Sports Medicine

, Volume 48, Issue 8, pp 1763–1771 | Cite as

Exercise Blood Pressure Guidelines: Time to Re-evaluate What is Normal and Exaggerated?

  • Katharine D. Currie
  • John S. Floras
  • Andre La Gerche
  • Jack M. GoodmanEmail author
Current Opinion


Blood pressure responses to graded exercise testing can provide important diagnostic and prognostic information. While published guidelines outline what constitutes a “normal” and “abnormal” (i.e., exaggerated) blood pressure response to exercise testing, the widespread use of exaggerated blood pressure responses as a clinical tool is limited due to sparse and inconsistent data. A review of the original sources from these guidelines reveals an overall lack of empirical evidence to support both the normal blood pressure responses and their upper limits. In this current opinion, we critically evaluate the current exercise blood pressure guidelines including (1) the normal blood pressure responses to graded exercise testing; (2) the upper limits of this normal response; (3) the blood pressure criteria for test termination; and (4) the thresholds for exaggerated blood pressure responses. We provide evidence that exercise blood pressure responses vary according to subject characteristics, and subsequently a re-evaluation of what constitutes normal and abnormal responses is necessary to strengthen the clinical utility of this assessment.


Compliance with Ethical Standards


K. D. Currie is supported by a Fellowship from the Canadian Institutes of Health Research (MFE-140863). J. S. Floras holds the Tier 1 Canada Research Chair in Integrative Cardiovascular Biology.

Conflict of interest

K. D. Currie, J. S. Floras, A. La Gerche, and J. M. Goodman declare that they have no conflict of interest.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Katharine D. Currie
    • 1
  • John S. Floras
    • 2
    • 3
  • Andre La Gerche
    • 4
    • 5
  • Jack M. Goodman
    • 1
    • 2
    Email author
  1. 1.Faculty of Kinesiology and Physical EducationUniversity of TorontoTorontoCanada
  2. 2.University Health Network and Mount Sinai Hospital Division of CardiologyTorontoCanada
  3. 3.Department of MedicineUniversity of TorontoTorontoCanada
  4. 4.Sports Cardiology and Cardiac Magnetic Resonance Imaging LabBaker Heart and Diabetes InstituteMelbourneAustralia
  5. 5.Cardiology DepartmentSt. Vincent’s Hospital MelbourneFitzroyAustralia

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