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May 30, 2026International Journal of General MedicineOpen Access

A higher metabolic equivalent-adjusted increase in systolic blood pressure during exercise was significantly negatively correlated with the relative increase in oxygen pulse before the anaerobic threshold (β -0.007), suggesting compromised cardiac pumping efficiency.

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Population

262 patients with exaggerated blood pressure response enrolled consecutively between March 2023 and March…

Design

Cross-sectional

Key result

A higher metabolic equivalent-adjusted increase in systolic blood pressure during exercise was significantly negatively correlated with the relative increase in oxygen pulse before the anaerobic threshold (β -0.007), suggesting compromised cardiac pumping efficiency.

Authors

YWY WangZLZhen LiFWFang Wu

Discussion

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Overview

EBPR with reduced O2 pulse may flag subclinical risk; leaves open whether monitoring improves hypertension prediction.

Key Points

  • To observe how exaggerated blood pressure responses during exercise impact oxygen pulse to identify hypertension risks.
  • Cross-sectional design enrolling 262 patients with exaggerated blood pressure response from March 2023 to March 2025.
  • Patients were categorized based on peak oxygen pulse into Normal and Reduced groups.
  • Binary logistic and multiple linear regression analyses were used to assess associations.
  • The Reduced O2 pulse group had more males, younger age, higher BMI, and worse metabolic profiles compared to the Normal group.
  • Advanced age and alcohol consumption were identified as risk factors for reduced O2 pulse, while female sex was protective.
  • An inverse relationship was found between MET-adjusted SBP increase and oxygen pulse efficiency.

Study Design

Type

Cross-Sectional (n=262)

Multicenter

No

Structured PICO

P
Population
262 patients with exaggerated blood pressure response (EBPR) enrolled consecutively between March 2023 and March 2025. Divided into Normal (n=149) and Reduced O2 pulse (n=113) groups based on peak O2 pulse ≥ 80% of predicted value.
O
Outcome
Peak O2 pulse ratio and O2 pulse relative increase before and after the anaerobic threshold (AT)surrogate

Main Result

Effect estimate: β -0.007 (95% CI -0.009 to -0.005)

p-value: p=<0.001

An exaggerated blood pressure response per unit metabolic demand during cardiopulmonary exercise testing is negatively correlated with oxygen pulse, indicating compromised cardiac pumping efficiency and potentially earlier identification of subclinical hypertension.

Limitations

  • Cross-sectional design cannot establish causality
  • Wide age range of enrolled population
  • Lack of detailed statistical analysis of medication regimens such as antihypertensive agents, statins, and beta-blockers
  • Single-center study may introduce selection bias and limit generalizability
  • Simplified relative increase metric used without analyzing plateau or inflection points of the O2pulse curve
  • O2pulse is an indirect surrogate for stroke volume and may be influenced by factors other than cardiac function

Cite This Study

Wang et al. (2026) conducted a cross-sectional in Exaggerated blood pressure response during exercise (n=262). Metabolic equivalent (MET)-adjusted systolic blood pressure increase was evaluated on Relative increase in oxygen pulse (O2pulse) before the anaerobic threshold (β -0.007, 95% CI -0.009 to -0.005, p=<0.001). A higher metabolic equivalent-adjusted increase in systolic blood pressure during exercise was significantly negatively correlated with the relative increase in oxygen pulse before the anaerobic threshold (β -0.007), suggesting compromised cardiac pumping efficiency.

synapsesocial.com/papers/6a1a80270307b78509432315https://doi.org/10.2147/ijgm.s608564
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Exercise blood pressure relative to fitness in male elite athletes: stage-specific response patterns and athlete-specific reference limits2026
  2. 2Exploring physiological factors underlying individual differences in exercise‐induced blood pressure responses2025
  3. 3Characteristics of post-exercise responders versus non-responders following aerobic or isometric exercise in physically inactive adults of African and South Asian descent with high-normal blood pressure or grade I hypertension2026
  4. 4Augmented muscle sympathetic reactivity in normotensive adults with elevated maximal exercise blood pressure2025
  5. 5Optimizing the Interpretation of Cardiopulmonary Exercise Testing in Endurance Athletes: Precision Approach for Health and Performance2025 · 7 citations