Int J Gen Med. 2026 May 28;19:608564. doi: 10.2147/IJGM.S608564. eCollection 2026.
ABSTRACT
OBJECTIVE: To observe the impact of exaggerated blood pressure response during exercise on oxygen pulse (Opulse), facilitating earlier and more precise identification of the subclinical threat of hypertension.
METHODS: This cross-sectional study consecutively enrolled 262 patients with exaggerated blood pressure response (EBPR) (March 2023-March 2025). Based on peak Opulse ≥80% of predicted value, patients were divided into Normal (n=149) and Reduced Opulse (n=113) groups. Baseline characteristics, laboratory findings, and CPET parameters were collected. Binary logistic regression analysis was used to identify independent factors associated with reduced peak Opulse ratio. Multiple linear regression models were employed with the relative increase of Opulse before and after the anaerobic threshold (AT) as dependent variables to explore the associations of blood pressure increase and metabolic equivalent (MET)-adjusted blood pressure increase with changes in Opulse relative increase.
RESULTS: Compared with the Normal Opulse group, the Reduced Opulse group had a higher proportion of males, younger age, higher BMI, and worse metabolic profiles. Logistic regression identified advanced age and alcohol consumption as independent risk factors for reduced peak Opulse, while female sex was protective. Regarding blood pressure, unadjusted SBP increase correlated positively with peak Opulse ratio and Opulse relative increase, whereas MET‑adjusted SBP increase showed a significant negative correlation with both. This inverse association suggests that an exaggerated blood pressure response per unit metabolic demand is linked to compromised cardiac pumping efficiency.
CONCLUSION: The negative correlation between ΔSBP/MET and Opulse suggests that an exaggerated blood pressure response may come at the cost of compromised cardiac pumping efficiency. An excessively high ΔSBP/MET value often indicates more significant changes in the structure and function of the heart, and is an aspect that requires particular attention in the future.
PMID:42238359 | PMC:PMC13227542 | DOI:10.2147/IJGM.S608564