᴏᴜʟᴅ ᴘᴜᴛ ᴀ ʀᴇᴄᴇɪᴠᴇʀ ᴅɪʀᴇᴄᴛʟʏ ᴏɴ ʜᴇʀ ᴄʜᴇꜱᴛ. ɪɴꜱᴛᴇᴀᴅ, ꜱʜᴇ ꜱɪᴍᴘʟʏ ᴡᴇɴᴛ ɴᴇᴀʀ ᴀ ꜱᴍᴀʟʟ ʙᴏx, ᴡʜɪᴄʜ ɪꜱ ᴀᴛᴛᴀᴄʜᴇᴅ ᴛᴏ ᴀ ᴘʜᴏɴᴇ ᴊᴀᴄᴋ ɴᴇᴀʀ ʜᴇʀ ʙᴇᴅ. ᴏɴᴄᴇ ᴀ ᴡᴇᴇᴋ, ꜱʜᴇ ᴀʟꜱᴏ ᴍᴇᴀꜱᴜʀᴇꜱ ʜᴇʀ ᴡᴇɪɢʜᴛ ᴀɴᴅ ʙʟᴏᴏᴅ ᴘʀᴇꜱꜱᴜʀᴇ -- ᴋᴇʏ ɪɴᴅɪᴄᴀᴛᴏʀꜱ ᴏꜰ ʜᴇᴀʀᴛ ꜰᴀɪʟᴜʀᴇ -- ᴀɴᴅ ᴛʜᴀᴛ ɪɴꜰᴏʀᴍᴀᴛɪᴏɴ ɪꜱ ᴀᴜᴛᴏᴍᴀᴛɪᴄᴀʟʟʏ ᴛʀᴀɴꜱᴍɪᴛᴛᴇᴅ ᴛᴏ ʜᴇʀ ᴅᴏᴄᴛᴏʀ. ɪꜰ ᴛʜᴇʀᴇ ᴀʀᴇ ᴘʀᴏʙʟᴇᴍꜱ, ᴛʜᴇ ᴍᴀᴄʜɪɴᴇ ᴀʟᴇʀᴛꜱ ʜᴇʀ ᴅᴏᴄᴛᴏʀ.
"ɴᴏᴡ, ᴇᴠᴇʀʏ ꜱɪɴɢʟᴇ ᴅᴀʏ ᴛʜᴇ ᴅᴇᴠɪᴄᴇ ɪꜱ ʙᴇɪɴɢ Qᴜᴇʀɪᴇᴅ," ꜱᴀɪᴅ ʜᴇʀ ᴅᴏᴄᴛᴏʀ, ᴊᴀᴍᴇꜱ ᴄᴏᴍᴀɴ ᴏꜰ ᴛʜᴇ ʜᴇᴀʀᴛ ʀʜʏᴛʜᴍ ɪɴꜱᴛɪᴛᴜᴛᴇ ɪɴ ᴛᴜʟꜱᴀ. "ɪᴛ'ꜱ ᴊᴜꜱᴛ ᴀ ᴘʜᴇɴᴏᴍᴇɴᴀʟ ᴛᴏᴏʟ."
ᴛʜᴇʀᴇ ɪꜱ ᴀ ᴅᴏᴡɴꜱɪᴅᴇ, ᴛʜᴏᴜɢʜ: "ɪɴꜰᴏʀᴍᴀᴛɪᴏɴ ᴏᴠᴇʀʟᴏᴀᴅ ɪꜱ ᴀ ᴠᴇʀʏ ꜱᴇʀɪᴏᴜꜱ ᴘʀᴏʙʟᴇᴍ" ꜰᴏʀ ᴛʜᴇ ᴅᴏᴄᴛᴏʀꜱ, ꜱᴀɪᴅ ᴅʀ. ʟʏɴɴᴇ ᴡᴀʀɴᴇʀ ꜱᴛᴇᴠᴇɴꜱᴏɴ, ᴅɪʀᴇᴄᴛᴏʀ ᴏꜰ ᴛʜᴇ ʜᴇᴀʀᴛ ꜰᴀɪʟᴜʀᴇ ᴘʀᴏɢʀᴀᴍ ᴀᴛ ʙʀɪɢʜᴀᴍ ᴀɴᴅ ᴡᴏᴍᴇɴ'ꜱ ʜᴏꜱᴘɪᴛᴀʟ ɪɴ ʙᴏꜱᴛᴏɴ ᴀɴᴅ ᴀ ᴘʀᴏꜰᴇꜱꜱᴏʀ ᴀᴛ ʜᴀʀᴠᴀʀᴅ ᴍᴇᴅɪᴄᴀʟ ꜱᴄʜᴏᴏʟ, ᴡʜᴏ ᴄᴏᴜɴᴛꜱ ʜᴇʀꜱᴇʟꜰ ᴀꜱ ᴀ ᴘʀᴏᴘᴏɴᴇɴᴛ ᴏꜰ ꜱᴍᴀʀᴛ ᴅᴇᴠɪᴄᴇꜱ. ᴍᴏʀᴇ ɪɴꜰᴏʀᴍᴀᴛɪᴏɴ, ꜱʜᴇ ᴡᴀʀɴᴇᴅ, ɪꜱ ɴᴏᴛ ᴀʟᴡᴀʏꜱ ʙᴇɴᴇꜰɪᴄɪᴀʟ.
ᴀ ꜱᴛᴜᴅʏ ᴜꜱɪɴɢ ᴀ ꜱɪᴍɪʟᴀʀ ᴅᴇᴠɪᴄᴇ, ᴍᴀᴅᴇ ʙʏ ᴍᴇᴅᴛʀᴏɴɪᴄ, ꜱᴜɢɢᴇꜱᴛꜱ ᴛʜᴀᴛ ɪꜱ ᴛʜᴇ ᴄᴀꜱᴇ. ᴛʜᴇ ᴍᴇᴅᴛʀᴏɴɪᴄ ꜱᴛᴜᴅʏ, ᴅɪʀᴇᴄᴛᴇᴅ ʙʏ ᴅʀ. ɢᴇᴏʀɢᴇ ᴄʀᴏꜱꜱʟᴇʏ, ᴘʀᴇꜱɪᴅᴇɴᴛ ᴏꜰ ꜱᴛ ᴛʜᴏᴍᴀꜱ ʜᴇᴀʀᴛ ᴀᴛ ʙᴀᴘᴛɪꜱᴛ ʜᴏꜱᴘɪᴛᴀʟ ɪɴ ɴᴀꜱʜᴠɪʟʟᴇ, ɪɴᴠᴏʟᴠᴇᴅ 2,000 ᴘᴀᴛɪᴇɴᴛꜱ ʀᴀɴᴅᴏᴍʟʏ ᴀꜱꜱɪɢɴᴇᴅ ᴛᴏ ʀᴇᴄᴇɪᴠᴇ ᴀ ᴅᴇꜰɪʙʀɪʟʟᴀᴛᴏʀ ᴛʜᴀᴛ ᴛʀᴀɴꜱᴍɪᴛᴛᴇᴅ ᴅᴀᴛᴀ ᴏʀ ᴀ ᴅᴇᴠɪᴄᴇ ᴛʜᴀᴛ ᴅɪᴅ ɴᴏᴛ ᴛʀᴀɴꜱᴍɪᴛ. ᴛʜᴏꜱᴇ ᴡɪᴛʜ ᴛʜᴇ ɴᴏɴᴛʀᴀɴꜱᴍɪᴛᴛɪɴɢ ᴅᴇᴠɪᴄᴇ ᴡᴇʀᴇ ꜱᴇᴇɴ ɪɴ ᴛʜᴇɪʀ ᴅᴏᴄᴛᴏʀ'ꜱ ᴏꜰꜰɪᴄᴇꜱ ᴇᴠᴇʀʏ ꜰᴇᴡ ᴍᴏɴᴛʜꜱ, ᴛʜᴇ ꜱᴛᴀɴᴅᴀʀᴅ ᴏꜰ ᴄᴀʀᴇ.