Clinical implications of the blood pressure response to exercise

The blood pressure response during exercise testing is useful in evaluating cardiac status. Failure of the systolic pressure to rise with increases in work load, or a hypotensive response, are signs of significant heart disease. In the patient with coronary artery disease, the maximal systolic pressure achieved during exercise correlates with survival. Exertional hypotension in coronary artery disease is an insensitive, but highly specific, indicator of three-vessel disease or significant left ventricular dysfunction.