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.

@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".

@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

@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.

@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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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.

@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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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.

Liked by nancyjac

@hopeful33250

@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

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Hello. thank you all for your posts regarding exercise and blood pressure. I recently had a cardio-pulmonary stress test. (CPX) The doctor is trying to determine if my long-standing symptoms of shortness of breath, low O2 sats, chest pressure, fatigue, and exercise intolerance are stemming from a problem with the heart or the lungs. During the CPX my systolic BP rose to 225. I'm not sure what the diastolic was. The technician was stopping the treadmill at that point and I was asking to stop at the same time. My final report says "no indication of cardiac or pulmonary disease". The systolic BP of 225 is not even mentioned in the report. Several hours after the test my O2 sats at home were 89,90,92 and I felt horrible. Is there anybody out there that may have had a similar experience?

Hello mriguy7. Thank you for sharing your story. I hope you are currently doing well and have found answers to the exercise induced hypertension. I was recently diagnosed with the same thing. It was discovered 2 weeks ago during a bicycle stress echo and then 2 days ago during an exercise R heart catheterization. I have not seen the doctor yet to discuss treatment options. A recent pulmonary stress test and cardiac stress MRI did not make mention of high BP in their reports so I am very confused. None of these recent tests indicated arterial blockages. However, the bike echo showed EKG changes consistent with myocardial ischemia. When I asked my doctor about this, she said this was a result of the blood pressure going so high during exercise and not necessarily from a blockage. She wants to prescribe BP meds and she does not even know what my resting blood pressures are. I have not exercised in years and feel this may just be due to being deconditioned. I plan to do some research on exercise induced hypertension before I start any medications because I am afraid my BP would get far too low when I am not exercising. I'll keep you posted on anything I learn about this. Please let me know how you are currently doing.

@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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Hello Schmidtsl. I am 62 years old and recently diagnosed with exercise induced hypertension after a cardiopulmonary stress test, bicycle echo, and right heart catheterization. I have not exercised since 2006 when a cardiac event brought me to the ER with heart attack-like symptoms. My symptoms have persisted since that day. I have not been able to build any exercise tolerance without s.o.b., fluid retention, and pressure sensations in my chest. Stress tests in the past never revealed exercise induced hypertension. My BP's are normal during the day. I attributed the exercise hypertension to being terribly de-conditioned but my cardiologist says that is not the reason. She is not sure at this point if I should start meds or not. She is considering a CT angiogram even though the CPX, Cardiac Stress MRI, and Bicycle echo are normal. I'm very confused. Wondering how you are doing as well as the many people that have posted with reports of exercise induced hypertension. How are you feeling? have you learned any more about it or joined a trial? Thanks.

@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

Hello schmidtsl. Just wondering how you are doing with your exercise induced hypertension. I have been diagnosed with the same. BP's are normal when not exercising. My doctors have not prescribed anything yet. I believe they are considering ordering a coronary angiogram. Are you being treated for this condition? What did your PCP advise? Thanks.

I am a 66 year old previously active woman who has played tennis for 55 years. I have asthma and mild to moderate emphysema. In the previous year I've had both a heart cath and nuclear stress test that were normal. Recently I have been experiencing heart issues including non-sustaining V-Tach. Lately when I walk, play tennis, golf or attempt mild exercise my chest gets tight, I have difficulty breathing and my leg/ thigh muscles feel like they are going to give out. Last week I had a treadmill stress test that was stopped because of those same symptoms. At about three minutes my HR was over 140 and my blood pressure reached 206/65. Needless to say this scared me. I've always had very low blood pressure. When I called to ask about the results I was told by the nurse that my EKG was normal and everything was fine. I asked the nurse to go back and ask the doctor why then did my blood pressure go so high etc. He told her that my high BP "could be an exaggerated response to the test." There was no further explanation. I have since found out through my own research that there is something called "exercise induced hypertension." Does anyone know what causes this so-called phenomenon? I'm scared. I can't even play golf or walk at a brisk pace without feeling like I am going to collapse. Since my doctor didn't seem to be alarmed I don't know what to think. This can't be normal.

Hello @nancyjac,

Welcome to Connect. You may notice that I moved your message and combined it with this existing discussion, where I hope you will connect with other members talking about exercise-induced hypertension.
If you click on VIEW & REPLY in your email notification, you will see the whole discussion and can join in, meet, and participate with other members talking about their or their loved ones' experiences.

You might be interested in reading this published study about exercise-related hypertension and whether that could be a predictor of some heart conditions:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315351/

I'm tagging @schmidtsl @bertaw @mriguy7 and Mentors @hopeful33250 and @predictable as they may be able to share their experiences as well. @nancyjac, I can understand your worry especially with matters related the heart; would you consider getting a second opinion, perhaps at a sports cardiology clinic?

@nancyjac

I am a 66 year old previously active woman who has played tennis for 55 years. I have asthma and mild to moderate emphysema. In the previous year I've had both a heart cath and nuclear stress test that were normal. Recently I have been experiencing heart issues including non-sustaining V-Tach. Lately when I walk, play tennis, golf or attempt mild exercise my chest gets tight, I have difficulty breathing and my leg/ thigh muscles feel like they are going to give out. Last week I had a treadmill stress test that was stopped because of those same symptoms. At about three minutes my HR was over 140 and my blood pressure reached 206/65. Needless to say this scared me. I've always had very low blood pressure. When I called to ask about the results I was told by the nurse that my EKG was normal and everything was fine. I asked the nurse to go back and ask the doctor why then did my blood pressure go so high etc. He told her that my high BP "could be an exaggerated response to the test." There was no further explanation. I have since found out through my own research that there is something called "exercise induced hypertension." Does anyone know what causes this so-called phenomenon? I'm scared. I can't even play golf or walk at a brisk pace without feeling like I am going to collapse. Since my doctor didn't seem to be alarmed I don't know what to think. This can't be normal.

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Thank you for sharing with me Mary. My blood pressure is normal at rest also. It used to be very low. I was put on Metoprolol to control my VTACH. It made my blood pressure way too low and my pulse was often in the 40's. They reduced the dosage of Metoprolol and added Propafenone which has worked controlling my VTACH.

I feel like they are dismissing my concerns as well. My cardiologist specializes in electrical issues of the heart. He says he does not treat "exercise induced hypertension." One person did suggest that I go to a Sports Cardiologist. We live in Florida. The only ones I've found are at the Cleveland Clinic and in North Carolina. I am seeing my Primary Care Doctor tomorrow. She is a really good doctor and I have a feeling she will not dismiss my concerns and will do her due diligence and research to figure it out.

I will keep posting and share what I'm being told. Thank you so much.

Nancy Jacobs

@kanaazpereira

Hello @nancyjac,

Welcome to Connect. You may notice that I moved your message and combined it with this existing discussion, where I hope you will connect with other members talking about exercise-induced hypertension.
If you click on VIEW & REPLY in your email notification, you will see the whole discussion and can join in, meet, and participate with other members talking about their or their loved ones' experiences.

You might be interested in reading this published study about exercise-related hypertension and whether that could be a predictor of some heart conditions:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315351/

I'm tagging @schmidtsl @bertaw @mriguy7 and Mentors @hopeful33250 and @predictable as they may be able to share their experiences as well. @nancyjac, I can understand your worry especially with matters related the heart; would you consider getting a second opinion, perhaps at a sports cardiology clinic?

Jump to this post

Thank you @kanaazpereira. I would definitely be interested in finding a sports cardiology clinic. We live in Florida and I've done searches on sports cardiology clinic and have not found one in Florida. The Cleveland Clinic has one, but there doesn't appear to be one near us. Thank you for the article. I have read it and will read it again. I am seeing my primary care doctor tomorrow and I'm hoping she can help with advice as well.

@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 was just diagnosed with exercise induced hypertension. Blood pressure is usually low any other time. I was wondering if you pursued the nephrology doctor? Have you gotten any relief? I hope so. Nancy Jacobs

@nancyjac

I am a 66 year old previously active woman who has played tennis for 55 years. I have asthma and mild to moderate emphysema. In the previous year I've had both a heart cath and nuclear stress test that were normal. Recently I have been experiencing heart issues including non-sustaining V-Tach. Lately when I walk, play tennis, golf or attempt mild exercise my chest gets tight, I have difficulty breathing and my leg/ thigh muscles feel like they are going to give out. Last week I had a treadmill stress test that was stopped because of those same symptoms. At about three minutes my HR was over 140 and my blood pressure reached 206/65. Needless to say this scared me. I've always had very low blood pressure. When I called to ask about the results I was told by the nurse that my EKG was normal and everything was fine. I asked the nurse to go back and ask the doctor why then did my blood pressure go so high etc. He told her that my high BP "could be an exaggerated response to the test." There was no further explanation. I have since found out through my own research that there is something called "exercise induced hypertension." Does anyone know what causes this so-called phenomenon? I'm scared. I can't even play golf or walk at a brisk pace without feeling like I am going to collapse. Since my doctor didn't seem to be alarmed I don't know what to think. This can't be normal.

Jump to this post

I would advise getting a 2nd opinion.

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