Use of graded exercise testing in assessing the hypertensive patient

Twenty-five patients with suspected hypertension were studied using the "Oxford" continuous intra-arterial blood pressure recording technique. Each patient carried out graded exercise on a bicycle ergometer, using a standard protocol, and then underwent a fully ambulatory 24-h outpatient blood pressure recording. Using computer analysis, ambulatory blood pressure in each patient was characterised by measuring the mean daytime systolic and diastolic pressures. Exercise was found to be associated with a characteristic increase in systolic and diastolic blood pressure. Submaximal and maximal exercise blood pressures were shown to correlate strongly with ambulatory blood pressure. A much weaker correlation was found between clinic and ambulatory blood pressure. These findings suggest that the blood pressure response to exercise may be a better indicator of elevated blood pressure than a causal clinic blood pressure in individual borderline subjects.