Exercise-induced Hypertension

Posted by mriguy7 @mriguy7, Dec 17, 2017

Hello,

I am a 55 yo male and long-time athlete, who recently developed very minor chest discomfort at rest. EKG's always having been normal, my PCP decided to order a Cardiac Stress Echo, which I had four days ago. During the second phase of the test at a heart rate of about 140, my systolic BP jumped to 230 and the techs aborted the test.

Needless to say the possibility that exercising with a HR of barely 140 bringing on a systolic BP spike high enough to cause a stroke is completely devastating to a life-long athlete. I was a runner since high school, avid tennis and basketball player, and most recently road cyclist doing century (100-mile) rides regularly.

Has anyone dealt with this issue? I have taken BP meds since I was 30 (have metabolic syndrome and family history of HBP) but my BP has always been well-controlled at a resting state (typical 140/90--current meds: Benicar 40 MG 1/day and Clonodine .1 MG 2/day) I will say that I have gained 25 lbs in the last two years and work a very stressful job resulting in my PCP increasing BP meds dose recently.

I have read that maybe some BP meds are better than others for this exercise-induced spiking of BP? I have also read that there are people with NORMAL BP that have this issue. Very confusing...

Has anyone found any cardiac arterial blockage issues that might cause this (I am going to demand a cardiac CTA when I see the cardiologist next week)?

The thought of never being able to exercise hard again is completely depressing---would appreciate any information anyone might have. Thanks so much.

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@bertaw

I am 61 year old woman and also have been diagnosed last year with exercise induced hypertension, however do not have high blood pressure during normal activities.

Due to shortness of breath I wore a heart monitor for 30 days with no abnormalities. I then had a treadmill stress test which is when the hypertension was noted. I reached 189/? shortly after starting an easy jog. No blockages were found on the CT. I checked my BP at the gym while on the elliptical with reading at warmup 144/60, stepping off and rechecking within 5 min at 129/74. Then went to a faster pace for 7 min and hit 195/67, rested for 3 min the reading was 126/57. So I drop to normal very quickly.

I have tried Lisinopril starting at 10mg down to 1.25 mg and experienced low BP so discontinued.

My questions are, is there any other tests that I should be requesting to find an underlying cause? Is there any other medication that does not lower blood pressure that might be suggested? Are there clinical trials out there to look into?

Thank you

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Is this clinical trial recruiting?

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@bertaw

I am 61 year old woman and also have been diagnosed last year with exercise induced hypertension, however do not have high blood pressure during normal activities.

Due to shortness of breath I wore a heart monitor for 30 days with no abnormalities. I then had a treadmill stress test which is when the hypertension was noted. I reached 189/? shortly after starting an easy jog. No blockages were found on the CT. I checked my BP at the gym while on the elliptical with reading at warmup 144/60, stepping off and rechecking within 5 min at 129/74. Then went to a faster pace for 7 min and hit 195/67, rested for 3 min the reading was 126/57. So I drop to normal very quickly.

I have tried Lisinopril starting at 10mg down to 1.25 mg and experienced low BP so discontinued.

My questions are, is there any other tests that I should be requesting to find an underlying cause? Is there any other medication that does not lower blood pressure that might be suggested? Are there clinical trials out there to look into?

Thank you

Jump to this post

I am your age and results of a treadmill stress test revealed similar results as yours (although higher on systolic). Cardiologist referred back to PCP for plan which is next week. I'm an RN, however, not with cardiology expertise, and want to be knowledgeable about possible treatments. My blood pressure is high normal when not exercising.I exercise 5-7 hours a week at moderate to high intensity. Any words of wisdom from your experiences with this?

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@hopeful33250

@bertaw

I would like to hear from you and know how you are doing. Are you still trying to exercise?

Teresa

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Don't you think it's normal to go up when you exercise ?your heart rate does and since it comes back down then as your heart rate does also?

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@hopeful33250

@bertaw

I would like to hear from you and know how you are doing. Are you still trying to exercise?

Teresa

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I agree. However, a spike from 130/76, resting to 207/125 during exercise is a little disconcerting. Especially when a past treadmill stress test (10 years ago) did not have this spike. I wouldn't be as concerned if I didn't have chest discomfort (also feels like my heart is flipping over in my chest at times unrelated to exercise) as well as extreme fatigue. If all this is normal, I guess I should save my worry and money.

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@hopeful33250

@bertaw

I would like to hear from you and know how you are doing. Are you still trying to exercise?

Teresa

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In that case I would be concerned also ,have you seen your cardiologist yet?With chest pain you need to be checked out

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@hopeful33250

@bertaw

I would like to hear from you and know how you are doing. Are you still trying to exercise?

Teresa

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Yes, cardiologist did exam, Treadmill Stress Test and Echocardiogram. I have 1st degree A/V block and "leaky" valves which are normal for my age. The spike in BP is not, though and the cardiologist is referring back to PCP for management. I'm concerned about the next step. I'm concerned about BP meds due to "normal" BP when not exercising. Just trying to be knowledgeable before getting on the "merry-go-round" of recommendations. I want to keep exercising and don't need a "train wreck".

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@hopeful33250

@bertaw

I would like to hear from you and know how you are doing. Are you still trying to exercise?

Teresa

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Agree just talk to your PCP

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@hopeful33250

@bertaw

I would like to hear from you and know how you are doing. Are you still trying to exercise?

Teresa

Jump to this post

I expect it is normal for the heart rate to increase during exercise. I did have a treadmill test yesterday so waiting for a review by cardiology. I couldn't see what my bp was at the hardest workout however after the cool down I was at 220/90. By the time I was released I was down to 140/70 which is still high for me but low enough to be safe to leave. I just have not read of a treatment. I will probably just not be able to do a strenuous workout. Just stick to low to moderate exercise.

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@hopeful33250

@bertaw

I would like to hear from you and know how you are doing. Are you still trying to exercise?

Teresa

Jump to this post

Your heart "flipping over in your chest" sounds like ectopics or bouts of atrial fibrillation. Perhaps your cardiologist did not realize you meant that symptom when you referred to discomfort. You might ask to wear a Holter monitor for awhile.

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@hopeful33250

@bertaw

I would like to hear from you and know how you are doing. Are you still trying to exercise?

Teresa

Jump to this post

HI I was doing this and it turned out I had Fibromuscular Dysplasia of renal arteries. Fibromuscular dysplasia is a condition that causes narrowing (stenosis) and enlargement (aneurysm) of the medium-sized arteries in your body. Reduced blood flow from narrowed arteries to the organs can affect the function of the organs. when it affects renal arteries exercise can induce sudden large BP change. It can be in arteries any wear heart, keck other organs. So I think perhaps ask you physician to rule that out it is extremely dangerous. My GP had sent me for MRI and the radiologist overheard my symptoms adn called her to change to CT with contrast he knew what it was with the symptoms.

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