{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:57:23Z","timestamp":1792612643015,"version":"4.5.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T00:00:00Z","timestamp":1684281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>Emerging evidence suggests that a hypertensive response to exercise (HRE) during dynamic or isometric stress tests assessing cardiac function is predictive of hypertension and cardiovascular events such coronary artery disease, heart failure and stroke. Whether HRE represents a marker of masked hypertension (MH) in individuals with no prior history of hypertension is still unclear. This is also the case for the association between MH and hypertension-mediated organ damage (HMOD) in the HRE setting.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We addressed this issue through a review and a meta-analysis of studies providing data on this topic in normotensive individuals undergone both to dynamic or static exercise and to 24-h blood pressure monitoring (ABPM). A systematic search was performed using Pub-Med, OVID, EMBASE and Cochrane library databases from inception up to February 28th 2023.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Six studies including a total of 1,155 untreated clinically normotensive individuals were considered for the review. Data provided by the selected studies can be summarized as follows: (i) HRE is a BP phenotype linked to a high prevalence of MH (27.3% in the pooled population); (ii) MH is, in turn, associated with a greater, consistent likelihood of echocardiographic left ventricular hypertrophy (OR: 4.93, CI: 2.16\u201312.2, P\u2005&amp;lt;\u20050.0001) and vascular organ damage, as assessed by pulse wave velocity, (SMD: 0.34\u2005\u00b1\u20050.11, CI: 0.12\u20130.56, P\u2005=\u20050002).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>On the basis of this, albeit limited, evidence, the diagnostic work-up in individuals with HRE should primarily be addressed to look for MH as well as for markers of HMOD, a highly prevalent alteration in MH.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajh\/hpad049","type":"journal-article","created":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T15:19:20Z","timestamp":1684336760000},"page":"53-59","source":"Crossref","is-referenced-by-count":6,"title":["Targeting Hypertensive Response to Exercise and the Association of Masked Hypertension With Subclinical Organ Damage: A Mini-Review and Meta-Analysis"],"prefix":"10.1093","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7689-478X","authenticated-orcid":false,"given":"Cesare","family":"Cuspidi","sequence":"first","affiliation":[{"name":"Department of Medicine and Surgery, University of Milano-Bicocca , Milano , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Gherbesi","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoraco-Vascular Diseases, Foundation IRCCS Ca\u2019 Granda Ospedale Maggior Policlinico of Milano , Milano , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3247-3203","authenticated-orcid":false,"given":"Andrea","family":"Faggiano","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health, University of Milano , Milano , Italy"},{"name":"Department of Cardio-Thoraco-Vascular Diseases, Foundation IRCCS Ca\u2019 Granda Ospedale Maggior Policlinico of Milano , Milano , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Sala","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health, University of Milano , Milano , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Grassi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Milano-Bicocca , Milano , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Carugo","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health, University of Milano , Milano , Italy"},{"name":"Department of Cardio-Thoraco-Vascular Diseases, Foundation IRCCS Ca\u2019 Granda Ospedale Maggior Policlinico of Milano , Milano , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marijana","family":"Tadic","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital \u201cDr. DragisaMisovic-Dedinje\u201d , Heroja Milana Tepica 1,11000 Belgrade , Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,5,17]]},"reference":[{"key":"2023121606081145600_CIT0001","first-page":"e13","article-title":"2017 ACC\/AHA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults","volume":"71","author":"Whelton","year":"2018","journal-title":"Hypertension"},{"key":"2023121606081145600_CIT0002","doi-asserted-by":"crossref","first-page":"2284","DOI":"10.1097\/HJH.0000000000001961","article-title":"2018 ESC\/ESH Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension","volume":"36","author":"Williams","year":"2018","journal-title":"J Hypertens"},{"key":"2023121606081145600_CIT0003","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1097\/HJH.0000000000002453","article-title":"International Society of Hypertension global hypertension practice guidelines","volume":"38","author":"Unger","year":"2020","journal-title":"J Hypertens"},{"key":"2023121606081145600_CIT0004","doi-asserted-by":"crossref","first-page":"2308","DOI":"10.1001\/jama.2018.6848","article-title":"Screening for cardiovascular disease risk with electrocardiography: US preventive services task force recommendation statement","volume":"319","author":"Curry","year":"2018","journal-title":"JAMA"},{"key":"2023121606081145600_CIT0005","doi-asserted-by":"crossref","first-page":"2346","DOI":"10.1161\/HYPERTENSIONAHA.122.19420","article-title":"Type-2 diabetes and the clinical importance of exaggerated exercise blood pressure","volume":"79","author":"Schultz","year":"2022","journal-title":"Hypertension"},{"key":"2023121606081145600_CIT0006","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.1097\/HJH.0000000000003201","article-title":"Antihypertensive treatment effect on exercise blood pressure and exercise capacity in older adults","volume":"40","author":"Jones","year":"2022","journal-title":"J Hypertens"},{"key":"2023121606081145600_CIT0007","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.advms.2016.11.010","article-title":"Impact of exaggerated blood pressure response in normotensive individuals on future hypertension and prognosis: systematic review according to PRISMA guideline","volume":"62","author":"Keller","year":"2017","journal-title":"Adv Med Sci"},{"key":"2023121606081145600_CIT0008","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1097\/HJH.0000000000002991","article-title":"Blood pressure response to treadmill exercise test and the risk for future cardiovascular events and new onset hypertension","volume":"40","author":"Zafrir","year":"2021","journal-title":"J Hypertens"},{"key":"2023121606081145600_CIT0009","doi-asserted-by":"crossref","first-page":"e019460","DOI":"10.1161\/JAHA.120.019460","article-title":"Association of blood pressure and heart rate responses to submaximal exercise with incident heart failure: The Framingham Heart Study","volume":"10","author":"Carneiro","year":"2021","journal-title":"J Am Heart Assoc"},{"key":"2023121606081145600_CIT0010","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/S0895-7061(03)01003-3","article-title":"Exaggerated exercise blood pressure is related to impaired endothelial vasodilator function","volume":"17","author":"Stewart","year":"2004","journal-title":"Am J Hypertens"},{"key":"2023121606081145600_CIT0011","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s40885-016-0052-y","article-title":"Hypertensive response to exercise: mechanisms and clinical implication","volume":"22","author":"Kim","year":"2016","journal-title":"Clin Hypertens"},{"key":"2023121606081145600_CIT0012","doi-asserted-by":"crossref","first-page":"R851","DOI":"10.1152\/ajpregu.00042.2017","article-title":"Abnormal cardiovascular response to exercise in hypertension: contribution of neural factors","volume":"312","author":"Mitchell","year":"2017","journal-title":"Am J Physiol Regul Integr Comp Physiol"},{"key":"2023121606081145600_CIT0013","doi-asserted-by":"crossref","first-page":"243","DOI":"10.4103\/1947-2714.185032","article-title":"Cardiovascular responses to an isometric handgrip exercise in females with prehypertension","volume":"8","author":"Bond","year":"2016","journal-title":"N Am J Med Sci"},{"key":"2023121606081145600_CIT0014","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1159\/000360975","article-title":"Exercise hypertension","volume":"1","author":"Shultz","year":"2013","journal-title":"Pulse"},{"key":"2023121606081145600_CIT0015","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1016\/j.jsams.2021.02.014","article-title":"Exercise blood pressure and cardiac structure: a systematic review and meta-analysis of cross-sectional studies","volume":"24","author":"Moore","year":"2021","journal-title":"J Sci Med Sport"},{"key":"2023121606081145600_CIT0016","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1038\/ajh.2011.75","article-title":"Association of masked hypertension and left ventricular remodelling with the hypertensive response to exercise","volume":"24","author":"Sharman","year":"2011","journal-title":"Am J Hypertens"},{"key":"2023121606081145600_CIT0017","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1097\/MBP.0000000000000226","article-title":"Two-dimensional speckle-tracking echocardiography-based left atrial strain parameters predict masked hypertension in patients with hypertensive response to exercise","volume":"22","author":"Aung","year":"2017","journal-title":"Blood Press Monit"},{"key":"2023121606081145600_CIT0018","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1097\/HJH.0000000000001943","article-title":"A brief submaximal isometric exercise test \u2018unmasks\u2019 systolic and diastolic masked hypertension","volume":"37","author":"Koletsos","year":"2019","journal-title":"J Hypertens"},{"key":"2023121606081145600_CIT0019","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1111\/sms.13525","article-title":"Masked hypertension and submaximal exercise blood pressure among adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC)","volume":"30","author":"Huang","year":"2020","journal-title":"Scand J Med Sci Sports"},{"key":"2023121606081145600_CIT0020","doi-asserted-by":"crossref","first-page":"10038","DOI":"10.3390\/ijerph191610038","article-title":"Mild left ventricular hypertrophy in middle-age male athletes as a sign of masked arterial hypertension","volume":"19","author":"Ma\u0142ek","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2023121606081145600_CIT0021","first-page":"6265","article-title":"The relationship of masked hypertension with autonomic dysfunction and cardiometabolic parameters: a case\u2013control study","volume":"26","author":"Inanc","year":"2022","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"2023121606081145600_CIT0022","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1093\/ajh\/hpy183","article-title":"When office blood pressure is not enough: the case of masked hypertension","volume":"32","author":"Cuspidi","year":"2019","journal-title":"Am J Hypertens"},{"key":"2023121606081145600_CIT0023","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1097\/00004872-199512000-00003","article-title":"Ambulatory blood pressure normality: results from the PAMELA study","volume":"13","author":"Mancia","year":"1995","journal-title":"J Hypertens"},{"key":"2023121606081145600_CIT0024","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1097\/MBP.0000000000000517","article-title":"Prevalence of masked hypertension evaluated by home blood pressure monitoring in a large sample of patients with office blood pressure &lt;140\/90 mm Hg","volume":"26","author":"Magalh\u00e3es","year":"2021","journal-title":"Blood Press Monit"},{"key":"2023121606081145600_CIT0025","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.3390\/diagnostics13061005","article-title":"Masked hypertension and exaggerated blood pressure response to exercise: a review and meta-analysis","volume":"13","author":"Cuspidi","year":"2023","journal-title":"Diagnostics (Basel)"},{"key":"2023121606081145600_CIT0026","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s11906-017-0787-1","article-title":"Blood pressure response to exercise and cardiovascular disease","volume":"19","author":"Schultz","year":"2017","journal-title":"Curr Hypertens Rep"},{"key":"2023121606081145600_CIT0027","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1097\/HJH.0000000000003339","article-title":"Unmasking left ventricular systolic dysfunction in masked hypertension: looking at myocardial strain. A review and meta-analysis","volume":"41","author":"Cuspidi","year":"2023","journal-title":"J Hypertens"},{"key":"2023121606081145600_CIT0028","doi-asserted-by":"crossref","first-page":"3794","DOI":"10.1093\/eurheartj\/ehac393","article-title":"Phenotyping the hypertensive heart","volume":"43","author":"Tadic","year":"2022","journal-title":"Eur Heart J"}],"container-title":["American Journal of Hypertension"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajh\/advance-article-pdf\/doi\/10.1093\/ajh\/hpad049\/53009862\/hpad049.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajh\/article-pdf\/37\/1\/53\/54533541\/hpad049.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajh\/article-pdf\/37\/1\/53\/54533541\/hpad049.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,16]],"date-time":"2023-12-16T06:08:28Z","timestamp":1702706908000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajh\/article\/37\/1\/53\/7169193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,17]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,5,17]]},"published-print":{"date-parts":[[2024,1,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ajh\/hpad049","relation":{},"ISSN":["0895-7061","1941-7225"],"issn-type":[{"value":"0895-7061","type":"print"},{"value":"1941-7225","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,1,1]]},"published":{"date-parts":[[2023,5,17]]}}}