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mriguy7
@mriguy7

Posts: 1
Joined: Dec 17, 2017

Exercise-induced Hypertension

Posted by @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.

REPLY

Hi @mriguy7. Welcome to Mayo Connect. I hope you’ll find several of us with experiences similar to yours and some ideas about issues worthy of discussion with your medical team. You and I have had similar experiences with two exceptions: First, I haven’t felt it proper to call myself an athlete for perhaps 30 years, although running, biking, and hiking were life-assuring before that. Second, I have not had a BP as high as yours at any time, so far as I know.

During 40 years of treatment for BP, I have been “treated” to a couple dozen hypertension medications, most of which didn’t last long. One of those was Clonidine, which is a drug that primarily influences hormones generated by the brain to influence the kidney, the adrenal glands, and the circulatory system. Generally, in treatment of BP, it is an additive when BP does not come under control readily with more common hypertension medications.

May I raise some questions and ask you to consider whether you want to answer them in replies posted here? First, what can you tell us about your “minor chest discomfort at rest?” Also, has your cardiologist told you that a BP of 140/90 is no longer considered normal — that the national target was lowered this year by 10 points for both systolic and diastolic levels?

Has your PCP ever advised you to consult with a nephrologist (kidney doctor), because your BP might be attributable to your kidneys or the adrenal glands attached to them more than to the heart or the circulatory system? Your use of Benicar suggests that kidney issues are involved in your current diagnosis.

Finally, what do your lab tests show about how you are handling potassium and sodium? My symptoms, which are similar to yours as I noted, were unresolved through years of treatment by my internist (who boasted of his cardiac expertise) and occasional encounters with cardiologists. When my HMO insisted that a nephrologist should check me out, I finally made some progress and am now under treatment for uncommon maladies, including a defective kidney that excretes potassium and leaves it at levels too low to be healthy. Two key words in my treatment are “potassium” (I need it reinforced to keep its levels up) and “Lasix” (a drug I never touch any more after it forced my potassium levels too low).

I hope my experiences give you some issues for discussion at length with your medical team. On target or not, the issues could help build your confidence in your medical team and answer the key questions that bothers you most — why did your BP peak so high during a Cardiac Stress test?

Hello @mriguy7 and welcome to Mayo Connect,

I am sorry to hear of your blood pressure problems that come about during exercise. I agree with Martin, @predictable, that while I’ve never considered myself an athlete, I have always enjoyed exercise. I have a number of chronic illnesses (one of which is heart-related) that keep me from exercising the way I used to. I know how difficult it is to adjust to what I call a “new normal” in life and accepting limitations that are not expected nor appreciated. We look forward to getting to know you and supporting you during this time of uncertainty.

If you are comfortable sharing more with us, please update us after your next appointment.

Teresa

@hopeful33250 Hi, Teresa. A few weeks ago I met with a few other ordinary folks like myself to talk about our common disorder, hATTR. After several hours of discussion of our personal and social needs, we agreed that the uncertainty coming on with the disorder is really the largest problem. It is not just the uncertainty of the diagnosis and prognosis along the way. It includes the self-doubt on the part of the doctors and labs and nurses and techs. It is the uncertainty on the part of the way we deal with family and friends, of church and business as we try to fit in ways which have to be strange for everyone. Little things. Can we hug? Have sex? Eat wedding cake? Play with our dog? Wear wool clothing? Visit Lagos? Or more basic, how can we pin down the diagnosis when Medicare demands a biopsy proof, and yet no biopsy procedure is 100% accurate. They all produce both false positives and false negatives. The answers to these uncertainties create both the peril and the opportunity for living as a chronically disordered person in an increasingly ordered society. I hope you and the others on the board will continue to compare notes on these matters to make life better for all of us .

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

Hello @bertaw

Welcome to Mayo Connect. Your BP problems connected with exercise are certainly unique. I was noticing that @predictable, a volunteer mentor, was responding to this situation above and he was discussing seeing a nephrologist (kidney specialist) because kidney problems can affect the BP. Have you consulted with a kidney specialist yet? A second opinion is always a good idea.

I hope that you continue to post, I look forward to hearing how you are doing.

Teresa

@hopeful33250

Hello @bertaw

Welcome to Mayo Connect. Your BP problems connected with exercise are certainly unique. I was noticing that @predictable, a volunteer mentor, was responding to this situation above and he was discussing seeing a nephrologist (kidney specialist) because kidney problems can affect the BP. Have you consulted with a kidney specialist yet? A second opinion is always a good idea.

I hope that you continue to post, I look forward to hearing how you are doing.

Teresa

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Thank you for your response. I have not seen a nephrologist but I will ask for a referral.

@bertaw

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

Teresa

@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

Just light exercise, yoga, for a few days. My Dr is trying a different rx that I will pick up today so Monday I will experiment again. I I told him I will try new treatments before trying nephrology. I will keep you posted on the results.
Once my BP hit 195 I was afraid to continue my cardio workout. Hopefully I can get back to that

@bertaw

Yes, I would probably be fearful if my BP hit 195. I have heart valve problems and really suffer with fatigue if I do cardio workouts so I stay with seated exercise programs as well as Tai Chi. Tai Chi has very gentle, flowing movements. It helps range of motion and is very, very relaxing. Here is a Youtube video if you would like to take a look, https://www.youtube.com/watch?v=ZxcNBejxlzs&t=31s

I hope the new RX works well for you. I look forward to hearing from you again.

Teresa

@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

Latest study on hypertension and exercise https://www.sciencedaily.com/releases/2018/02/180213154336.htm

@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

Is this clinical trial recruiting?

@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?

@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?

@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 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.

@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

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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