Exercise characteristics and incidence of abnormal electrocardiogram response in long-distance runners with exercise-induced hypertension

While long-distance running has important health benefits, chronic elevation of blood pressure during exercise might induce cardiac events and sudden death. This study aimed to investigate characteristics of exercise and incidence of abnormal exercise electrocardiography findings in long-distance runners with exercise-induced hypertension. Long-distance runners (n = 606) underwent a questionnaire survey, history taking, and exercise stress testing, and they were classified into the non-exercise-induced (n = 268) and exercise-induced (n = 338) hypertension groups. Exercise-induced hypertension was defined as systolic blood pressure ≥210 mm Hg during maximal exercise. Abnormal electrocardiogram response (AER) were defined as abnormal electrocardiography findings, such as arrhythmias or ST-segment changes, during exercise stress testing. There were no differences in general and exercise-related characteristics between the non-exercise-induced and exercise-induced hypertension groups. The AER group (AERg, n = 37) had a significantly longer training history and total exercise time than the non-AER group (non-AERg, n = 569) (p <.05). Atrial arrhythmias and ST-segment depression were more prevalent in the exercise-induced hypertension group than in the non-exercise-induced hypertension group (atrial arrhythmias: 5% [17/338] vs. 1.9% [5/268]; ST-segment depression: 2.7% [9/338] vs.4% [1/268]; p <.05). The incidence of AER was significantly higher in the exercise-induced hypertension group (n = 30, 8.8%) than in the non-exercise-induced hypertension group (n = 7, 2.6%) (p <.05). This study showed that long-distance runners with AER had a longer training history and total exercise time than those without AER, and the exercise-induced hypertension group had a higher rate of AER.