Blood Pressure Measurements during Exercise Testing

``The chapter Blood Pressure Measurement During Exercise reviews the 3 methods of sphygmomanometry to measure blood pressure and normal and abnormal blood pressure responses to exercise. Mercury, aneroid, and oscillometric assessment of Korotkoff sounds provide accurate measurement. Periodic calibration is important for aneroid and oscillometric devices. With verification, automated oscillometric measurements during exercise can be accurate. The normal blood pressure response to exercise testing is an incremental increase in systolic blood pressure with minimal change in diastolic blood pressure. Exercise induced hypotension, particularly early in exercise, is predictive of severe coronary artery disease (CAD). Its occurrence at peak exercise at a high level of exertion may occur in normal individuals secondary to exhaustion. An exaggerated systolic response to exercise is modestly predictive of future hypertension. A slow decrease is systolic blood pressure during recovery is suggestive of CAD, likely secondary to less vagal tone, analogous to a slow decrease in heart rate during recovery.